Chapter 37 Drug Therapy for Peptic Ulcer Disease and Hyperacidity
The nurse is caring for a client who is receiving antacids to relieve GI discomfort. What nursing action is most appropriate? · Administer the antacid 1 hour before or 2 hours after other oral medications. · Limit fluid intake to decrease dilution of the medication in the stomach. · Administer this drug with other drugs or food to prolong therapeutic effects. · Have the client swallow the antacid whole and do not crush or chew the tablet.
Administer the antacid 1 hour before or 2 hours after other oral medications. Explanation: A client taking antacids should be advised to take the antacid 1 hour before or 2 hours after other oral medications. These tablets are often chewed to increase effectiveness. Limiting fluid intake can result in rebound fluid retention so that clients should be encouraged to maintain hydration. It is not necessary to take an antacid with other drugs nor with food.
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? · "It is important that I take the drug after each meal." · "I should crush the medication and mix it into apple sauce." · "I'll have to stop using antacids." · "I need to swallow the drug whole."
"I need to swallow the drug whole." Explanation: Omeprazole, a proton pump inhibitor, must be swallowed whole; it should not be cut, crushed or chewed. The drug should be taken approximately an hour before a meal, not after a meal. Concomitant use of antacids is common, though the health care provider may instruct the client to take the two medications at different times during the day.
The health care provider 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." · "You will take it for 5 days, then skip 5 days, then take it for another 5 days and you will be done with it." · "You will need to take this medication for the rest of your life." · "You must take this medication for the full 10 days."
"You will need to take this medication for 4 to 8 weeks to ensure healing has occurred." Explanation: Sucralfate must be taken for 4 to 8 weeks to ensure healing of the ulcer has occurred.
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs? · Hypertension · Seizures · Gynecomastia · Hypoxia
Gynecomastia Explanation: Cimetidine is more likely to cause gynecomastia and mental confusion than other H2RAs.
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic? · Omeprazole · Sucralfate · Magaldrate · Cimetidine
Omeprazole Explanation: Omeprazole is a proton pump inhibitor which is used as part of combination therapy to treat H. pylori infections. Magaldrate is an antacid that is used to relieve GI hyperacidity. Sucralfate is a GI protectant that is used as short-term treatment of duodenal ulcers. Cimetidine is a H-2 receptor antagonist used to treat duodenal and benign gastric ulcers.
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? · Rabeprazole · Dexlansoprazole · Pantoprazole · Omeprazole
Omeprazole Explanation: Omeprazole is available over the counter; pantoprazole, rabeprazole, and dexlansoprazole are prescription medications.
A client diagnosed with an 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. · Two different microbes are involved, requiring two different antimicrobials. · One antimicrobial tends to alter the action of the adjunct medications. · A single antimicrobial is generally not strong enough to eradicate the infectio
Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms. Explanation: Effective treatment of an H. pylori-associated ulcer involves two antimicrobials—including amoxicillin, clarithromycin, metronidazole, or tetracycline—to reduce the risk of resistance. None of the other options present accurate information regarding the basis for treatment.
An older adult client has been on long-term proton pump inhibitor (PPI) therapy. The nurse practitioner should focus on what assessment related to adverse effects? · bone density · dental health · integumentary system · joint mobility
bone density Explanation: Long-term use of PPIs is associated with increased risk of hip fractures in people older than 50 years of age; the risk of fractures increases the longer the medications are taken and is greater in people who take higher dosages of PPIs. Bone density assessment may thus be warranted. None of the other options are associated with this class of medications.
The client will receive cimetidine 800 mg PO at bedtime. Prior to administration, the nurse should inform the client that common side effects related to this medication include: · headache. · anxiety. · visual disturbances. · tremors.
headache. Explanation: Headache, dizziness, somnolence, and mental confusion may occur with H2 antagonists.
A client is prescribed cimetidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has: · diabetes mellitus. · pulmonary disease. · migraine headaches. · renal disease.
renal disease. Explanation: H2RAs must be used with caution in clients with renal disease. Since these drugs are eliminated through the kidneys, dosages are reduced to avoid adverse effects.
A female client has GERD and is taking cimetidine. She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse? · "Sure, you may take an antacid with cimetidine." · "Yes, but be sure to wait at least 2 hours to take the antacid after you take the cimetidine." · "I wouldn't advise it. You may experience severe constipation · "No, the two drugs will work against each other.
