A client is about to be sent home with a prescription for mild pain relief. The nurse is reviewing the chart and sees lab results that indicate poor liver function. Which drug prescription would cause the nurse to question the healthcare provider further?

A. Celecoxib: Celecoxib is a selective COX-2 inhibitor used for mild to moderate pain and inflammation. It is primarily metabolized by the liver but generally does not cause significant hepatotoxicity in short-term use. Routine monitoring is recommended in clients with severe liver impairment, but it is not absolutely contraindicated. B. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is largely metabolized by the liver and excreted by the kidneys. While caution is advised in clients with hepatic dysfunction, ibuprofen is less hepatotoxic compared with acetaminophen, and occasional short-term use is often considered safe with monitoring. C. Aspirin: Aspirin is an NSAID with antiplatelet and analgesic properties. It is metabolized by the liver, but hepatotoxicity is uncommon at therapeutic doses. Liver impairment may necessitate caution due to altered metabolism and increased bleeding risk, but it is not the primary concern for mild pain in this scenario. D. Acetaminophen: Acetaminophen is extensively metabolized in the liver, and impaired hepatic function significantly increases the risk of hepatotoxicity. Even standard therapeutic doses can accumulate in clients with poor liver function, potentially leading to acute liver injury. The nurse should question the prescription and verify whether an alternative analgesic or adjusted dosing is appropriate.