pharm Ch 37

Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect?

digoxin

The nurse is preparing to discharge a client who has been prescribed sucralfate. When does the nurse instruct the client to take the medication?

one hour before or 2 hours after meals and at bedtime

The nurse administers ranitidine cautiously to clients with evidence of what condition?

pregnancy

An older client has been prescribed omeprazole for the treatment of gastresophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?

"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

A female client is currently taking sucralfate and has been given a prescription for ciprofloxacin for treatment of a urinary tract infection. The nurse will inform the client that she should take her medication in what way?

"Take the ciprofloxacin 2 hours before the sucralfate."

A female client has GERD and is taking cimetidine. She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?

"Yes, but be sure to wait at least 2 hours to take the antacid after you take the cimetidine."

The health care provider has prescribed sucralfate for a client with a gastric ulcer. The client asks how long he must take this medication. What is the nurse's best response to this client?

"You will need to take this medication for 4 to 8 weeks to ensure healing has occurred."

A nurse is teaching a client about prescribed lansoprazole. The nurse instructs the client to take the drug at which time?

1 hour before eating

When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?

Alopecia

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?

Amoxicillin

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

Constipation

A female client comes to the clinic with reports of burning pain in the stomach. She states that she thinks she had a virus 48 hours ago and she vomited many times. She hasn't vomited in 24 hours. She asks the health care provider to give her a prescription for omeprazole because she saw an ad on TV that said it would heal stomach pain. The nurse assists the client in understanding that PPIs are considered drugs of choice for treatment of what conditions? (Select all that apply.)

Duodenal ulcers Zollinger-Ellison syndrome Gastric ulcers

Which of the following could a nurse expect to administer intravenously?

Esomeprazole

A male client is overweight and lives a sedentary lifestyle. He presents to the office with reports of acid regurgitation, especially at night. The nurse is aware that this client is displaying symptoms of what disorder?

Gastresophageal reflux 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?

Headache

A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client?

Hip fractures

A client is taking an antacid that contains aluminum salts. The nurse would monitor the client for:

Hypophosphatemia

The nurse is providing care for a 51-year-old client who has been taking cimetidine for several months. When monitoring for adverse effects, the nurse should perform what assessment?

Inspect the client's chest for the development of gynecomastia.

A client with a gastrointestinal (GI) disorder is prescribed the proton pump inhibitor omeprazole. Which information would the nurse include when instructing the client about this medication?

Instruct the client to swallow the capsule whole.

A client is brought to the emergency department for a drug overdose. The nurse concludes the emetic is safe to give to the client if which client assessment finding is noted?

Mental status is intact.

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

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?

Omeprazole

A group of nursing students are analyzing the various categories of upper gastrointestinal system drugs. The instructor determines the session is successful when the students correctly choose which drug(s) as an example of a proton pump inhibitor?

Omeprazole Esomeprazole

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?

Proton pump inhibitors

The nurse is preparing to administer a prescribed medication to a client diagnosed with GERD. If the nurse discovers the client has a history of vitamin B12, which medication(s) will the nurse administer cautiously? Select all that apply.

Rabeprazole Pantoprazole

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?

Rebound acidity

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?

Smaller than the average prescribed dose

The nurse is caring for a female client who has been recently been prescribed misoprostol. What change in the client's health status should the nurse communicate most promptly to the primary health care provider?

The client believes that they may be pregnant.

A female client's diagnoses include diabetes mellitus, gastric ulcer disease, and chronic renal disease. When the nurse reviews her medications with her, the nurse discover that she self-administers antacids containing magnesium. What statement is true about antacids containing magnesium?

They are contraindicated for clients with renal disease.

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?

Use a reliable contraceptive.

The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:

an hour before meals.

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?

decreases production of gastric secretions

An older adult reports chronic abdominal pain and dark, tarry stools. The client has a history of chronic arthritis being treated with naproxen daily. What is the most likely cause of the presenting symptomology?

gastric ulcer

A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is:

headache

The client will receive cimetidine 800 mg PO at bedtime. Prior to administration, the nurse should inform the client that common side effects related to this medication include:

headache.

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

Occasionally, a bismuth preparation is added to the treatment regimen for duodenal ulcers. What are bismuth's effects against H. pylori organisms.

increases secretion of mucus and bicarbonate inhibits pepsin activity accumulates in ulcer craters

A client presents to the clinic reporting vomiting and burning in the mid-epigastria. The nurse suspects peptic ulcer disease and knows that to confirm this, the primary health care provider is likely to prescribe a diagnostic test to detect the possible presence of what?

infection with Helicobacter pylori

Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:

interfere with the metabolism of other drugs.