Yes, but be sure to wait at least 2 hours to take the antacid after you take the cimetidine." Explanation: If both cimetidine and antacids are prescribed, give them at least 2 hours apart to prevent decreased absorption of cimetidine. The nurse should advise the client to wait at least 2 hours between doses and to take the antacid after the cimetidine. The other three statements are not true.
The health care provider 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 the rest of your life." · "You must take this medication for the full 10 days." · "You will need to take this medication for 4 to 8 weeks to ensure healing has occurred." · "You will take it for 5 days, then skip 5 days, then take it for another 5 days and you will be done with it."
You will need to take this medication for 4 to 8 weeks to ensure healing has occurred." Explanation: Sucralfate must be taken for 4 to 8 weeks to ensure healing of the ulcer has occurred.
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? · exerting an antibiotic effect · inhibiting acid secretion · healing damaged cells · increasing mucus secretion
inhibiting acid secretion Explanation: Lansoprazole is a proton pump inhibitor. Drugs in this class (sometimes known as gastric acid pump inhibitors) suppress gastric acid secretion.
Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect? · Hypotension · Macular rash and cough · Diarrhea · Drug-drug interactions
Drug-drug interactions Explanation: Ranitidine, which is longer acting and more potent than cimetidine, is not associated with the antiandrogenic 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 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? · the connection between smoking and chronic pain · the importance of taking prescribed medication until symptoms subside · smoking effects on the healing of ulcers · general health dangers research has proven to be associated with smoking
smoking effects on the healing of ulcers Explanation: Duodenal ulcers are associated with cigarette smoking. The ulcers of smokers heal more slowly and recur more rapidly than do those of nonsmokers. The treatment is focused on healing, and smoking will impede the achievement of that goal. Acute not chronic pain is the focus of the client's concerns. Medication should be taken until discontinued by the health care provider. While a discussion concerning the health dangers associated with smoking is appropriate, such information is not related to the client's current health issue.
A nurse is teaching a client about prescribed lansoprazole. The nurse instructs the client to take the drug at which time? · 2 hours after a meal · first thing on arising · 1 hour before eating · at bedtime
1 hour before eating Explanation: Proton pump inhibitors such as lansoprazole should be swallowed whole at least 1 hour before eating. The proton pump inhibitors suppress gastric acid secretion by blocking the final step in the production of gastric acid by the gastric mucosa. After meals will inhibit suppression of gastric acid. On rising and at bedtime are not optimal times to take lansoprazole
The nurse is preparing for discharge a client who has a prescription for sucralfate. When does the nurse instruct the client to take the medication? · 1 hour before or 2 hours after meals and at bedtime · After each meal, no more than 15 minutes after finishing · With an antacid before breakfast · With meals
1 hour before or 2 hours after meals and at bedtime Explanation: Administer drug on an empty stomach, 1 hour before or 2 hours after meals and at bedtime to ensure therapeutic effectiveness of the drug. Administer antacids, if ordered, between doses of sucralfate and not within 30 minutes of taking the drug.
The nurse is preparing for discharge a client who has a prescription for sucralfate. When does the nurse instruct the client to take the medication? · After each meal, no more than 15 minutes after finishing · With an antacid before breakfast · 1 hour before or 2 hours after meals and at bedtime · With meals
1 hour before or 2 hours after meals and at bedtime Explanation: Administer drug on an empty stomach, 1 hour before or 2 hours after meals and at bedtime to ensure therapeutic effectiveness of the drug. Administer antacids, if ordered, between doses of sucralfate and not within 30 minutes of taking the drug.
A client has been prescribed 200 micrograms of misoprostol to be taken 4 times a day orally for the prevention of gastric ulcers. The drug is available in 100 microgram tablets. How many tablets should the nurse administer to the client each time? · 2 tablets · 1 tablet · Half a tablet · 3 tablets
2 tablets The required dosage is 200 mcg. Available tablets contain 100 mcg of the drug. Therefore, the nurse should administer two tablets each time to the client.
Occasionally, a bismuth preparation is added to the treatment regimen for duodenal ulcers. What are bismuth's effects against H. pylori organisms. · Inhibits pepsin activity · Accumulates in ulcer craters · Antibacterial effects · All of these
All of these Explanation: A bismuth preparation is added to some regimens. Bismuth exerts antibacterial effects against H. pylori. It also increases secretion of mucus and bicarbonate, inhibits pepsin activity, and accumulates in ulcer craters.
