Med Surg - Digestive and Gastrointestinal Pharmacology

medication included in the regimen for IBD

anticholinergic medications 30 minutes before a meal

client taking sulfasalzine

avoid direct sunlight and use sunblock when outside

PCP recommended senna for management of constipation, the nurse should provide which of the following education points?

avoid taking the drug on a long term basis

A client with gallstones tells the nurse, "The doctor has to do something. Isn't there something he can give me to dissolve them?" What medication does the nurse know may help dissolve the gallstones?

chenodial

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions?

pentagastrin

occasional episodes of constipation - pharmacologic intervention should the nurse recommend to the patient for ongoing use

psyllium hydrophilic mucilloid (metamucil)

lab data should be monitored for a client with IBD who is prescribed sulfasalazine

serum creatinine level

client diagnosed with severe UC is prescribed azathiprine, what assessment data concerning the medication warrants immediate intervention

sore throat, fever and chills

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia?

spironolactone

mucosal protective agents

sucralfate (Carafate) bismuth subsalicylate (Pepto) misoprostol treatment of active stress ulcerations and in long term therapy for peptic ulcer disease action: reacts with stomach acid to form a thick paste that adheres to ulcers side effects: constipation ** take 1 hour before meals and at bedtime ** increase fluids and fiber

colorectal cancer, what is the rationale for administering cephalexin?

to reduce intestinal bacteria levels

patient is prescribed lorcaserin, what teaching is most appropriate

increase the fiber and water in your diet

pharmacodynamics of ursodeoxycholic acid

inhibits the synthesis and secretion of cholesterol

client diagnosed with UC and prescribed mesalamine

instruct the client not to crush or break or chew tablets or capsules

side effect to the male client who is prescribed cimetidine

medication can cause impotence and gynecomastia

The client reporting "acid" when lying down at night asks the nurse if there is any medication that might help. Which statement is the nurse's best response?

"There are several over-the-counter and prescription medications available to treat this. You should discuss this with your health-care provider."

The nurse is discharging a client 2 days postoperative hiatal hernia repair. Which discharge instructions should the nurse include? Select all that apply.

- "Take all of the prescribed antibiotic." - "Eat six small meals per day." - "Use the legs to bend down, not the back."

anticholinergics

for anti-nausea tend to dry GI secretions and reduce smooth muscle spasms and reduce acute GI symptoms (nausea/vomiting) decease GI peristalsis, helpful in preventing/treating diarrhea

The nurse is preparing to administer esomeprazole. Which intervention should the nurse implement? Select all that apply.

- Elevate the client's head of the bed. - Check the client's ID with the medication administration record (MAR) - Ask the client his or her date of birth

The client diagnosed with a severe acute exacerbation of Crohn's disease is prescribed total parenteral nutrition (TPN). Which interventions should the nurse implement when administering TPN? Select all that apply.

- Monitor the client's glucose level every 6 hours. - Administer the TPN on an IV pump. - Check the TPN according to the six rights prior to administering.

H2 receptor antagonists

- dine ranitidine (Zantac) famotidine (Pepcid) cimetidine (Tagamet) nizatidine (Axid) action: blocks H2 receptors in stomach REDUCING gastric secretion indications: duodenal/gastric ulcers, GERD side effects: headache, GI upset ** eat with meals at bedtime

client diagnosed with IBD is prescribed sulfasalazine

ensure the client drinks at least 2,000 mL of water daily

proton pump inhibitors

-prazole omeprazole (Prilosec) pantoprazole (Protonix) esomeprazole (Nexium) lansoprazole (prevacid) action: inhibits an enzyme needed for gastric acid secretion side effects: GI upset, C, diff. bone fractures ** monitor for diarrhea, cramping, bloody stool

a patient receiving lactulose should have what desired outcome?

2-3 soft bowel movements daily

advantage to administering H2 antagonist over antacid to a patient dx with GERD

H2 blockers require less freq dosing than antacids

pharmacologic intervention for pain related to pancreatitis

IV hydromorphone (dilaudid)

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent?

Lactulose

Ursodeoxycholic acid

Medication used to dissolve small gallstones in patients who are poor surgical candidates Also, the treatment for Primary Biliary Cirrhosis

A client is actively bleeding from esophageal varices. Which medication would the nurse most expect to be administered to this client?

Octreotide (Sandostatin)

Which statement is the scientifi c rationale for administering a proton-pump inhibitor (PPI) to a client diagnosed with GERD?

PPI medications inhibit the enzyme that generates gastric acid.

The nurse on a medical unit has received the morning report. Which medication should the nurse administer first?

Pantoprazole to a client on call to surgery.

Gynecomastia is a common side effect of which of the following diuretics?

Spironolactone

The home health-care nurse is caring for a male client diagnosed with a hiatal hernia and reflux. Which data indicates the medication therapy is effective?

The client states that he did not wake up with heartburn during the night.

The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason?

To reduce gastric and pancreatic secretions

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices?

Vasopressin

sulfasalazine

action: inhibits prostaglandin synthesis, decreases colon inflammation indication: IBS, ulcerative colitis, Crohn's disease side effects: anemia, GI upset, rash, headache ** monitor CBC

patient admitted with symptoms of an anorectal infection. cultures indicate that the patient has a viral infection. what should the nurse anticipate to administer?

acyclovir

The single modality of pharmacologic therapy for chronic type B viral hepatitis is:

alpha-interferon

antacids

aluminum hydroxide calcium carbonate magnesium hydroxide sodium bicarbonate

acid neutralization

antacids - take after a meal. action: NEUTRALIZES stomach acid indications: used for peptic ulcers, GERD, decreased phosph levels with chronic kidney disease side effects: constipation ** take 1-2 hours before/after other medications

misoprostol

misoprostol (cytotec) prostaglandin prevention of gastric ulcers in patients taking NSAIDs - inhibit gastric secretion - protect gastric mucosa side effects: dysmenorrhea, miscarriage, GI upset ** NOT to be taken when pregnant

discharging a client with GERD, what should you teach

notify PCP if the medication does not resolve the symptoms

a patient has developed variceal bleeding, what medication should the nurse anticipate on giving?

octreotide (Sandostatin)

a medication recommended to treat asthma

omeprazole daily

pancrelipase

pancrelipase (Pancrease) action: contains lipase, amylase, protease to facilitate digestion of fats, carbs and proteins in GI tract indication: pancreatic insufficiency r/t pancreatitis side effects: nausea, diarrhea, cramping

what finding for a patent who has been taking orlistat is most important to report to the PCP

patient is pale and has many bruises