A nurse is reviewing the chart of a postoperative client who has been prescribed ketorolac for pain management. Which of the following findings would require the nurse to question the continued use of ketorolac?

A. Mild nausea is a relatively common gastrointestinal side effect of NSAIDs, including ketorolac. It occurs due to irritation of the gastric mucosa and prostaglandin inhibition. While it should be monitored and managed (e.g., administering with food if appropriate or using antiemetics), it does not require discontinuation unless it progresses to severe symptoms such as persistent vomiting or signs of gastrointestinal bleeding. B. Ketorolac has a strict maximum duration of therapy of 5 days regardless of route (IV, IM, or oral). This limitation exists because the medication has a high risk of serious adverse effects with prolonged use. These include gastrointestinal ulceration and bleeding, renal impairment, and inhibition of platelet aggregation, which increases bleeding risk—especially concerning in postoperative clients. Use beyond 5 days significantly elevates these risks, so the nurse must question the order and notify the provider. C. Mild lower-extremity edema can occur with NSAIDs due to fluid retention and altered renal prostaglandin activity. Although it should be assessed and monitored, especially in clients with cardiac or renal conditions, mild edema alone is not an immediate reason to discontinue the medication unless it worsens or is accompanied by signs of renal dysfunction or heart failure. D. A decrease in pain level from 8/10 to 4/10 demonstrates that the medication is providing effective analgesia. This is an expected therapeutic outcome and does not indicate a need to stop the medication.