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform? · Inform the PHCP if the patient exhibits tardive dyskinesia symptoms. · Closely monitor the patient for confusion and dizziness. · Monitor the patient for reports of pain or sour taste. · Monitor the patient for concentrated urine and restlessness.
Closely monitor the patient for confusion and dizziness. Explanation: The nurse should closely monitor the elderly patient who has been administered cimetidine 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.
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform? · Inform the PHCP if the patient exhibits tardive dyskinesia symptoms. · Monitor the patient for concentrated urine and restlessness. · Monitor the patient for reports of pain or sour taste. · Closely monitor the patient for confusion and dizziness.
Closely monitor the patient for confusion and dizziness. Explanation: The nurse should closely monitor the elderly patient who has been administered cimetidine 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.
Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect? · Dextroamphetamine · Digoxin · Simvastatin · Quinidin
Digoxin Explanation: Administering an antacid to a client taking digoxin will decrease the absorption of digoxin and result in a decreased digoxin effect. Quinidine, dextroamphetamine, and simvastatin are not affected by the use of antacids.
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? · Anxiety · Visual disturbances · Tremor · Headache
Headache Explanation: Adverse effects with H2RAs such as ranitidine are typically uncommon and mild with the usual doses and duration of treatment. However, effects can include diarrhea or constipation, headache, dizziness, muscle aches, and fatigue.
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 · venous thromboembolism · fluid volume excess · rebound gastroesophageal reflux disease (GERD)
Hemorrhage Explanation: Omeprazole increases blood levels of the anticoagulant warfarin, thus creating a risk for bleeding. Such an elevation in warfarin would not increase the risk for the development of any of the other options.
A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client? · Peptic ulcer disease · Hypercalcemia · Hip fractures · Liver cancer
Hip fractures Explanation: Proton pump inhibitors (PPIs) are known to decrease calcium absorption which can lead to hypocalcemia. This in turn affects the bones leading to osteoporosis. For clients over the age of 50, the long term use of PPIs (more than one year) will increase the risk for hip fractures due to the affect on the bones. PPTs can be used to treat gastric ulcers. It is not known to cause liver cancer.
A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client? · Peptic ulcer disease · Liver cancer · Hypercalcemia · Hip fractures
Hip fractures Explanation: Proton pump inhibitors (PPIs) are known to decrease calcium absorption which can lead to hypocalcemia. This in turn affects the bones leading to osteoporosis. For clients over the age of 50, the long term use of PPIs (more than one year) will increase the risk for hip fractures due to the affect on the bones. PPTs can be used to treat gastric ulcers. It is not known to cause liver cancer.
Why are histamine2 receptor antagonists preferred in the treatment of upper gastrointestinal (GI) disorders over traditional histamine1 receptor antagonists? · Histamine1 receptor antagonists are ineffective in the presence of prescribed antacids. · Histamine1 receptor antagonists interfere with prescribed proton pump inhibitors (PPIs). · Histamine1 receptor antagonists are costlier than histamine2 receptor antagonists. · Histamine1 receptor antagonists do not block histamine effects on gastric acid production.
Histamine1 receptor antagonists do not block histamine effects on gastric acid production. Explanation: Traditional antihistamines or histamine1 receptor antagonists prevent or reduce other effects of histamine but do not block histamine effects on gastric acid production. Histamine2 receptor antagonists inhibit both basal secretion of gastric acid and the secretion stimulated by histamine, acetylcholine, and gastrin.
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? · "It is important that I take the drug after each meal." · "I'll have to stop using antacids." · "I should crush the medication and mix it into apple sauce." · "I need to swallow the drug whole."
I need to swallow the drug whole." Explanation: Omeprazole, a proton pump inhibitor, must be swallowed whole; it should not be cut, crushed or chewed. The drug should be taken approximately an hour before a meal, not after a meal. Concomitant use of antacids is common, though the health care provider may instruct the client to take the two medications at different times during the da
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis? · Abdominal pain · Increased fracture risk · Diarrhea · Headache
Increased fracture risk Explanation: An increase in fractures of the hip, wrist, and spine have been seen in clients taking high doses of PPIs and undergoing treatment of osteoporosis with bisphosphonates.
