Ch. 35: Drugs Used For PUD
A client taking ginger for motion sickness complains of heartburn. What is the nurse's best response?
"Adverse effects are rare, but heartburn has been reported by some individuals taking ginger."
A patient has been prescribed esomeprazole (Nexuim). What statement by the patient indicates that he has a good understanding of his newly prescribed drug?
"I need to swallow the drug whole and not chew the capsules."
A nurse is teaching a 47-year-old client about omeprazole, which the physician has prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?
"I need to swallow the drug whole."
Ms. Kime is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux. Which statement made by the patient indicates that she understood the teaching provided about taking these medications?
"I should take ranitidine 2 hours before or after my antacid dosage."
The physician at your clinic has prescribed a chewable antacid to a patient with peptic ulcer disease. Which of the following instructions should you offer the patient regarding use of the drug?
"Take the antacid two hours before or after other oral medications."
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."
The physician 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 patient's GI discomfort is prescribed antacids. Nursing interventions associated with this prescription should include:
Administer the antacid 1 hour before or 2 hours after other oral medications.
Which agent would a nurse identify as the prototype histamine-2 receptor antagonist?
Cimetidine
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?
Closely monitor the patient for confusion and dizziness.
The nurse should warn a patient taking aluminum and calcium-containing antacids about which adverse effects?
Constipation
A patient has been prescribed rabeprazole (Aciphex). It will be important for the nurse to assess the patient's drug history to determine if the patient is taking which of the following drugs?
Digoxin
A nurse should monitor a client taking which of the following drugs for increased adverse effects and toxicity if omeprazole (Prilosec) therapy is initiated? Select all that apply:
Digoxin (Lanoxin) Diazepam (Valium) Warfarin (Coumadin)
Ms. Diniger is prescribed omeprazole for gastric reflux disorder. Which strategy would help minimize the risk of adverse effects associated with omeprazole?
Divide daily dosage larger than 80 mg into smaller doses to be administered through the day.
Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?
Drug-drug interactions
A patient with GI upset is prescribed an antacid for outpatient use. Which of the following instructions should the nurse provide the patient and family members?
Explain that the drug may change the color of the stool.
If a patient is receiving sucralfate and omeprazole, the doses can be taken together. True or False?
False
A male client is overweight and lives a sedentary lifestyle. He presents to the office with complaints of acid regurgitation, especially at night. The nurse is aware that this client is displaying symptoms of what disorder?
Gastroesophageal reflux disease
When comparing the H2RAs to each other, you would find that cimetidine (Tagamet) is more likely to cause which adverse effect?
Gynecomastia
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
Gynecomastia
The physician has prescribed ranitidine for a patient in your unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the patient?
Headache
Histamine2 receptor antagonists are used in the treatment of upper GI disorders. Why aren't histamine1 receptor antagonists used?
Histamine1 receptor antagonists do not block histamine effects on gastric acid production.
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
Increased fracture risk
A male client is receiving morphine sulfate for pain after an accident. The physician has also ordered cimetidine IV to assist in preventing a stress ulcer. The nurse will monitor for what effect that is caused by the interaction of these two drugs?
Increased incidence of respiratory depression
A 25-year-old client arrives at the walk-in clinic reporting vomiting and a burning sensation in the midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?
Infection with H. pylori
A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent?
Omeprazole
A patient is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
Omeprazole
After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?
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 female client presents to the physician'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 his ulcer with antacids. Based on the client's age, the nurse expects the physician to prescribe a dose of antacid that compares with the average prescribed dose in what way?
Smaller than the average prescribed dose
Why would a nurse encourage a patient to avoid using OTC medications to treat decreased acid?
Some of these drugs can change the normal environment of the GI tract
Patient teaching should include what instruction about antacids?
Take antacid 1 hour before other medications.
The nurse is caring for a male client in the medical unit. He is fed via a nasogastric tube. The dose of antacid is based on what factors?
The pH of the stomach contents
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.
The nurse is caring for a patient who is going home on sucralfate (Carafate). The nurse would teach the patient to take sucralfate:
before meals.
A patient 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 physician is likely to order a diagnostic test to detect the possible presence of:
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.
The nurse is administering an H-2 receptor antagonist to a patient with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug:
provides protection of the stomach lining via acid blockage.
