Pharmacology PrepU Chapter 57: Drugs Affecting GI Secretions

The nurse instructs the patient to use over-the-counter ranitidine (Zantac) instead of cimetidine (Tagamet). What risk is decreased when using ranitidine over cimetidine?

Drug-to-Drug Interaction

If a client is receiving sucralfate and omeprazole, the doses can be taken together.

False

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?

Gynecomastia

Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?

Gynecomastia

The nurse is teaching a client about lansoprazole prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease?

Inhibiting acid secretions

The nurse should be aware that ranitidine achieves a therapeutic effect by which means?

Inhibiting the secretion of gastric acid

A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?

1 hour before eating

The client has Maalox ordered for administration before meals. Which condition is contraindicated with the administration of Maalox?

Renal dysfunction

A nurse is teaching a client about omeprazole, which has been 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."

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?

"I should eat a high-fiber diet."

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."

Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which medication will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.)

-Antibiotics -A PPI (proton-pump inhibitor)

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms most likely be resolved?

1-2 weeks

A patient is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the patient's symptoms be abolished?

1-2 weeks

A common drug regimen for eradication of H. pylori includes a proton pump inhibitor (PPI) and two antibiotics. What is one of the preferred antibiotics?

Amoxicillin

A client with a diagnosis of peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications?

Antacids

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 client taking aluminum- and calcium-containing antacids about which adverse effects?

Constipation

A clinic nurse is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient's safety, which of the following would be a priority nursing action?

Coordinate bone density testing for the patient.

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:

Metabolic Alkalosis

A nurse assesses a client for signs and symptoms of tardive dyskinesia when the client is receiving which drug?

Metoclopramide

A client has a history of liver dysfunction. Which histamine-2 receptor antagonist would the nurse expect to be prescribed?

Nizatidine -Nizatidine is the drug of choice for clients with liver dysfunction because it does not undergo first-pass metabolism in the liver like the other histamine-2 receptor antagonists

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

Omeprazole

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?

PPIs (Proton Pump Inhibitors

A 35-year-old man is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the health care provider is prescribing a proton pump inhibitor. Why might the provider prescribe a PPI rather than an H2RA?

PPIs suppress acid more strongly and for a longer time.

A client is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication?

Peptic ulcer disease

A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to:

Pork

A client is prescribed ranitidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has:

Renal (kidney) disease

A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the client's safety. What would be an appropriate nursing diagnosis?

Risk for injury related to drug-induced somnolence, dizziness, confusion, or hallucinations

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

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

Pancrelipase would most likely be used to treat a patient with cystic fibrosis.

True

The use of calcium carbonate is associated with the development of acid rebound.

True

What is the rationale for using two antimicrobials when treating a Helicobacter pylori infection?

Two antimicrobials are needed to prevent the emergence of drug-resistant H. pylori organisms.

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

A 23-year-old female client is prescribed misoprostol (Cytotec). Which client teaching intervention is most important?

Use effective contraceptive measures note: can cause spontaneous abortions

Which teaching intervention is most important to share with the client prescribed misoprostol?

Use effective contraceptive measures.

The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:

an hour before meals -sucralfate must be given time to act before significant gastric activity and requires an acidic environment to be effective

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

How should the critical care nurse most accurately titrate the dose and frequency of administration of an intragastric drip of an antacid through a nasogastric tube?

by aspirating stomach contents and measuring the pH

The nurse is caring for a client who is prescribed esomeprazole. The client informs the nurse that he is also taking sucralfate. The nurse would anticipate which effect as a possibility when these two drugs are administered?

decreased absorption of the esomeprazole

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

The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction?

hemorrhage

A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition?

hepatic disease

The nurse is administering an H-2 receptor antagonist to a client 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

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

renal dysfunction -The leading cause of peptic ulcers in the United States is the use of NSAIDs.

A client, with recent abdominal pain and a 40-pack per year smoking history, is prescribed a treatment regimen for a diagnosis of duodenal ulcer. What important teaching would the nurse include in relation to treatment?

smoking effects on the healing of ulcers

What is an effect of histamine release that is related to ulcer formation?

stimulates gastric acid secretion

Which of the following would a nurse expect to administer if the goal of therapy is to block the release of hydrochloric acid in the stomach?

Histamine-2 receptor antagonist

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

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.

A female client has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?

"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."

When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?

Alopecia

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:

Headache

The health care provider has prescribed ranitidine for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client?

Headache

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 client is taking cimetidine (Tagamet) for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?

Hepatic disease