A woman in her third trimester of pregnancy has a history of back pain. The client says, "I do best on Doan's pills (magnesium salicylate), so I will just start taking them again." How should the nurse respond?
Standard Text: Select all that apply.
1. "If they helped you before, I would recommend you take them now."
2. "The magnesium salicylate in Doan's pills is not related to the salicylate in aspirin."
3. "I believe we should talk with the doctor to find a different medication for your discomfort."
4. "You should take aspirin instead."
5. "Have you tried any nonpharmaceutical pain relief measures?"
Correct Answer: 3,5
Rationale 1: Magnesium salicylate is pregnancy category D in the third trimester.
Rationale 2: The two drugs have salicylate in common and have similar contraindications and adverse effects.
Rationale 3: Magnesium salicylate should not be used. A different drug should be chosen.
Rationale 4: Aspirin is pregnancy class D in the third semester.
Rationale 5: Nonpharmaceutical treatment measures should be used first, as drugs should be avoided during pregnancy.
Global Rationale: Magnesium salicylate is an oral drug approved for fever and mild to moderate pain and inflammation associated with osteoarthritis, RA, bursitis, and other muscle or joint conditions. It inhibits prostaglandin synthesis just as aspirin, but it is less potent, causes less GI irritation, and has less effect on platelet aggregation than aspirin. Magnesium salicylate should not be administered to patients with known hypersensitivity to other salicylates. Other contraindications and adverse effects are similar to those of aspirin. This drug is pregnancy category C for the first and second trimesters and D for the third trimester. Nonpharmaceutical treatment measures should be used first, as drugs should be avoided during pregnancy.
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