PrepUs for Pharm Chapter 40

A client has presented to the emergency department with a 48-hour history of spasticity, malaise and agitation. Arterial blood gas testing reveals that the client has metabolic alkalosis. What is the nurse's best assessment?

Assess the client's use of sodium bicarbonate and other antacids Sodium bicarbonate and other antacids can cause metabolic alkalosis due to their action of increasing pH. H2 antagonists do not have this adverse effect. Diverticular disease, ulcers and GERD do not directly create a risk for metabolic alkalosis.

A client has a magnesium-based antacid prescribed for administration as needed. Which condition contraindicates the administration of this classification of medications?

renal dysfunction Magnesium-based antacids are contraindicated in clients with renal failure. Magnesium-based antacids are not contraindicated with hypertension, regular heart rate, or stress ulcer.

For treatment of a gastric ulcer, what would the recommended dosing schedule of famotidine (Pepcid) be?

20 mg bid Famotidine should be administered 40 mg every day at bedtime or 20 mg bid. for treatment of a gastric ulcer.

Which client would be most likely to benefit from treatment with ondansetron (Zofran)?

A woman who is receiving chemotherapy for the treatment of colon cancer Ondansetron is used to prevent nausea and vomiting associated with cancer chemotherapy and radiotherapy, and in postoperative states when expectation is high that nausea or vomiting will occur or when nausea and vomiting must be avoided. It is less likely to be used in postsurgical care, though this may be the case. Renal failure and skeletal fractures are not indications for the use of ondansetron.

A client has been prescribed rabeprazole (Aciphex). It will be important for the nurse to assess the client's drug history to determine if the client is taking which drug?

Digoxin The nurse should assess for the use of digoxin. Rabeprazole interacts with digoxin and increases its serum concentration. It is necessary to monitor for signs of digoxin toxicity when these drugs are given together. Morphine, levodopa, and dicyclomine hydrochloride can cause adverse interactions with metoclopramide

Misoprostol is contraindicated for clients with what condition?

Pregnancy This drug is contraindicated during pregnancy because it is an abortifacient. The other options are incorrect.

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?

Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily. The leading cause of peptic ulcers in the United States is the use of NSAIDs. NSAIDS inhibit cyclooxygenase receptors, and one of the functions of these sites is the production of the mucous lining in the stomach. While the other situations may contribute to GI distress, NSAID used in primary risk factor for this client.

A client's GI discomfort is prescribed antacids. Nursing interventions associated with this prescription should include to:

administer the antacid 1 hour before or 2 hours after other oral medications. A client taking antacids should be advised to take the antacid 1 hour before or 2 hours after other oral medications. These tablets are often chewed to increase effectiveness. Limiting fluid intake can result in rebound fluid retention.

The client will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse should inform the client that common side effects related to this medication include:

headache. Headache, dizziness, somnolence, and mental confusion may occur with H2 antagonists.

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

infection with Helicobacter pylori. Peptic ulcers may result from increased acid production, decrease in the protective mucous lining of the stomach, infection with Helicobacter pylori bacteria, or a combination of these.