DRUG STUDY NAME OF DRUG: CELECOXIB CLASSIFICATION: DOSAGE/ROUTE ACTION Physiologic Mechanism Decreased pain and inflammation caused

d by arthiritis Pharmacologic Mechanism Prevention of M Inhibits the enzyme COX-2. This enzyme is required for the synthesis of prostaglandins. Has analgesic, antiinflammatory, and antipyretic properties INDICATION Relief of signs and symptoms of osteoarthritis. Relief of signs and symptoms of rheumatoid arthritis in adults. CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES Assess patients range of motion, degree of swelling, and pain in affected joints before and periodically throughout therapy. Assess patient for allergy to sulfonamides, aspirin, or NSAIDS. Patients with these allergies should not receive celecoxib. May be administered without regard to meals. Instruct patient to take celecoxib exactly as directed. Do not take more than prescribed dose. Increasing doses does

not appear to increase effectiveness. Advise patient to notify health care professional promptly if signs or symptoms of GI toxicity (abdominal pain, black stools), skin rash, unexplained weight gain, edema occurs. Patient should discontinue celecoxib and notify health care professional if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flu-like symptoms) occur.

NURSING CARE PLAN

ASSESSMENT SUBJECTIVE: The patient may report: Chest pain, heaviness, or pressure that may radiate to the shoulders, arms, neck, jaw, or upper abdomen.

DIAGNOSIS Acute pain related to decreased myocardial blood flow

PLANNING After 8 hous of nursing intervention the patient will: remain free from pain. Maintain stable vital signs. Maintain relaxed body posture.

OBJECTIVE: Tachycardia Elevated blood pressure Jugular vein distention Cool, clammy skin

V/S: BP- 120/50 TEMP.- 36.7 RR- 23 PR- 65

INTERVENTION Assess for vital signs and symptoms of pain such as facial grimacing, rubbing of neck or jaw, reluctance to move, increased blood pressure, and tachycardia. Note onset, duration, location, and pattern of pain. Use a pain rating scale to assess the patients perception of the pains severity. Administer sublingual nitroglycerin as ordered. Instruct the patient to notify a nurse immediately when experiencing pain. Have the patient stop current activity, and place him on bed rest in a semi- to high Fowlers position. Administer oxygen as ordered.

EVALUATION After 8 hours of nursing intervention the patient was free from pain, maintains stable vital signs, and relaxed body posture.