A nurse in a primary care clinic is caring for a 40-year-old male client who was diagnosed with asthma during childhood. Complete the following sentence by using the lists of options: The client is most at risk for developing ________, due to their ________.

The client is most at risk for developing Gastrointestinal bleeding, due to their use of ibuprofen. Rationale for Correct Answers Gastrointestinal bleeding is a well-documented risk associated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, especially when used at high doses or for prolonged periods. NSAIDs inhibit cyclooxygenase-1 (COX-1), reducing protective gastric prostaglandins, which increases the risk of gastric mucosal injury, ulcers, and bleeding. This client is taking ibuprofen 600 mg twice daily, which is a moderate-to-high dose, and has been doing so for five days. The risk is compounded by concurrent prednisone use, a corticosteroid that also impairs gastric mucosal defense and healing. The combination of NSAIDs and corticosteroids significantly increases the risk of upper GI bleeding. Rationale for Incorrect Response 1 Options Hypokalemia is more commonly associated with beta-agonists like albuterol or with diuretic use, not NSAIDs or corticosteroids in short-term use. Hyperglycemia is a known side effect of corticosteroids like prednisone, but the question asks for the greatest risk, and GI bleeding from NSAID-steroid combination poses a more immediate and serious threat. Osteoporosis is a long-term complication of corticosteroid use, not a short-term risk in a 2-week course. Rationale for Incorrect Response 2 Options Use of prednisone contributes to GI bleeding risk, but NSAIDs are the primary driver, especially when combined with steroids. Use of albuterol may cause tremors, tachycardia, or hypokalemia, but not GI bleeding. Use of fluticasone (inhaled corticosteroid) has minimal systemic absorption and is not associated with GI bleeding. Take-Home Points NSAIDs like ibuprofen increase the risk of GI bleeding, especially when combined with corticosteroids. Short-term prednisone use can exacerbate GI mucosal vulnerability. Asthma management requires careful medication reconciliation to avoid harmful drug interactions. Clients with asthma and comorbid pain should be counseled on safer analgesic alternatives when using corticosteroids.