Pharm 2. Chapter 57

The physician has prescribed ranitidine for a patient in your unit. Prior to administering the drug for the first time, which of the following adverse effects should you mention to the patient?

Headache

A nurse is teaching a 47-year-old client about omeprazole, which the physician has 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."

Which statement by a patient receiving pancrelipase indicates that the patient has understood his instructions?

"I should take the drug with meals and snacks."

A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following 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."

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

Amoxicillin

A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame?

30 minutes

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

Alopecia

The nurse is teaching a 31-year-old patient about lansoprazole, which the physician has prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease?

By inhibiting acid secretion

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 patient taking aluminum and calcium containing antacids about which of the following adverse effects? (Choose one)

Constipation

The nurse is caring for a patient who is prescribed esomeprazole magnesium (Nexium) for the treatment of diarrhea. The patient informs the nurse that he is also taking sucralfate for GI distress. What effects of interaction between the two drugs should the nurse inform the patient about?

Decreased absorption of the esomeprazole magnesium

A female client self-administers magnesium antacids. She presents to the office with symptoms of dizziness and weakness. The nurse knows that these symptoms are secondary to what common adverse effect of magnesium antacids?

Diarrhea

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

False

A male patient is taking cimetidine (Tagamet). Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?

Gynecomastia

Which of the following adverse effects is more likely to be caused by cimetidine than by other H2RAs?

Gynecomastia

A patient is taking cimetidine (Tagamet) for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to patients with which of the following conditions?

Hepatic disease

Carter, age 2, is diagnosed with cystic fibrosis; the physician places him on pancrelipase. What would be the most appropriate diagnosis for Carter related to his medication regimen?

Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes

Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?

Increased fracture risk

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?

Omeprazole

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

Peptic ulcer disease

A female client presents to the physician'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?

Rebound acidity

The patient has Maalox ordered for administration before meals. Which of the following conditions is contraindicated with the administration of Maalox?

Renal dysfunction

A patient 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 which of the following?

Serum phosphate level

A 75-year-old client is treating his ulcer with antacids. Based on the client's age, the nurse expects the physician to prescribe a dose of antacid that compares with the average prescribed dose in what way?

Smaller than the average prescribed dose

A patient reports chronic abdominal pain. The patient has a 40-pack year history but reports a decrease in smoking to approximately ½ pack/day. The physician, after thorough assessment and evaluation and labs, prescribes a treatment regimen for duodenal ulcer. What important teaching would the nurse include in relation to treatment?

Smoking's effects on healing

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

In treating Helicobacter pylori infection, a physician prescribes two antimicrobials. Why two?

Two 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.

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

an hour before meals.

Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in patients who

are pregnant.

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.

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

interfere with the metabolism of other drugs.

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.

Which of the following reduce the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate (ATPase) enzyme system of the gastric parietal cells? (Select all that apply)

• Esomeprazole (Nexium) • Lansoprazole (Prevacid)

The nurse should administer which of the following medications cautiously to clients with vitamin B12 deficiency as the prolonged use of these drugs decreases the body's ability to absorb vitamin B12? Select all that apply:

• Rabeprazole (Aciphex) • Pantoprazole (Protonix)

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

Ranitidine is a histamine2 receptor antagonist (H2RA) prescribed for treatment of peptic ulcer disease and gastric reflux. Dosage of ranitidine must be reduced in patients with what condition?

Renal disease