drugs for peptic ulcer disease
A patient experiences dehydration after receiving chemotherapy. Which instruction should the nurse provide to prevent this adverse effect?
"Drink an adequate amount of fluid prior to treatment."
The nurse instructs a patient on the treatment modalities for peptic ulcer disease (PUD). Which patient statement should indicate the need for further teaching?
"NSAIDs are used effectively in the treatment of peptic ulcer disease."
The nurse is assessing a patient with peptic ulcer disease (PUD). Which symptom should concern the nurse the most?
Bright-red emesis
esomeprazole
Do not crush the pill. Swallow it whole.Proton pump inhibitor capsules are designed to withstand the acidic environment of the stomach so the drug can be absorbed in the small intestine. Crushing the pill destroys the ability to withstand the acidic environment, greatly reducing the effectiveness of the drug.Side effects may include headache, diarrhea, nausea, dizziness, and increased risk of fracture.Headache, diarrhea, nausea, and dizziness are common side effects of esomeprazole. Esomeprazole also interferes with calcium absorption, increasing the risk of fracture in clients with osteoporosis.Take the pill 20-30 min before the first meal of the day.Food decreases absorption by up to 35%, so the medication should be taken 20-30 min before food so it can be absorbed completely. Continue
ranitidine side effects
Do not crush the pills; they must be swallowed whole. Extended release medications are specially formulated to release the medication slowly over time. If these pills or capsules are crushed or chewed, the release of medication is no longer regulated properly, which may result in decreased therapeutic effects and/or increased adverse effects.
A patient reports several bouts of diarrhea. Which data should the nurse obtain during the initial assessment?
Drug history
A patient reports drinking more than four alcoholic beverages per day. Which manifestation of peptic ulcer disease (PUD) should the nurse expect in this patient?
Increased gastric irritation
An infant develops diarrhea. Which medication should the nurse anticipate being prescribed?
Loperamide (Imodium)
What is the purpose of misoprostol ?
Misoprostol inhibits gastric acid secretion and protects the mucosa, thus preventing peptic ulcer formation.
decision making : peptic ulcer disease which client requires the most urgent care?
Mr. Wallace has a bleeding ulcer, which requires more immediate attention than the other clients who do not have bleeding ulcers.
Based on Mrs. Kurosawa's risk factors, what other client teaching should you provide for Mrs. Kurosawa?
Mrs. Kurosawa has several risk factors for osteoporosis and poor bone strength, which increases her risk for bone fractures. These risk factors include age, gender, and taking esomeprazole. Therefore, you should provide client teaching related to increasing bone strength and preventing falls.
A patient is diagnosed with chronic pancreatitis. Which should the nurse expect to be prescribed for this patient?
Pancreatic enzyme supplementation
Amoxicillin contraindications
Penicillin, Cephalosporins
A patient taking omeprazole (Prilosec) for peptic ulcer disease (PUD) develops severe diarrhea. Which adverse effect should the nurse suspect?
Pseudomembranous colitis
Mr. Wright is confused about why he needs to take antibiotics for H. pylori when he doesn't have a peptic ulcer. How would you respond?
The combination of regular NSAID therapy and H. pylori infection triples the risk of developing a peptic ulcer. If the H. pylori is eradicated with antibiotics, this risk is greatly reduced.
vAfter starting Mr. Wallace's IV, you check on Mr. Torres. He says that the physician told him he had an ulcer, and he has heard that ulcers are caused by bacteria. He insists on getting some antibiotics in addition to the ranitidine that the physician prescribed. How would you respond to Mr. Torres?
This statement provides the correct rationale for why antibiotics have not yet been prescribed to Mr. Torres. If H. pylori is not present, then antibiotics are not needed, and actually would cause a worse outcome for clients with PUD.
A patient is prescribed diphenoxylate with atropine (Lomotil). For which reason should the nurse realize this medication was prescribed?
Treat diarrhea.
The nurse is reviewing drugs prescribed for the management of peptic ulcer disease (PUD) with a group of new colleagues. Which cell should the nurse explain is inhibited by drugs used to reduce gastric acid secretion?
parietal
The nurse is explaining the actions and effects of ranitidine (Zantac). Which statement should indicate a need for further teaching?
"I should feel immediate improvement with ranitidine."
A patient is questioning the need to drink adequate fluids prior to receiving a chemotherapy treatment. Which reason should the nurse provide?
"It decreases the possibility of dehydration."
The nurse is discussing the medication omeprazole (Prilosec) with a colleague. Which should the nurse describe as the mechanism of action for this medication?
"It inhibits the final pathway involved in acid secretion and inhibits proton pumps."
The nurse is caring for several patients with intestinal influenza. For which patient should diphenoxylate with atropine (Lomotil) be used cautiously?
85-year-old patient
You next check on Mrs. Kurosawa, who has been prescribed esomeprazole 20 mg once daily PO for 4 weeks. What class of medication is esomeprazole, and what is its mechanism of action?
Esomeprazole is a proton pump inhibitor that helps inhibit secretion of H+ into the stomach. This decreases acid volume and thus reduces irritation of the ulcer to allow healing.
A patient is prescribed psyllium (Metamucil). Which adverse effect should the nurse explain is easiest to avoid?
Esophageal obstruction
clarithromycin
Grapefruit juice increases the risk of experiencing adverse effects. Grapefruit juice amplifies the effects of clarithromycin. Although this may increase its efficacy, it also increases the risk of experiencing adverse effects.
A patient is being tested for peptic ulcer disease (PUD). Which should the nurse recall as the primary reason for this disorder?
H. pylori infection
clarithromycin contraindication
Macrolides,
The nurse is reviewing medications used to treat peptic ulcer disease (PUD). Which medication should the nurse recognize acts by blocking the final pathway involved in gastric acid secretion?
Omeprazole (Prilosec)
A patient is concerned about developing nausea and vomiting after chemotherapy treatment. Which medication should the nurse anticipate being prescribed to help prevent these adverse effects?
Ondansetron (Zofran)
A patient taking diphenoxylate with atropine (Lomotil) is demonstrating symptoms of an overdose. For which adverse effect should the nurse monitor?
Respiratory depression
side effects of esomeprazole?
Severe diarrhea and pain during urination are adverse effects of esomeprazole that may require discontinuation of the drug. Because Mr. Wallace is taking a high dose of esomeprazole to treat his bleeding ulcer, he should notify the nurse immediately if he experiences these adverse effects.
A patient with inflammatory bowel disease is allergic to aspirin. Which medication should the nurse identify as contraindicated?
Sulfasalazine (Azulfidine)
A patient is prescribed an H2-receptor antagonist. Which should the nurse include when teaching about this medication?
Take the drug at bedtime.
A patient is diagnosed with peptic ulcer disease (PUD). For which reason should the patient be instructed to stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)?
They cause direct damage to gastrointestinal mucosal cells.