Final answer:
NSAIDs should be used with caution to avoid bleeding, especially in people over 60 or with certain medical conditions like cirrhosis. They increase the risk for stomach bleeding and can cause kidney damage. Acetaminophen does not have the same bleeding risks and may be a safer alternative for pain relief.
Step-by-step explanation:
When considering the use of nonsteroidal anti-inflammatory drugs (NSAIDs), certain precautions are essential to avoid complications such as bleeding. To minimize the risk of stomach bleeding, which can increase in those over 60, on blood thinners, steroids, with a history of stomach ulcers, or with bleeding problems, NSAIDs should be used cautiously. Patients with cirrhosis should avoid NSAIDs due to the elevated risk for bleeding associated with this condition, making the correct answer (a) Avoid in cirrhosis; risk for bleeding.
NSAIDs can also lead to kidney damage, particularly in individuals over 60, or those with high blood pressure, heart disease, or pre-existing kidney disease. It is also important to note that NSAIDs should not be taken immediately after an injury that causes bleeding as they can interfere with blood clotting. Aspirin, a type of NSAID, should not be taken for 10-14 days before surgery to avoid excessive bleeding. Acetaminophen may be a safer alternative for pain relief as it does not inhibit platelet aggregation and is not associated with increased bleeding risks.
Patients with conditions like hypertension or diabetes are not expressly contraindicated to use NSAIDs, but due caution regarding potential impacts on blood pressure and kidney function should be observed. However, as evidenced by option (a), NSAIDs should be avoided in patients with cirrhosis due to the heightened risk of bleeding.