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis? · Abdominal pain · Increased fracture risk · Headache · Diarrhea
Increased fracture risk Explanation: An increase in fractures of the hip, wrist, and spine have been seen in clients taking high doses of PPIs and undergoing treatment of osteoporosis with bisphosphonates.
A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the mid-epigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease? · Decreased stomach acid secretion · Overconsumption of spicy foods · Excessive worrying · Infection with H. pylori
Infection with H. pylori Explanation: Peptic ulcers can result from cell destruction caused by Helicobacter pylori infection, gastric acid, pepsin, and ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs).
A client presents to the walk-in clinic reporting vomiting and burning in the mid-epigastria. The nurse suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the provider is likely to order a diagnostic test to detect the possible presence of what? · Gastric irritation caused by NSAIDs. · Decreased stomach acid secretion. · Infection with Helicobacter pylori · Upper gastrointestinal bleeding
Infection with Helicobacter pylori Explanation: Peptic ulcers may result from increased acid production, decrease in the protective mucous lining of the stomach, infection with Helicobacter pylori bacteria, or a combination of these. Peptic ulcers do not result from decreased acid secretion. While gastric irritation can be caused by NSAIDs, gastric irritation can result from many different causes so this would not be specifically assessed for unless the client was found to use NSAIDs frequently, which is not indicated by the question.
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? · exerting an antibiotic effect · healing damaged cells · inhibiting acid secretion · increasing mucus secretion
Inhibiting acid secretion Explanation: Lansoprazole is a proton pump inhibitor. Drugs in this class (sometimes known as gastric acid pump inhibitors) suppress gastric acid secretion.
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: · result in hypotension. · cause macular rash and cough. · interfere with the metabolism of other drugs. · cause diarrhea.
Interfere with the metabolism of other drugs. Explanation: 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.
The nurse is caring for a client with cystic fibrosis who has not been taking his prescribed pancreatic enzymes recently. What is the primary assessment finding the nurse will see as a result of this nonadherence? · Abdominal pain · Constipation · Diarrhea · Malnutrition
Malnutrition Explanation: Clients with cystic fibrosis take pancreatic enzymes to promote digestion and absorption of nutrients, so failure to take the drug would result in malnutrition and weight loss. Constipation, diarrhea, and abdominal pain would not be in the primary assessment finding.
A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication? · Sucralfate · H2RAs · Antacids · Proton pump inhibitors
Proton pump inhibitors Explanation: The treatment of choice for Helicobacter pylori infection is a PPI and clarithromycin plus either amoxicillin or metronidazole.
A female client presents to the health care provider'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? · Hypocalcemia · Hyperactive gastric mucosa · Rebound acidity · Gastric reflux
Rebound acidity Explanation: Calcium antacids have high neutralizing capacity and rapid onset. They may cause rebound acidity and hypercalcemia
The nurse administers ranitidine cautiously to clients with evidence of what condition? · Pulmonary disease · Migraine headaches · Diabetes mellitus · Renal disease
Renal disease Explanation: All histamine-2 antagonists are eliminated through the kidneys; dosages need to be reduced in clients with renal impairment. No caution is necessary with ranitidine therapy in people with diabetes, pulmonary disease, or migraine headaches.
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. · Is 15 pounds over ideal weight · Has a stressful job as a air traffic controller. · Eats spicy food at least twice a week.
Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily. Explanation: The leading cause of peptic ulcers in the United States is the use of NSAIDs. NSAIDS inhibit cyclooxygenase receptors, and one of the functions of these sites is the production of the mucous lining in the stomach. While the other situations may contribute to GI distress, NSAID used in primary risk factor for this client.
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? · No antacids, because they are contraindicated in the elderly · Smaller than the average prescribed dose · The same as the average prescribed dose · Larger than the average prescribed dose
Smaller than the average prescribed dose Explanation: Smaller doses of antacids may be effective in older adults, because they usually secrete less gastric acid than younger adults do.
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 · No antacids, because they are contraindicated in the elderly · The same as the average prescribed dose · Larger than the average prescribed dose
Smaller than the average prescribed dose Explanation: Smaller doses of antacids may be effective in older adults, because they usually secrete less gastric acid than younger adults do.
