An 11-year-old client is having a cavity filled in the left mandibular first molar. The health care provider has prescribed aspirin for pain relief after the procedure. The nurse discovers upon assessment that the child is suffering from a flulike illness. The nurse contacts the health care provider about the prescribed medication for pain. What is the risk if aspirin is administered to this client?
Reye syndrome
Excess antiplatelet action
Asthma
Salicylate poisoning
The Correct Answer is A
A. Reye syndrome is correct because administering aspirin to children, especially during viral illnesses like the flu, can lead to this serious and potentially fatal condition characterized by acute encephalopathy and liver failure.
B. Excess antiplatelet action is incorrect; while aspirin does have antiplatelet effects, this is not the primary concern in a child with a viral illness.
C. Asthma is incorrect; while some individuals with asthma may have sensitivity to aspirin, it is not specifically related to the child's flulike illness.
D. Salicylate poisoning is incorrect; while high doses of aspirin can lead to toxicity, the immediate risk in the context of flu-like illness is Reye syndrome, which is a more specific concern.
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Correct Answer is D
Explanation
A. Giving the drug with food may delay absorption but does not affect the extent of the first-pass effect.
B. Administering the drug in small, frequent doses may help maintain therapeutic levels but will not significantly alter the first-pass effect.
C. Limiting protein intake could reduce drug binding to proteins, but this is not a standard approach for managing first-pass metabolism.
D. Administering the drug intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect, thereby increasing the amount of free drug available to body cells.
Correct Answer is D
Explanation
A. Taking smaller doses of decongestants several times a day may be appropriate for some medications but does not address the risk of rebound congestion associated with prolonged use.
B. Expecting relief within a few days may not be realistic if the cold symptoms persist for 2 weeks, indicating a potential need for further evaluation.
C. OTC decongestants can be effective, and many patients find relief from symptoms without requiring a prescription.
D. Using decongestants for an extended period can lead to rebound congestion, where nasal passages become more congested once the medication is stopped, making this a crucial point for the nurse to communicate.