Gastrointestinal questions

A nurse is caring for four clients who have peptic ulcer disease. The nurse should recognize misoprostol is contraindicated for what client?

A client who is pregnant (category X)

A nurse is teaching a client who is taking sucralfate PO for metic ulcer disease has a new Rx for phenytoin to control seizures. Which of the instructions should include?

Allow a 2 hour interval between these medications.

A patient is about to start taking alosetron (Lotronex) to treat diarrhea. You should instruct the patient to watch for and report which of the following adverse effects of this drug?

Alosetron, a serotonin 5-HT3 receptor antagonist, can cause constipation that can lead to impaction and perforation. Monitor bowel patterns and stop the drug for constipation. Alosetron is unlikely to cause difficulty swallowing. Psyllium, a fiber supplement, can cause esophageal obstruction and difficulty swallowing. Instruct patients to take psyllium with 8 oz of water. Alosetron is unlikely to cause blurred vision. Dimenhydrinate, an antihistamine, can cause blurred vision. Alosetron is unlikely to cause confusion, but it can cause anxiety.

A patient is about to start taking omeprazole (Prilosec) to treat a duodenal ulcer. Which of the following instructions should you include when talking with the patient about taking this drug?

Consume adequate vitamin D and calcium. Omeprazole, a proton pump inhibitor, can cause bone loss with long-term use, so instruct patients to increase weight-bearing activities and consume sufficient amounts of calcium and vitamin D to help prevent osteoporosis. Food can reduce the absorption of omeprazole, so instruct patients to take this drug 1 hr before a meal. Antacids are unlikely to interfere with the absorption of omeprazole and might help reduce gastric distress. Grapefruit juice interacts with many different drugs, including cyclosporine (Sandimmune), midazolam (Versed), and lovastatin (Mevacor), but it is unlikely to affect the metabolism of omeprazole.

A patient is about to start taking aluminum hydroxide (Amphojel) to reduce gastric acid. Which of the following instructions should you include when talking with the patient about taking this drug?

Instruct patients to chew aluminum hydroxide tablets thoroughly (not swallow them whole) and follow the tablets or the liquid suspension with water to make sure it gets to the stomach promptly. This type of antacid can cause constipation, so make sure patients increase fluid and fiber intake and exercise more. Patients can take this drug up to four times a day.

A patient is starting therapy with misoprostol (Cytotec) to prevent a gastric ulcer. Since she is a 30-year-old woman, you should give her which of the following instructions? (Select all that apply.)

Misoprostol, a prostaglandin E analog, is a drug in pregnancy risk category X. It can induce uterine contractions and abort a pregnancy. Instruct women of childbearing age to confirm that they are not pregnant before taking this drug and to use effective contraception throughout drug therapy. Provide oral and written information about the risks of taking misoprostol during pregnancy. This drug can cause dysmenorrhea, so be sure to monitor for excessive menstrual pain or bleeding. Patients take this drug four times a day, with meals and again at bedtime.

You are about to administer ondansetron (Zofran) to a patient to prevent anesthesia-induced nausea and vomiting. You prepare to monitor the patient for which of the following adverse effects of this drug?

Ondansetron, a serotonin antagonist, can cause dizziness, lightheadedness, and sedation. It is unlikely to cause bronchospasm, hypertension, or anxiety. However, it can cause a headache, so recommend an over-the-counter analgesic for headache pain. This drug can also cause tachycardia and angina in patients who have a history of coronary artery disease.

A patient is starting therapy with psyllium (Metamucil). You explain to the patient that psyllium will have which of the following therapeutic effects? (Select all that apply.)

Psyllium, a bulk laxative, treats constipation and reduces diarrhea by increasing bulk to create soft, formed stools. It helps patients who have diverticulosis, irritable bowel syndrome, and fecal ostomies. Aluminum hydroxide (Amphojel), an antacid, increases gastric pH. Omeprazole (Prilosec), a proton pump inhibitor, decreases the secretion of gastric acid. Ondansetron (Zofran), a serotonin antagonist, helps relieve nausea and vomiting

A nurse is providing a client who has peptic ulcer disease with instructions about managing his condition. Which of the following instructions should the nurse include?

Seek measures to reduce stress and avoid smoking

A patient is about to start taking sulfasalazine (Azulfidine) to treat inflammatory bowel disease. You should instruct the patient to watch for and report which of the following adverse effects of this drug?

Sulfasalazine, an anti-inflammatory drug, can cause blood dyscrasias, such as agranulocytosis and hemolytic and macrocytic anemia. Instruct patients to avoid crowds and people who have communicable infections and to report sore throat, fever, or other indications of infection. Sulfasalazine can cause arthralgia, so instruct patients to report joint pain. Sulfasalazine is more likely to cause diarrhea than constipation. It is unlikely to cause dry mouth. Loperamide (Imodium) is an example of an antidiarrheal drug that causes dry mouth.

A nurse is providing instructions to a client who has a prescription for amoxicillin nd clarithromycin to treat a peptic ulcer. Which of the following information should the nurse include in the teaching?

Take these medications with food.

A nurse is teaching a client who has a new Rx for omeprazole for management of heartburn. Which of the following information should the nurse include in the teaching?

This medication decreases the production of gastric acid.

You are about to administer diphenoxylate plus atropine (Lomotil) to a patient to reduce diarrhea. Which of the following drugs should you have available to treat an overdose of this drug combination?

With high doses, diphenoxylate plus atropine, an opioid agonist antidiarrheal drug combination, can cause CNS effects similar to morphine. Have naloxone ready in case of drug overdose. Monitor respirations and level of sedation. Mucomyst treats acetaminophen (Tylenol) overdose. Flumazenil reverses the effects of benzodiazepines. Diphenhydramine reduces extrapyramidal symptoms resulting from metoclopramide (Reglan) use.