A client who takes NSAIDs daily for rheumatoid arthritis is being treated for anemia. Which intervention is most important for the nurse to include in the plan of care?

A client who takes NSAIDs daily for rheumatoid arthritis is being treated for anemia. Which intervention is most important for the nurse to include in the plan of care?

• A. Offer dietary selections rich in iron.
• B. Monitor liver function test results.
• C. Protect skin from bruising.
• D. Observe for gastrointestinal bleeding.

Answer: (D)

The main concept here is that NSAIDs raise the risk of gastrointestinal bleeding. When a client is being treated for anemia, any loss of blood through the GI tract can worsen anemia quickly, so detecting bleeding early is the priority. NSAIDs damage the stomach and intestinal lining by reducing protective prostaglandins, increasing the chance of ulcers and occult or overt bleeding. Therefore, the most important nursing action is to monitor for signs of GI bleeding—such as dark, tarry stools, vomiting blood, or a sudden drop in hemoglobin or blood pressure—and report these findings promptly. This focus helps prevent further blood loss and guides necessary adjustments in therapy. While providing iron-rich foods can support anemia, it won’t address the bleeding risk; liver function monitoring and protecting skin from bruising don’t target the immediate, most dangerous complication in this scenario.

The main concept here is that NSAIDs raise the risk of gastrointestinal bleeding. When a client is being treated for anemia, any loss of blood through the GI tract can worsen anemia quickly, so detecting bleeding early is the priority. NSAIDs damage the stomach and intestinal lining by reducing protective prostaglandins, increasing the chance of ulcers and occult or overt bleeding. Therefore, the most important nursing action is to monitor for signs of GI bleeding—such as dark, tarry stools, vomiting blood, or a sudden drop in hemoglobin or blood pressure—and report these findings promptly. This focus helps prevent further blood loss and guides necessary adjustments in therapy. While providing iron-rich foods can support anemia, it won’t address the bleeding risk; liver function monitoring and protecting skin from bruising don’t target the immediate, most dangerous complication in this scenario.