Chapter 37

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?

Constipation

An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?

"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

Which of the following antacids may produce constipation and should be used cautiously in clients that have chronic constipation?

Calcium carbonate, aluminum hydroxide

Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect?

Digoxin

Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?

Drug-drug interactions Ranitidine, which is longer acting and more potent than cimetidine, is not associated with the antiandrongenic adverse effects or the marked slowing of metabolism in the liver, as cimetidine is, and therefore does not interfere with the metabolism of other drugs.

A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is:

HA, the nurse will encourage the client to adjust lights or temperature and avoid noise if headaches occur and to contact the health care provider if the headache becomes intolerable.

A client presents for follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment?

Inhibiting gastric acid production

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, unlike cimetidine, ranitidine does not affect the cytochrome P450 drug-metabolizing system in the liver and therefore does not interfere with the metabolism of other drugs by that system.

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?

Omeprazole

The nurse is talking with nursing students about the drugs that affect the gastrointestinal secretions. What group of drugs would the nurse tell the students is used to treat peptic ulcers by suppressing the secretion of hydrochloric acid into the lumen of the stomach?

PPIs

A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:

Serum phosphate level, aluminum binds with phosphate. This can lower phosphate levels and cause an electrolyte imbalance.

A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way?

Smaller than the average prescribed dose, because they usually secrete less gastric acid than younger adults do.

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

Because of the possible adverse effects of long-term proton pump inhibitor (PPI) use, the nurse practitioner should focus on what assessment in a 72-year-old client?

bone density

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?

Decreases production of gastric secretions

Omeprazole (Prilosec) may be used with what antibiotic in some H. pylori eradication regimens?

Amoxicillin

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. When the patient is receiving an antiemetic, the nurse monitors the patient frequently for continued reports of pain, sour taste, spitting blood, or coffee-ground-colored emesis. When antacids are given to the patient, the nurse should observe the patient for concentrated urine and restlessness. When the patient is administered prolonged doses of metoclopramide, the nurse reports any sign of tardive dyskinesia or extrapyramidal symptoms to the PHCP.

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

After several months of persistent heartburn, a 57 year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem?

Proton pump inhibitors; avoiding large meals; remaining upright after meals

An older adult reports chronic abdominal pain and dark, tarry stools. The client has a history of chronic arthritis being treated with naproxen daily. What is the most likely cause of the presenting symptomology?

gastric ulcer