ch 40: upper GI
The nurse practitioner instructs the client to use over-the-counter ranitidine instead of cimetidine. What risk is decreased when using ranitidine rather than cimetidine?
drug-to-drug interaction
Ranitidine common side effects
headache
a client diagnosed with H. Pylori-associated ulcer has been prescribed treatment that includes two antimicrobials. what does the nurse identify as the reason for using multiple antimicrobials?
two antimicrobials help prevent the emergence of drug-resistant H.pylori organisms.
older client prescribed omeprazole to treat GERD. what info should the nurse provide when asked why the client isn't taking famotidine?
"PPI, like omeprazole, produce fewer adverse effects among the the older population"
omeprazole prescribed as part of a regimen for H. pylori. what suggests client's understanding of use of the drug?
"i need to swallow the drug whole"
which med will decrease absorption with the administration of an antacid?
digoxin
client receiving antacids to relieve GI discomfort. what nursing action is most important?
administer antacid 1 hour before or 2 hours after other oral medications
Misoprotol protects gastric mucosa from erosion and ulceration, contraindicated in clients who:
are pregnant
client prescribed chlorpromazine hydrochloride for nausea. nurse should assess what before drug is administered?
assess signs of fluid and electrolyte imbalances
An antacid has been added to the treatment regimen for a client on multiple medications. When is the best time for the nurse to administer the antacid?
at bedtime
older client taking calcium-based antacid. when teaching the nurse should include instructions on preventing what?
constipation
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 client with hep c experiences symptoms of gastroesophageal relfux. what H2 antagonist would be most appropriate?
nizatidine
client diagnosed with peptic ulcer due to H. pylori. nurse anticipates administering which agent in conjunction with an antibiotic?
omeprazole
A client taking ginger for motion sickness reports heartburn. What is the nurse's best response?
"adverse effects are rare, but heartburn has been reported by some individuals taking ginger"
female client with GERD takes ranitidine. with continuous gastric discomfort, she asks to take an antacid. what's the appropriate response?
"yes, but be sure to wait at least 2 hours to take antacid after the ranitidine"
A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?
1 to 2 weeks
The client prescribed nizatidine chooses to take the medication once a day at bedtime. What dosage will the nurse administer?
150-300 mg
which client is at risk for development of an acute ulcer? select all that apply
2nd degree burns over 50% of the body mechanical ventilator for 5 days experienced a recent stroke diagnosed with jaundice
The nurse is caring for four clients. Which client would benefit most from misoprostol, a synthetic prostaglandin E analog?
83 year old male the rheumatoid arthritis
rationale adding bismuth to a client's medication regimen with peptic ulcer disease complicated by H. pylori
provides antibacterial effects
the nurse administers ranitidine cautiously to clients with evidence of what condition?
renal disease
blocks release of hydrochloric acid in the stomach
Histamine-2 receptor antagonist (h2 blockers)
antacids contraindicated in clients with heart failure
sodium bicarbonate
older client on PPI. the nurse focuses on what assessment related to adverse effects?
bone density
Magnesium-based antacid before meals, withhold med if client exhibits what?
renal dysfunction
A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency?
by aspirating stomach contents and measuring pH
a client is prescribed rabeprazole. it'll be important for the nurse to assess the client's drug history to determine if the client is taking which drug?
digoxin
While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client?
hemorrhage
a client is taking cimetidine for increased gastric pain and hypersecretion. nurses should use caution administering cimetidine to those with?
hepatic disease
adverse reaction of PPI specific to menopausal women with osteoporosis
increased fracture risk
client reports vomiting and burning sensation in mid-epigastric region. suspected ulcer disease, what is a potential cause?
infection with H. pylori
The nurse should be aware that ranitidine achieves a therapeutic effect by which means?
inhibiting the secretion of gastric acid
Suppression of hydrochloric acid secretion in lumen of the stomach
protein pump inhibitors
