1301 Ch. 43 Antiulcer Drugs

Which statement demonstrates to the nurse that the patient understands instructions regarding the use of histamine2-receptor antagonists? A. "Smoking decreases the effects of the medication, so I should try a cessation program." B. "I should take this medication 1 h after each meal to decrease gastric acidity." C. "I should decrease bulk and fluids in my diet to prevent diarrhea." D. "Since I am taking this medication, it is all right for me to eat spicy foods."

A. "Smoking decreases the effects of the medication, so I should try a cessation program." Patients taking histamine2-receptor blocking agents should avoid spicy foods, extremes in temperatures, alcohol, and smoking. They should also increase bulk and fluids in their diets to prevent constipation. The medications should be taken with meals, not after meals.

What is a priority nursing intervention when administering ranitidine? A. Administer just before meals. B. Administer 1-2 h after meals. C. Administer right after eating. D. Administer during meals.

A. Administer just before meals. Ranitidine should be given just before meals to decrease food-induced acid secretion or at bedtime.

The nurse is caring for a patient who is experiencing gastric distress from the long-term use of aspirin for treatment of arthritis. Which intervention does the nurse anticipate that the provider may order? A. Administer misoprostol. B. Stop all aspirin therapy. C. Instruct the patient to take the aspirin with milk. D. Instruct the patient to take the aspirin on an empty stomach.

A. Administer misoprostol. Misoprostol is indicated for the prevention of NSAID-induced ulcer. It may be taken during NSAID therapy, including with aspirin. The patient may not be able to be completely taken off of all aspirin products; there is no evidence to support the need to take the aspirin with milk. Certain drugs like NSAIDs, which include aspirin, should be taken with food.

A patient has been prescribed aluminum hydroxide and has received patient teaching. Which statement by the patient indicates an understanding of the instructions? A. "I will drink 2 ounces of water after taking aluminum hydroxide." B. "I will take aluminum hydroxide within 30 min of my other medications." C. "I will take aluminum hydroxide at mealtime." D. "I will take a laxative if I develop constipation."

A."I will drink 2 ounces of water after taking aluminum hydroxide." The patient should drink 2 ounces of water after taking aluminum hydroxide to ensure the drug reaches the stomach. Aluminum hydroxide should not be taken at mealtime, as it slows gastric emptying time. Aluminum hydroxide should not be taken within 1-2 h of other oral medications. The patient should contact the health care provider if constipation develops, as the antacid may need to be changed; self-treatment should be avoided.

What information should the nurse include in a teaching plan for the patient who is prescribed sucralfate? A. "This medication will form a protective barrier over the gastric mucosa." B. "This medication will enhance gastric absorption of meals." C. "This medication will neutralize gastric acid." D. "This medication will inhibit gastric acid."

A."This medication will form a protective barrier over the gastric mucosa." Sucralfate affects the gastric mucosa. It forms a paste-like substance in the stomach, which adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.

The patient tells the nurse that he has been treating his stomach pain with a lot of calcium carbonate. It is most important for the nurse to assess the patient for A. Burnett's syndrome. B. hypernatremia. C. metabolic alkalosis. D. acid rebound.

A.Burnett's syndrome. Rationale: Hypercalcemia and Burnett's syndrome, formerly called milk-alkali syndrome, can result from excessive use of calcium carbonate. Excess sodium bicarbonate use may cause hypernatremia and water retention, metabolic alkalosis caused by excess bicarbonate, and acid rebound.

An older adult patient reports taking aluminum hydroxide on a daily basis to relieve symptoms of gastroesophageal reflux disease. The nurse needs to evaluate for which condition? A. Constipation B. Diarrhea C. Flatulence D. Abdominal pain

A.Constipation Rationale: Use of aluminum hydroxide most often causes constipation. Magnesium products can cause diarrhea.

A patient who complains of gastric distress from aspirin will most likely benefit from the administration of which medication? • A. Misoprostol B. Lansoprazole C. Magaldrate D. Magnesium trisilicate

A.Misoprostol Rationale: Patients who complain of gastric distress from NSAIDs such as aspirin or indomethacin prescribed for long-term therapy can benefit from misoprostol.

Which medications are most likely to be included in a dual drug therapy program for peptic ulcer disease from H. pylori? A. Omeprazole and clarithromycin B. Tetracycline and metronidazole C. Ranitidine and amoxicillin D. Ciprofloxacin and sucralfate

A.Omeprazole and clarithromycin Rationale: Omeprazole and clarithromycin are commonly included in a dual drug therapy program for peptic ulcer disease from H. pylori.

The patient has been prescribed a treatment regimen that includes nizatidine. Which statement by the patient indicates a therapeutic outcome? A. "I don't have any more stomach pain." B. "My constipation has been relieved." C. "I don't have such frequent headaches." D. "My anxiety has been under control."

B. Allergic reaction to the medication The patient's symptoms are indicative of an allergic reaction to the medication.

The patient's health care provider prescribes rabeprazole to a patient. The nurse recognizes that this drug is effective for the patient because it belongs to which drug class? A. Antiinfective agent B. Proton pump inhibitor C. Antacid D. Histamine2 blocker

B. Proton pump inhibitor The drug rabeprazole is classified as a proton pump inhibitor.

The patient is ordered cimetidine. It is most important for the nurse to teach the patient about what dietary needs? A. Avoid use of salt substitutes. B. Eat foods rich in vitamin B12. C. Eat a high-protein diet. D. Avoid citrus foods.

