My patient takes ibuprofen for sinus congestion!

Nurses Medications

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I have a patient that takes ibuprofen for her sinus, how do I explain to her that this is not a wise idea?

P.s. She is on a diuretic as well so I guess nasal decongestants are contraindicated...

Blackheartednurse said:
I'm a home health nurse this was not a homework question.I actually see a patient that takes IBUPROFEN for sinus!

Sinus inflammation? Sinus infection? Sinus discomfort? Sinus congestion? Sinus WHAT?

Jus' sayin' it seems like a lot of information was left out of the original post, like others had noted, and it sounded like a student may have posed the question. Regardless, glad you got everything worked out.

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rainbowbrite85 said:
Sinus inflammation? Sinus infection? Sinus discomfort? Sinus congestion? Sinus WHAT?

Jus' sayin' it seems like a lot of information was left out of the original post, like others had noted, and it sounded like a student may have posed the question. Regardless, glad you got everything worked out.

I think a combo of those:)

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Blackheartednurse said:
well guys I went to see this patient today and yay I'm happy the doctor prescribed her LORATADINE for sinus.

Okay. The doctor prescribed her an antihistamine. This will help with the congestion. You understand that if she continues to have sinus pain, she'll still take ibuprofen, right? I guess I'm confused about the shock here.

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Specializes in Emergency & Trauma/Adult ICU.

Others have asked, but I'll try a more direct approach.

What is your issue with your patient taking ibuprofen for sinus-related PAIN?

Or to put it another way ... the next time you have sinus congestion and the PAIN that generally goes with it ... would you want to just take Loratadine or would you also want your PAIN relieved?

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Altra said:
Others have asked, but I'll try a more direct approach.

What is your issue with your patient taking ibuprofen for sinus-related PAIN?

Or to put it another way ... the next time you have sinus congestion and the PAIN that generally goes with it ... would you want to just take Loratadine or would you also want your PAIN relieved?

No I just was surprised she didn't have any other med to take for her sinuses, as far as the headache is fine she can take the ibuprofen.

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Specializes in ICU, PICU, School Nursing, Case Mgt.

Uh, yeah, but you indicated in your original post that you were concerned that this was "not a wise idea" and you wanted to talk her out of taking it.

In your last post you indicated surprise that she was not on a decongestant...however, that was not the tone of the original post.

I think all of us posters have been rather surprised at your naivete...since you say your are currently working as a nurse.

THis is rather basic. Perhaps you should take some time to review your patients meds and find out why they are taking them. Maybe look up the drugs in your Pharm book for the indications and doses as well as the contraindications and adverse effects...I hope you still have yours from school.

Hope you will grow in your knowledge and confidence.

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SWS RN said:
Uh, yeah, but you indicated in your original post that you were concerned that this was "not a wise idea" and you wanted to talk her out of taking it.

In your last post you indicated surprise that she was not on a decongestant...however, that was not the tone of the original post.

I think all of us posters have been rather surprised at your naivete...since you say your are currently working as a nurse.

THis is rather basic. Perhaps you should take some time to review your patients meds and find out why they are taking them. Maybe look up the drugs in your Pharm book for the indications and doses as well as the contraindications and adverse effects...I hope you still have yours from school.

Hope you will grow in your knowledge and confidence.

I just don't want her to take an excessive ibuprofen that is all.It is not wise to get addicted to ibuprofen on daily basis, that is why I was seeking alternatives.

Just a question weren't you surprised, questioned orders, meds a brand new nurse? Were you born an experienced nurse and have not ask other nurses for clarification or asked "stupid" questions. If you didnt than it is scary and surprising at the same time. No one was born knowing it all but many have forgotten how inexperienced they once were. Well anyway, I'm not a fan of just medicating patient with pain killers just for a peace of mind I like to look at other alternatives.

Also from my understanding the patient thinks Ibuprofen will fix her congestion. Or perhaps I misunderstood her. I never had sinuses so I don't know what it's like to have a sinus headache.Maybe that is why I was surprised that the patient medicate herself with Ibuprofen, I always thought that patients takes decongestants or antihistamines.

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Blackheartednurse said:
I just dont want her to take an excessive ibuprofen that is all.It is not wise to get addicted to ibuprofen on daily basis,that is why I was seeking alternatives.

Just a question werent you surprised,questioned orders,meds a brand new nurse? Were you born an experienced nurse and have not ask other nurses for clarification or asked "stupid" questions.If you didnt than it is scary and surprising at the same time.No one was born knowing it all but many have forgotten how unexperienced they once were.Well anyway,I'm not a fan of just medicating patient with pain killers just for a peace of mind I like to look at other alternatives.

