pharm: Quiz 12

A client with Inflammatory Bowel Disease (IBS) is prescribed sulfasalazine (Azulfidine) and complains of nausea/vomiting, diarrhea, and abdominal pain. What is the best nurse's education regarding medications for this client?

Even with these side effects, you need to take this medication to prevent the inflammation of the lining of your bowel" -Common adverse effects of taking sulfasalazine is nausea/vomiting, diarrhea, upset stomach, and abdominal pain. Dividing up the doses and using enteric coated tablets with food in the stomach will help prevent the adverse effects.

The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?

nausea and vomiting

The physician orders misoprostol (Cytotec) for the female client with peptic ulcer disease (PUD). What is a priority question for the nurse to ask the client prior to administration of this medication?

"Are you pregnant?" Misoprostol (Cytotec) is contraindicated during pregnancy; it is sometimes used to terminate pregnancies.

The client takes diphenoxylate with atropine (Lomotil) for diarrhea. The client asks the nurse why he does not experience pain relief since this drug is an opioid. What is the best response by the nurse?

"Because this opioid does not have analgesic properties." Unlike most opioids, diphenoxylate with atropine (Lomotil) does not have analgesic properties because of the addition of atropine which is an anticholinergic. This was added to the diphenoxylate to prevent abuse of the opiod.

An elderly patient with diverticulosis is instructed to take the bulk laxative psyllium mucilloid (Metamucil). Which question would be most important for the nurse to ask the patient?

"Do you have any difficulty swallowing?" psyllium mucilloid (Metamucil) is dissolved in eight ounces of water or juice and becomes thick after stirring and sitting. It must be followed with another eight ounces of fluid. If a patient has difficulty swallowing the psyllium mucilloid (Metamucil) will form a bezoar in the esophagus and potentially cause an obstruction.

The client receives omeprazole (Prilosec). He asks the nurse why that little purple pill is better than his ranitidine (Zantac). What is the best response by the nurse?

"It decreases acid in your stomach, better than ranitidine (Zantac)." Proton-pump inhibitors reduce acid secretion to a greater extent than H2-receptor antagonists, and have a longer duration of action. Omeprazole (Prilosec) is more effective than rantidine (Zantac), but will not kill bacteria Omeprazole (Prilosec) does not have fewer side effects than rantidine (Prilosec). Omeprazole (Prilosec) is not cheaper than rantidine (Zantac).

A nurse is caring for a female client who has a prescription for aluminum hydroxide (Amphojel) suspension to treat peptic ulcer disease (PUD). Identify the instructions the nurse should include regarding taking this medication. (Select all that apply.)

-"Continue to take this medication even when you are feeling better to allow your ulcer to heal" -"Shake this medication before taking each dose" -"You may take this medication one hour before a meal and three hours after eating up to seven times a day" Aluminum hydroxide is rated as Pregnancy Risk Category C. Discontinue use and notify provider if you become pregnant. Shake the medication prior to taking each dose in order to disperse the medication. Take other medications at least 1 hr before or 3 hr after taking aluminum hydroxide. Aluminum hydroxide may cause constipation. Notify your provider if it persists. You may need to alternate this antacid with one that has constipation as an adverse effect. Continue to take the medication even after you no longer have symptoms so that the ulcer will continue to heal. The medication is prescribed at frequent dosing intervals to promote healing of the ulcer. Seven times a day, 1 hr before, 3 hr after meals, and at bedtime is a common dosing schedule.

Your patient has several risk factors for developing PUD (Peptic Ulcer Disease). Following an EGD with biopsy, it is determined that his ulcer is caused by helicobacter pylori. Which of the following drugs would you anticipate the physician to order now as a priority? (Select all that apply.)

-antibiotic -proton pump inhibitor Proton pump inhibitors and antibiotics are given if H-pylori is the cause of peptic ulcer disease. Proton pump inhibitors block acid formation healing the ulcer and antibiotics kill the bacteria which causes the ulcer.

The client has been vomiting for several days. What priority problem will the nurse assess for? Signs and symptoms of:

Metabolic alkalosis Excessive vomiting causes loss of hydrogen ions which causes elevated pH and increased HC03 and elevated CO2.

A patient asks the nurse how sucralate (Carafate) works. The nurse replies by stating, "sulcrafate:

binds to normal and ulcerated mucosa, creating a protective barrier

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? (Select all that apply.)

ranitidine (Zantac) nizatidine (Axid) cimetidine (Tagamet) famotidine (Pepcid) H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of heartburn, and assist in preventing complications of peptic ulcer disease. These medications also suppress gastric acid secretions and are used in active ulcer disease, erosive esophagitis, and pathological hypersecretory conditions. The other medications listed are proton pump inhibitors. H2-receptor antagonists medication names end with -dine. Proton pump inhibitors medication names end with -zole.

Since all antiemetics often cause this adverse effect, an area of teaching would include:

safety precautions by avoiding driving due to drowsiness -Antiemetics suppress areas in the chemoreceptor trigger zone (CTZ) which can cause drowsiness and dizziness. Patients require education to not drink alcohol or drive or operate equipment when taking these medications.