Pain Management Nursing Practice Exam

Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is closely associated with gastrointestinal bleeding due to their mechanism of action. NSAIDs work by inhibiting the enzyme cyclooxygenase (COX), which reduces the production of prostaglandins. Prostaglandins play a critical role in maintaining the mucus lining of the gastrointestinal tract and facilitating normal gastric function. When prostaglandin levels are reduced, the protective mucosal barrier is compromised, which can lead to irritation, ulcers, and, ultimately, bleeding in the gastrointestinal tract.

Gastrointestinal bleeding can present as symptoms such as abdominal pain, melena (dark stools), and hematemesis (vomiting blood). Although other serious side effects like renal toxicity, cardiac arrhythmias, and liver impairment can occur with NSAID use, the risk of gastrointestinal bleeding is particularly significant and well-documented in clinical practice, especially with prolonged use and in patients with additional risk factors like a history of peptic ulcer disease or concurrent use of anticoagulants. This emphasizes the importance of monitoring patients on long-term NSAID therapy for signs of gastrointestinal complications.