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10 Cards in this Set
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A patient reports having persistent mild to moderate pain in both knees usually associated with standing. The patient reports knee stiffness for 10 to 15 minutes each morning. The NP learns that the patient has use heating pads and acetaminophen, which no longer relieve the pain. The NP orders an erythrocyte sedimentation rate, which is normal. The NP should consider prescribing? |
A topical non-steroidal anti-inflammatory drug NSAID. Topical NSAIDs, acupuncture, Tramadol are effective for pain relief in knee osteoarthritis. Treatment for osteoarthritis should begin with non-pharmacological treatment, and acetaminophen should be first line pharmacologic treatment. NSAIDs should be used when these two measures are no longer effective. Cox-2 Inhibitors are more expensive and should be used in the presence of GI side effects or for moderate-to-severe pain. Glucosamine and chondroitin do not believe most osteoarthritis pain |
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A 70 year old patient describes moderate-to-severe pain associated with osteoarthritis in fingers, thumbs, hip and knees. The patient is currently taking high-dose acetaminophen. The patient has a strong family history of cardiovascular disease and has been diagnosed with hypertension. To help alleviate the patient's pain, the primary care NP should consider prescribing? |
Naproxen. And low dose aspirin. Aspirin at the dosage of 325 mg every day or 81 mg daily is effective in reducing the incidence of Mi and stroke. Concomitant use of an NSAID with Aspirin has been shown to reduce the cardioprotective effects of aspirin. However, naproxen does not appear to have this risk |
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Patient with mild to moderate osteoarthritis pain has been taking acetaminophen for pain. The NP prescribes and non-selective NSAID. At a follow-up visit, the patient reports mild GI side effects. The NP should |
Order misoprostol to take with the NSAID. If the patient experiences GI distress, Co administration of histamine 2 blockers, proton pump inhibitors, or misoprostol may be considered. Tramadol is used for severe pain. A cox-2 inhibitor is generally used for long-term therapy. Naproxen is another non-selective NSAID and would likely have similar GI side effects |
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A patient is taking 81 mg of aspirin daily to decrease MI risk and uses acetaminophen for mild osteoarthritis symptoms. For flare-ups of osteoarthritis pain, the NP should prescribe |
Naproxen. Concomitant use of NSAID with Aspirin has been shown to reduce the cardioprotective effects of aspirin. Naproxen does not appear to have this risk |
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An 80 year old patient has been taking Naproxen for osteoarthritis for 6 months. The patient reports adequate pain relief but complains of feeling tired. The NP he will order |
A cBC. Elderly patients are more susceptible to the adverse effects of NSAIDs, especially slow GI bleeds leading to anemia manifested as fatigue, lethargy. Patients complaining of fatigue should have a CBC to evaluate for anemia |
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A patient who has rheumatoid arthritis begins taking Naproxen 500 mg once-daily for pain. After one week, the patient calls the NP to report no change in inflammation. The NP should |
Counsel the patient that pain relief may not occur for another week. The analgesic effect of NSAIDs should be noticed Within 1 to 4 hours of administration, however the full anti-inflammatory effect will not be apparent until after a few weeks. Tramadol and ketorolac are used for severe pain. It is not necessary to increase the dose of Naproxen |
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The primary NP sees an adolescent who reports moderate to severe dysmenorrhea. The NP recommends an NSAIDs and counsels the patient about its use. Which statement by the patient indicates a need for further teaching? |
I will take this medication every 4 to 6 hours as needed for pain. When treating primary dysmenorrhea, NSAIDS should be started 24 to 72 hours before the patient starts menstrual bleeding. The medication should be taken on a routine basis for 2 to 3 days. It should not be taken during pregnancy |
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The NP is performing a medication reconciliation on a patient who takes digoxin for CHF and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to? |
Use naproxen instead of ibuprofen. Ibuprofen and indomethacin increase the effects of digoxin, so the NP should recommend another NSAID such as naproxen, that does not have this effect. Increasing the dose of digoxin or the ibuprofen would increase the likelihood of digoxin toxicity further. Potassium should be monitored while taking NSAIDs long-term but supplements should not be given unless there is a potassium deficiency. |
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An NP prescribes a non-selective NSAID for a patient who has osteoarthritis. The patient expresses concerns about possible side effects of this med. When counseling the patient about the medication, the NP should tell this patient |
To take each dose of the NSAID with a full glass of water. To avoid GI associated distress with NSAIDs a full glass of water is recommended. Patients may take NSAIDs with antacids. Patients should avoid alcohol while taking NSAIDs. Patients should report Jess symptoms to their provider. |
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A patient who has osteoarthritis is scheduled to have knee surgery. The patient takes aspirin for Mi prophylaxis and naproxen for pain and inflammation. Which statement by the patient to the primary care NP indicates a need for further teaching? |
I would need to stop taking both medications one week before I have surgery. Although both medications interfere with platelet formation, some NSAIDs may continue to be taken before surgery, depending on the procedure and the surgeon preference. The patient should stop taking aspirin 5 days before surgery |