Also from my understanding the patient thinks Ibuprofen will fix her congestion.Or perhaps I misunderstood her.I never had sinuses so I dont know what is like to have a sinus headache.Maybe that is why I was surprised that the patient medicate herself with Ibuprofen,I always thought that patients takes decongestants or antihistamines.

There's a difference between questioning orders and questioning what a patient knows works for her. She's not taking "pain killers," she's taking an anti-inflammatory, which reduces inflammation in the sinus cavity. If you think out the pathophysiology of the process and think out the pharmacology of the medication, then you'll see why it works. Additionally, pain relief isn't peace of mind. It's pain relief. These are two vastly different things.

Secondly, you DO have sinuses. Everyone has sinuses. You don't have sinus problems. For some patients, like myself as I mentioned in an earlier post, decongestants and antihistamines are ineffective.

My problem is only partially caused by allergies; it's more a result of malformed sinus cavities and excessive swelling. Inhaled steroids (like Nasonex) used to work, but they're not strong enough to do the trick any longer. I've also used Pulmicort Respules in a neti pot. That was heaven. I could breathe then, but insurance stopped paying for the Pulmicort, because it was an off-label use.

I only give you my little background there to make a small point: I know what works for me. Your patient knows what works for her. Decongestants and antihistamines have some side effects that are less than desirable for some patients. Make sure that you provide good patient education on the side effects of Loratadine, or Claritin, and reinforce the teaching. Also, reinforcing the points of taking Ibuprofen would not be a bad idea.

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Specializes in LTC.
Blackheartednurse said:
I just dont want her to take an excessive ibuprofen that is all.It is not wise to get addicted to ibuprofen on daily basis,that is why I was seeking alternatives.

I really don't think you have to worry about her getting addicted to Ibuprofen.

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casi said:
I really don't think you have to worry about her getting addicted to Ibuprofen.

I dont mind getting addicted physically I mean psychologically.

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Specializes in ICU, PICU, School Nursing, Case Mgt.
Blackheartednurse said:
I just dont want her to take an excessive ibuprofen that is all.It is not wise to get addicted to ibuprofen on daily basis,that is why I was seeking alternatives.

Do you realize that Ibuprofen is not related to narcotics in any way??? It is a NSAID...non steroidal anti inflammatory drug...and it would be impossible to become "addicted to it" in any way shape or form...(yes, I understand perhaps too frequent usage could result in "rebound" headaches--but that's not we are talking about here-talking about addiction)

Again, your naivete surprises me...you should know this fact by now if you are practicing and also I hope you are not telling or "educating" your patients to not take Ibuprofen at the risk of addiction...that's wrong on so many levels.

Just a question werent you surprised,questioned orders,meds a brand new nurse? Were you born an experienced nurse and have not ask other nurses for clarification or asked "stupid" questions.If you didnt than it is scary and surprising at the same time.No one was born knowing it all but many have forgotten how unexperienced they once were.Well anyway,I'm not a fan of just medicating patient with pain killers just for a peace of mind I like to look at other alternatives.

Of course I asked questions as a new nurse and 18 years later, I still ask questions.....BUT, I also Looked up medication--especially before I gave it or educated my patients about it. That's what I was suggesting you do.

Also from my understanding the patient thinks Ibuprofen will fix her congestion.Or perhaps I misunderstood her.I never had sinuses so I dont know what is like to have a sinus headache.Maybe that is why I was surprised that the patient medicate herself with Ibuprofen,I always thought that patients takes decongestants or antihistamines.

1. But this not what you indicated in the original post...that she thought it would fix her congestion.

2. I hope you have sinuses---or you have a severe anatomical problem, or a birth defect...did you take Anatomy and Physiology as a pre requirement to nursing school????

I have not forgotten how inexperienced I was as a new nurse, and hopefully, soon you will have some more information "under your belt" and won't be quite so green. Maybe, before you say something, just stop and think of the logic behind it, or look up information on the topic yourself...you will be surprised at how much you will learn on your own.

And yes, other more experienced nurses should answer questions, I think you will get a better response if you have a little more understanding of the topic before you ask the question.

For example, the addiction to Ibuprofen statement, that's something you should know by now...it's basic, so I can see an experienced nurse raising her/his eyebrows at that one.

Anyway, good luck to you in all you do...also, I would love to see you work in an acute care setting to get a little more seasoning...there's that word again. ?

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Why is this medication prescribed?

Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription ibuprofen is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ibuprofen may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke;if you smoke;and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.

If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take ibuprofen right before or right after the surgery.

NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or who drink three or more alcoholic drinks per day while taking ibuprofen. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ketoprofen (Orudis KT, Actron) and naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Also tell your doctor if you have or have ever had ulcers, bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking ibuprofen and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools

https://medlineplus.gov/druginfo/meds/a682159.html

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