A client who reports the use of ibuprofen for chronic back pain is being assessed for possible NSAID toxicity. The nurse identifies symptoms including bilateral foot swelling, dark yellow urine, and a decrease in urinary frequency. Which system is likely being damaged?

A. Hepatic: Hepatic (liver) damage from NSAIDs usually presents with jaundice, fatigue, or elevated liver enzymes. Dark yellow urine could suggest bilirubinuria, but in the context of edema and decreased urine output, liver involvement is less likely the primary concern. B. Renal: NSAIDs can reduce renal perfusion and cause nephrotoxicity, leading to fluid retention (bilateral foot swelling), oliguria (decreased urine output), and dark yellow urine due to concentrated urine. These findings indicate renal system damage and possible NSAID-induced nephropathy. C. Gastrointestinal: NSAID toxicity commonly causes GI irritation, ulcers, or bleeding, often presenting with abdominal pain, nausea, or melena. The patient’s current symptoms do not reflect primary GI involvement. D. Neurological: Neurological toxicity from NSAIDs is uncommon. Symptoms such as confusion, dizziness, or headache would indicate CNS involvement, which is not seen in this case.