The nurse reviews a celecoxib prescription for pain control after coronary artery bypass graft surgery. Which action is appropriate?
1Administer celecoxib with food because food removes the cardiovascular risk after surgery.
2Hold celecoxib and contact the prescriber because it is contraindicated in the CABG setting.✓ Correct answer
3Give celecoxib with aspirin because aspirin fully prevents the cardiovascular risk of celecoxib.
4Administer half the celecoxib dose because dose reduction makes postoperative CABG use acceptable.
Explanation
Celecoxib and other NSAIDs are contraindicated in the setting of coronary artery bypass graft surgery because of increased cardiovascular thrombotic risk. Taking the drug with food, adding aspirin, or lowering the dose does not remove this contraindication. The nurse should hold the medication and clarify the postoperative pain plan with the prescriber.
Clinical reasoning Selective COX-2 inhibition does not eliminate the cardiovascular thrombotic risk associated with NSAIDs. The risk is especially important around CABG surgery.
Decision rule Do not administer celecoxib for perioperative CABG pain. Hold the order and obtain a safer alternative rather than trying to offset the risk with food, aspirin, or dose reduction.