A nurse is caring for a client who is starting to take aspirin 81 mg daily. Which of the following findings should the nurse identify as a risk factor for the client’s development of an aspirin-induced ulcer?
A.
The client has a history of alcohol use disorder but is currently sober
B.
The client recently had a norovirus infection
C.
The client smokes one pack of cigarette per day
D.
The client has a history of rheumatoid arthritis
The Correct Answer and Explanation is:
The correct answer is C. The client smokes one pack of cigarettes per day.
Explanation:
Aspirin, especially when taken daily as in the case of low-dose aspirin (81 mg), can increase the risk of developing gastrointestinal (GI) ulcers. Understanding risk factors for aspirin-induced ulcers is crucial for proper patient management.
Smoking as a Risk Factor: Smoking is a well-established risk factor for the development of peptic ulcers, including those induced by medications such as aspirin. Nicotine and other chemicals in cigarettes can irritate the gastric mucosa and impair mucosal defenses, making the stomach lining more susceptible to damage from irritants like aspirin. Smoking also increases gastric acid secretion and decreases the production of protective mucus, which can further exacerbate ulcer formation. Therefore, a client who smokes one pack of cigarettes per day is at an elevated risk for developing an aspirin-induced ulcer.
Other Options:
- A. The client has a history of alcohol use disorder but is currently sober: While a history of alcohol use can increase the risk of ulcer formation, especially when combined with ongoing alcohol consumption, the fact that the client is currently sober means this is less of an immediate risk factor compared to smoking.
- B. The client recently had a norovirus infection: Norovirus typically causes gastroenteritis, which might lead to temporary stomach upset but is not directly associated with an increased risk of aspirin-induced ulcers. The infection itself does not contribute to the chronic risk of ulcers that aspirin does.
- D. The client has a history of rheumatoid arthritis: Aspirin is often used to manage pain and inflammation associated with rheumatoid arthritis. While individuals with rheumatoid arthritis may be at increased risk of GI complications from NSAIDs, the history alone does not directly increase the risk of an aspirin-induced ulcer as much as smoking does.
In summary, smoking is a significant risk factor for the development of ulcers, and a client who smokes one pack of cigarettes per day is at a higher risk for aspirin-induced ulcers compared to the other factors listed.