Davis Ch. 56: Oral & Esophageal Disorders

Quicker onset of action to provide relief H2RAS PPIS

H2RAS Rationale: PPIs have a delayed onset of action compared to H2RAs, so patients may need additional therapy for immediate relief of symptoms.

Generic names include cimetidine, famotidine, and ranitidine H2RAS PPIS

H2RAS Rationale: Common H2-blockers include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), or ranitidine (Zantac 75). Stronger prescription-strength H2-blockers are available.

Clinical indication - used to treat H. pylori in addition to GERD H2RAS PPIS

H2RAS Rationale: H2RAs are also indicated for treatment of H. pylori in addition to antibiotic therapy. PPIs are used to treat GERD.

Decrease acid production of parietal cells H2RAS PPIS

H2RAS Rationale: H2RAs decrease acid production of parietal cells in the stomach lining by blocking histamine-2 at one of the first steps of acid production.

Tolerance to medication is likely to occur H2RAS PPIS

H2RAS Rationale: With H2RAs therapy, medication tolerance is likely to occur. This is not seen with PPI therapy.

This or That? For each option, drag and drop the correct information related to either H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs). Blocks acid secretion in the last step of production in the stomach H2RAS PPIS

PPIS Rationale: H2RAs block acid secretion in the first step of production in the stomach, while PPIs block acid secretion in the last step.

Interfere with the absorption of ketoconazole, ampicillin, iron, and digoxin. H2RAS PPIS

PPIS Rationale: PPIs can interfere with the absorption of ketoconazole, ampicillin, iron, and digoxin. The H2RA cimetidine can interact with warfarin, phenytoin, and theophylline with long-term use.

Longer duration of action H2RAS PPIS

PPIS Rationale: PPIs have a delayed onset of action and a duration of action lasting up to 24 hours. H2RAs have an onset of action of 1 hour and a duration of about 12 hours. PPIs have a longer duration of action than H2RAs, so they are more effective for long-term management of clinical symptoms.

OTC medications include lansoprazole and omeprazole. H2RAS PPIS

PPIS Rationale: OTC PPIs include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC). Prescription-strength PPIs are available.

Which of these symptoms would the nurse expect to find in a client with gastroesophageal reflux disease? Select all that apply. a. Atypical chest pain b. Sleep issues c. Adult-onset asthma d. Elevated temperature e. Laryngitis

a. Atypical chest pain b. Sleep issues c. Adult-onset asthma e. Laryngitis

Which foods should be avoided in a client who has already been diagnosed with gastroesophageal reflux disease? Select all that apply. a. Chocolate b. Beer c. Caffeinated coffee d. Peppermint gum e. Broth or consommé

a. Chocolate b. Beer c. Caffeinated coffee d. Peppermint gum

What are common clinical findings associated with the presence of gastroesophageal reflux disease? Select all that apply. a. Dental caries b. Odynophagia c. Hoarseness throughout the day but worse in the evening d. Bronchitis e. Pelvic pain

a. Dental caries b. Odynophagia d. Bronchitis

The lower prevalence of gastroesophageal reflux disease in underdeveloped countries is attributed to which of the following factors? Select all that apply. a. Lifestyle b. Dietary habits c. Prevalence of Helicobacter pylori d. Reduced carbon emissions e. Smoking cessation

a. Lifestyle b. Dietary habits c. Prevalence of Helicobacter pylori

Which medication option would have a longer duration of action in treating the clinical condition of gastroesophageal reflux disease? a. Proton pump inhibitors b. Antacids c. Corticosteroids d. Opioid analgesics

a. Proton pump inhibitors

A client with gastroesophageal reflux disease has a catheter and sensor that is placed in the nose and terminates in the distal esophagus. The client has also been asked to keep a diary of symptoms and activities. Which diagnostic test has been ordered for this client? a. Twenty-four-hour ambulatory esophageal pH monitoring b. Pulmonary function tests c. Endoscopy d. Telemetry monitoring

a. Twenty-four-hour ambulatory esophageal pH monitoring

Which conditions may influence the development of gastroesophageal reflux disease? Select all that apply. a. Pernicious anemia b. Obesity c. Loss of esophageal motility d. Hiatal hernia e. Constipation

b. Obesity c. Loss of esophageal motility d. Hiatal hernia

What medications used in the treatment of gastroesophageal reflux disease work by increasing gastric emptying? a. Antacids b. Prokinetics c. Proton pump inhibitors d. Histamine receptor antagonists

b. Prokinetics

In working with clients who have been diagnosed with gastroesophageal reflux disease, which statement is accurate related to the use of proton pump inhibitors as therapeutic treatment? a. It is also useful in the treatment of H. pylori. b. The client is encouraged to increase fluid intake while taking this therapy to prevent dehydration from occurring. c. It leads to resolution of clinical condition after two months of therapy. d. Tolerance is unlikely.

d. Tolerance is unlikely.