B.Eat foods rich in vitamin B12. Rationale: Teach patient to eat foods rich in vitamin B12 to avoid deficiency as a result of drug therapy.

When administering the histamine2 blocker ranitidine, the nurse will A. monitor laboratory results because ranitidine decreases the effect of oral anticoagulants. B. separate ranitidine and antacid dosage by at least 1 hour if possible. C. teach the patient to avoid foods rich in vitamin B12. D. expect a reduction in the patient's pain to occur after 5 days of therapy.

B.separate ranitidine and antacid dosage by at least 1 hour if possible. Rationale: Antacids can be given 1 hour before or after ranitidine (Zantac) as part of the antiulcer drug regimen. Ranitidine (Zantac) can increase the effect of oral anticoagulants. Patients on ranitidine (Zantac) should eat a diet rich in vitamin B12 to avoid deficiency as a result of drug therapy. The patient's abdominal pain is expected to decrease after 1 to 2 weeks of drug therapy.

The health care provider prescribes lansoprazole (Prevacid) for a patient. Which assessment indicates to the nurse that the medication has had a therapeutic effect? A. The patient has no gastric pain. B. The patient has no diarrhea. C. The patient has no esophageal pain. D. The patient is able to eat.

C. The patient has no esophageal pain. Lansoprazole is a proton pump inhibitor that is effective in suppressing gastric acid secretions. An absence of esophageal pain would be an indication that the patient does not have reflux esophagitis.

The nurse is caring for a patient who is taking sucralfate for treatment of a duodenal ulcer. Which assessment requires immediate action by the nurse? A. A sodium level 140 mEq/L B. A calcium level 8.5 mg/dL C. Absent bowel sounds, hard abdomen D. Urinary output of 30 mL/h

C.Absent bowel sounds, hard abdomen As sucralfate is not systemically absorbed, there are few adverse effects. Constipation is an adverse effect of sucralfate, so the absence of bowel sounds and a hard abdomen would require immediate action from the nurse. The sodium and calcium levels listed are considered to be within the normal range; 30 mL/h is a normal urinary output.

A patient with peptic ulcer disease is noted to have a positive breath test for H. pylori. The nurse would anticipate treating the patient with A. antacids and narcotics. B. pepsin inhibitors and antiemetics. C. proton pump inhibitors and antibiotics. D. emetic agents and tranquilizers.

C.proton pump inhibitors and antibiotics. Rationale: A common treatment protocol for H. pylori is triple antibiotic therapy and a proton pump inhibitor.

A patient with a gastric ulcer is ordered sucralfate. This medication works to A. calm the patient to reduce acid production. B. block the H2 receptors. C. neutralize the gastric acids. D. coat the gastric lining.

D.coat the gastric lining. Rationale: Sucralfate (Carafate) is a mucosal protective drug. It forms a viscous substance that covers the ulcer and protects it from acid and pepsin.

A patient is taking famotidine to inhibit gastric secretions. Which side effects of famotidine will the nurse teach the patient? (Select all that apply.) a. Dizziness b. Headaches c. Hypokalemia d. Hyperkalemia e. Blurred vision f. Erectile dysfunction

a. Dizziness c. Hypokalemia f. Erectile dysfunction

A patient is diagnosed with peptic ulcer disease. The nurse realizes that which of these is a predisposing factor for this condition? a. Helicobacter pylori b. Hyposecretion of pepsin c. Decreased hydrochloric acid d. Escherichia coli

a. Helicobacter pylori

A patient is taking famotidine. What information should the nurse teach the patient about this drug? (Select all that apply.) a. The drug should be administered for 4 to 8 weeks. b. The drug must be administered 30 minutes before meals. c. The drug must be administered separately from iron by at least 1 hour. d. The drug must always be administered with magnesium hydroxide. e. Smoking should be avoided while taking this drug. f. Foods high in vitamin B12 should be increased in the diet.

a. The drug should be administered for 4 to 8 weeks. c. The drug must be administered separately from iron by at least 1 hour. e. Smoking should be avoided while taking this drug. f. Foods high in vitamin B12 should be increased in the diet.

The patient is taking esomeprazole for erosive gastroesophageal reflux disease. Which should the nurse include in patient teaching? a. Take the medication daily with breakfast. b. Healing should occur in 1 week. c. This medication decreases stomach acid secretion. d. A blood test to check kidney function should be done.

c. This medication decreases stomach acid secretion.

When a patient complains of pain accompanying a peptic ulcer, why should the nurse give an antacid? a. Antacids decrease gastrointestinal motility. b. Antacids decrease gastric acid secretion. c. Antacids strengthen the lower esophageal sphincter's action. d. Antacids neutralize hydrochloric acid and reduce pepsin activity.

d. Antacids neutralize hydrochloric acid and reduce pepsin activity.

A student nurse is preparing to administer sucralfate to a patient. Which statement by the student nurse demonstrates understanding of sucralfate's mechanism of action? a. Sucralfate neutralizes gastric acidity. b. Gastric acid secretion is decreased by inhibiting histamine at histamine2 receptors in parietal cells. c. Gastric acid secretion is suppressed by inhibiting the hydrogen/potassium adenosine triphosphatase enzyme. d. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer.

d. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer.