Name three common adverse effects of NSAIDs and one nursing strategy to minimize risk.

• A. GI irritation/bleeding, renal impairment, increased blood pressure; nursing strategy: assess renal function and GI symptoms, use the lowest effective dose, administer with food, monitor BP, consider alternative analgesics when appropriate.
• B. Drowsiness, dry mouth, rash; take with caffeine.
• C. Hepatotoxicity, hypoglycemia, tachycardia; monitor liver enzymes.
• D. Hearing loss, tinnitus, rash; monitor audiology.

Answer: (A)

This question tests recognizing common NSAID adverse effects and a nursing approach to reduce risk. NSAIDs inhibit cyclooxygenase, which lowers prostaglandin production. Prostaglandins help protect the gastric mucosa and support renal perfusion, so blocking them can lead to GI irritation with potential bleeding and to renal impairment, especially in vulnerable patients. NSAIDs can also cause sodium and water retention, which may raise blood pressure. So the most characteristic and clinically important risks are GI irritation/bleeding, renal impairment, and increased blood pressure.

A nursing strategy to minimize these risks includes assessing renal function and GI symptoms, using the lowest effective dose for the shortest duration, administering with food to reduce GI upset, monitoring blood pressure, and considering alternative analgesics when appropriate for patients at higher risk. This approach aligns with the mechanism and helps balance pain relief with safety.

Other options describe effects that are not the typical or most common NSAID adverse effects (for example, drowsiness, dry mouth, rash; hepatotoxicity-related signs; tinnitus with high-dose salicylates), so they don’t fit as well as the best answer.