Chapter 57: Drugs Affecting Gastrointestinal Secretions

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful? "I need to limit my fluid intake." "I should eat a high-fiber diet." "I may need something to control diarrhea." "I need to avoid sugarless lozenges."

"I should eat a high-fiber diet."

A client has been prescribed omeprazole by the primary health care provider. When the nurse asks whether the medication is providing relief, the client replies, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond? "That's good, but remember that you shouldn't take it on days when you're not having any symptoms." "I'm glad it's working for you, but you'll probably find it works even better if you take it after eating." "That's great. If you find later that it's not working as well, you might want to try taking it at bedtime." "I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."

"I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved? 1 to 2 weeks 6 weeks 10 weeks 12 weeks

1 to 2 weeks

A client has been prescribed 200 micrograms of misoprostol to be taken 4 times a day orally for the prevention of gastric ulcers. The drug is available in 100 microgram tablets. How many tablets should the nurse administer to the client each time? 1 tablet 2 tablets Half a tablet 3 tablets

2 tablets

A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame? 15 minutes 30 minutes 45 minutes 60 minutes

30 minutes

A common drug regimen for eradication of H. pylori includes a proton pump inhibitor (PPI) and two antibiotics. What is one of the preferred antibiotics? Gentamicin Ketoconazole Vancomycin Amoxicillin

Amoxicillin

What priority teaching point should the nurse include when instructing clients about the use of antacids? Reduce calorie intake to reduce acid production. Take before each meal and before bed. Be aware of risk of acid rebound with long-term use. Consider liquid diet if diarrhea occurs.

Be aware of risk of acid rebound with long-term use.

A nurse is providing education to an adult female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching? A)Supplement therapy with magnesium antacids. B)Report postmenopausal bleeding. C)Use effective contraceptive measures. D)Administer the drug one time per day.

C)Use effective contraceptive measures.

Which of the following antacids may produce constipation and should be used cautiously in clients that have chronic constipation? Select all that apply: Calcium carbonate (Mylanta) Magnesium hydroxide (Milk of Magnesia) Magnesium oxide (Mag-Ox) Aluminum hydroxide (ALternaGEL) Sodium bicarbonate (Bellans)

Calcium carbonate (Mylanta) Aluminum hydroxide (ALternaGEL)

Which would a nurse anticipate as having antiandrogenic effects? Cimetidine Famotidine Ranitidine Nizatidine

Cimetidine

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects? Constipation Diarrhea Dehydration Flatulence

Constipation

T/F Saliva substitute is absorbed systemically.

False

A male client is taking cimetidine. Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists? Hypoxia Hypertension Gynecomastia Seizures

Gynecomastia

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs? Hypoxia Hypertension Gynecomastia Seizures

Gynecomastia

A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition? Hepatic disease Cancer Hypertension Diabetes mellitus

Hepatic disease

The nurse should be aware that ranitidine achieves a therapeutic effect by which means? Raising the pH of gastric secretions Inhibiting the secretion of gastric acid Binding to proton pumps Decreasing gastric motility

Inhibiting the secretion of gastric acid

A female client is self-administering cimetidine. What is the home care nurse's most important assessment of this client? Adverse reactions Potential drug-drug interactions Allergic reactions Toxicity

Potential drug-drug interactions

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication? Proton pump inhibitors Sucralfate H2RAs Antacids

Proton pump inhibitors

A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client? Hypocalcemia Rebound acidity Gastric reflux Hyperactive gastric mucosa

Rebound acidity

The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what? Hypertension Heart rate of 68 Renal dysfunction Stress ulcer

Renal dysfunction

T/F Pancrelipase would most likely be used to treat a patient with cystic fibrosis.

True

A 30-year-old nonpregnant patient is prescribed misoprostol. Which of the following should the nurse instruct the patient as part of the teaching plan? Swallow the tablet one hour before eating. Administer the drug one hour before travel. Do not chew, open, or crush the tablet. Use a reliable contraceptive.

Use a reliable contraceptive.

A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way? a)Smaller than the average prescribed dose b)Larger than the average prescribed dose c)The same as the average prescribed dose d)No antacids, because they are contraindicated in the elderly

a)Smaller than the average prescribed dose

Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in clients who: have diabetes. are hypertensive. have arthritis. are pregnant.

are pregnant

The following data identified during a nursing assessment and interview. When considering risks for the development of a peptic ulcer, which situation should the nurse discuss with the client? a)Eats spicy food at least twice a week. b)Has a stressful job as a air traffic controller. c)Is 15 pounds over ideal weight d)Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.

d)Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for: metabolic alkalosis. hypocalcemia. hypercholesterolemia. metabolic acidosis.

metabolic alkalosis.

A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent? Lansoprazole Omeprazole Rabeprazole Esomeprazole

omeprazole

Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection? Famotidine Calcium carbonate Omeprazole Sucralfate

omeprazole

A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions? Select all that apply: Rebound hyperacidity Anorexia Headache Dehydration Confusion

-Rebound hyperacidity -Headache -Confusion

The nurse is teaching a client about lansoprazole prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease? inhibiting acid secretion exerting an antibiotic effect healing damaged cells increasing mucus secretion

inhibiting acid secretion

A client is prescribed ranitidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has: renal disease. diabetes mellitus. pulmonary disease. migraine headaches.

renal disease.

The health care provider has prescribed ranitidine for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client? Tremor Headache Visual disturbances Anxiety

Headache

After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor? Omeprazole Esomeprazole Lansoprazole Pantoprazole

Omeprazole

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection? protects ulcer craters decreases pepsin production assists in eliminating the bacteria decreases production of gastric secretions

decreases production of gastric secretions

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic? Omeprazole Magaldrate Sucralfate Cimetidine

Omeprazole

Carter, age 2, is diagnosed with cystic fibrosis; the physician places him on pancrelipase. What would be the most appropriate diagnosis for Carter related to his medication regimen? a)Risk for injury related to the side effects of the drug therapy b)Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes c)Alterations in elimination related to the disease process d)Alteration in comfort related to the drug therapy and the adverse effect of a headache

b)Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes

Antacids have not been effective in managing a client's gastroesophageal reflux disease, so the health care provider is prescribing a proton pump inhibitor. Why might the health care provider prescribe a proton pump inhibitor (PPI) rather than a histamine2 receptor antagonist (H2RA)? PPIs suppress acid more strongly and for a longer time. H2RAs do not suppress acid. PPIs suppress acid more strongly and for a shorter time. PPIs are less expensive.

PPIs suppress acid more strongly and for a longer time.

While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client? hemorrhage fluid volume excess venous thromboembolism rebound gastroesophageal reflux disease (GERD)

hemorrhage

A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to ragweed. pollen. pork. shellfish.

pork