How does histamine release contribute to ulcer formation? · initiates pepsin synthesis · destroys parietal cells · stimulates denaturing of gastrin · stimulates gastric acid secretion
Stimulates gastric acid secretion Explanation: Vagal stimulation causes release of histamine from cells in the gastric mucosa. The histamine then acts on receptors located on the parietal cells to increase production of hydrochloric acid, which is a factor in stomach ulcer formation. Histamine is not associated with either pepsin or gastrin, and it does not destroy the parietal cells.
Client teaching should include what instruction about antacids? · Take antacid 1 hour before other medications. · Take antacid with other medications. · Take antacid 1/2 hour after other medications. · Take antacid only at bedtime.
Take antacid 1 hour before other medications. Explanation: Administer the drug apart from any other oral medications approximately 1 hour before or 2 hours after to ensure adequate absorption of the other 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? · "Both medications should be taken together on an empty stomach." · "Eat breakfast, then take the sucralfate, and then an hour later take the ciprofloxacin." · "Take the sucralfate 30 minutes before the ciprofloxacin." · "Take the ciprofloxacin 2 hours before the sucralfate."
Take the ciprofloxacin 2 hours before the sucralfate." Explanation: It is important for the client to take the ciprofloxacin 2 hours prior to taking sucralfate to ensure full absorption of the ciprofloxacin.
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? · Disease processes · Client age · Signs and symptoms · The pH of the stomach contents
The pH of the stomach contents Explanation: When a client has a nasogastric tube in place, antacid dosage may be titrated by aspirating stomach contents, determining pH, and then basing the dose on the pH. (Most gastric acid is neutralized and most pepsin activity is eliminated at a pH greater than 3.5.)
A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? · H2 receptors in the upper GI tract outnumber H1 receptors by a factor of 2:1. · H2RAs have a longer duration of action and fewer adverse effects than H1RAs. · H2RAs may be administered orally and in an outpatient environment but H1RAs require intravenous administration. · The parietal cells of the stomach have H2 receptors but not H1 receptors.
The parietal cells of the stomach have H2 receptors but not H1 receptors. Explanation: H2RAs block the effect of histamine at H2 receptors, particularly those in the parietal cells of the stomach. Antihistamines that block histamine-1 (H1) receptors, the most frequent site of action for antihistamines, do not affect H2 receptor sites, and H2RAs do not block H1 sites. H1 sites are not prevalent in the GI tract. Both classes of drugs may be administered orally
The nurse caring for a client with cystic fibrosis administers pancreatic enzymes on what schedule? · One hour after meals and snacks · With meals and snacks · Two hours before meals and snacks · In the morning and before be
With meals and snacks Explanation: To be sure the pancreatic enzymes are in place when food enters the small bowel, the enzymes are administered with every meal and snack. Administering them before or after meals would render them ineffective.
Which drugs treat heartburn by neutralizing the acidity of the stomach by combining with hydrochloric acid (HCl) and increasing the pH of the stomach acid? · famotidine · aluminum hydroxide · omeprazole · metoclopramide
aluminum hydroxide Explanation: Aluminum hydroxide neutralizes or reduces the acidity of the stomach and duodenal contents by combining with hydrochloric acid and increasing the pH of the stomach. Omeprazole is a proton pump inhibitor that suppresses gastric acid secretion by inhibition of the hydrogen-potassium adenosine triphosphatase (ATPase) enzyme system of the gastric parietal cells. Famotidine is a histamine-2 receptor antagonist that inhibits the action of histamine at H2 receptor cells of the stomach, which then reduces the secretion of gastric acid. Metoclopramide is used to treat delayed gastric emptying and emesis—that is, it increases the motility of the upper GI tract without increasing the production of secretions.
The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered: · with meals. · with an antacid. · immediately after each meal. · an hour before meals.
an hour before meals. Explanation: Sucralfate, a gastrointestinal protectant, must be given time to act before significant gastric activity, and it requires an acidic environment to be effective. For these reasons, sucralfate should be given an hour before meals and antacids.
Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in clients who: · have diabetes. · have arthritis. · are pregnant. · are hypertensive.
are pregnant. Explanation: Misoprostol is contraindicated during pregnancy because it may cause abortion, premature birth, or birth defects. It is also contraindicated in women of childbearing potential who are not using effective contraception
