Ch. 50, 51, 52 Gastrointestinal Drugs MC

pepsinogen

converted to pepsin by hydrochloric acid

The nurse is preparing to administer the first dose of misoprostol for a patient who has been diagnosed with a gastric ulcer. What condition would be a contraindication to this medication? a. hypothyroidism b. Type 2 diabetes mellitus c. pregnancy d. hypertension

c. pregnancy

proton pump inhibitors

drugs that block all acid secretion in the stomach

antiflatulents

drugs used to relieve the many painful symptoms associated with gas

normal pH of stomach

1-4

diarrhea

adverse effect of magnesium-containing antacids

cimetidine indication

GERD, peptic ulcer disease, erosive esophagitis, upper GI bleeding, stress ulcer prophylaxis

sodium bicarbonate

a highly soluble antacid form with a quick onset but short duration of action

simethicone (Gas-X)

antiflatulent

cautious use of antacids

1. heart failure 2. hypertension 3. sodium restrictions

Administration of histamine₂ blockers and antacids should be separated by at least how long? - 30 minutes - 1 hour - 2 hours - 4 hours

- 1 hour

When should antacids be taken in relation to other medications? - 1-2 hours before medication - With all medications - 1-2 hours after medications - 30 minutes after medications

- 1-2 hours after medications

Which antacid has the potential to cause kidney stones? - Sodium bicarbonate - Aluminum hydroxide - Magnesium hydroxide - Calcium carbonate

- Calcium carbonate

Antacids promote the integrity of the abdominal wall by neutralizing which acid? - Lipase - Gastric - Amylase - Lactase

- Gastric

If taken in large dose, PPIs can be combined with antibiotics to treat which gastric ailment? - H. Pylori - Hypersecretion - Hypomagnesemia - Occult blood in the stool

- H. Pylori

The nurse has an order to administer a PPI to a patient who has already eaten breakfast. What is the nurse's next step? - Consult with the charge nurse. - Administer the mediation anyway. - The nurse needs to call the health care provider. - Hold the medication and educate the patient that this medication needs to be taken on an empty stomach.

- Hold the medication and educate the patient that this medication needs to be taken on an empty stomach.

Which is an adverse effect of long-term PPI use? - Bleeding - Petechiae - Gastric ulcers - Hypomagnesemia

- Hypomagnesemia

Why is drinking 2-4 ounces of water recommended after taking a liquid antacid? - It facilitates systemic absorption - Helps with nausea associated with antacids - Helps with diarrhea associated with antacids - Increases gastric emptying time

- Increases gastric emptying time

Histamine₂ blockers should be administered at which time to decrease food-induced acid secretion? Select all that apply. - Just before meals - During meals - Just after meals - Just after waking - At bedtime

- Just before meals - At bedtime

The mode of action of histamine₂ blockers includes inhibition of gastric acid secretion by blocking histamine in which type of cell? - Stem cell - Chief cell - Acid cell - Parietal cell

- Parietal cell

Antacids are primarily used to treat which condition? - Gastroesophageal reflux disease - Irritable bowel syndrome - Peptic ulcer disease - Pancreatitis

- Peptic ulcer disease

Which condition can result from long-term high doses of PPIs? - HIV - Seizures - Pneumonia - Acute coronary syndrome

- Pneumonia

Which antacid is unsuitable for treating peptic ulcers? - Magnesium hydroxide - Aluminum hydroxide - Sodium bicarbonate - Calcium carbonate

- Sodium bicarbonate

When a patient is taking self-prescribed antacids, at what point should the patient seek medical advice? - One month - Six weeks - Two weeks - Five days

- Two weeks

The nurse determines the client needs further instruction on cimetidine is which statements were made? (Select all that apply) 1. "I will take the cimetidine with my meals." 2. "I'll know the medication is working if my diarrhea stops." 3. "My episodes of heartburn will decrease if the medication is effective." 4. "Taking the cimetidine with an antacid will increase its effectiveness." 5. "I will notify my health care provider if I become depressed or anxious." 6. "Some of my blood levels will need to be monitored closely since I also take warfarin for atrial fibrillation."

1. "I will take the cimetidine with my meals." 2. "I'll know the medication is working if my diarrhea stops." 4. "Taking the cimetidine with an antacid will increase its effectiveness." (cimetidine = H2-receptor antagonist) NCLEX

sucralfate (Carafate)

1. stimulates secretion of mucous and bicarb 2. 4 x per day dosing (transient effects) 3. high non-compliance 4. must be taken on empty stomach

A client who uses NSAIDs has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which finding is noted? 1. resolved diarrhea 2. relief of epigastric pain 3. decreased platelet count 4. decreased WBC count

2. relief of epigastric pain (misoprostol is used for treatment of NSAID-induced ulcers) NCLEX

A client has been taking omeprozole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? 1. diarrhea 2. heartburn 3. flatulence 4. constipation

2. heartburn (omeprazole = PPI) NCLEX

7. The order reads: "Give cimetidine (Tagamet) 300 mg in 100 mL normal saline IVPB tid and at bedtime. Infuse over 30 minutes." The infusion pump can only be programmed to deliver over 60 minutes (mL per hour). The nurse will set the pump to deliver how many mL/hour for each IVPB dose?

200 mL/hr

An older adult client recently has been taking cimetidine. The nurse monitors the client for which most frequent CNS side effect of this medication? 1. tremors 2. dizziness 3. confusion 4. hallucinations

3. confusion (cimetidine = H2-receptor antagonist) NCLEX

omeprazole works best

30-60 minutes before meals

A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse should schedule the medication for which times? 1. with meals and at bedtime 2. every 6 hrs around the clock 3. one hr after meals and at bedtime 4. one hr before meals and at bedtime

4. one hr before meals and at bedtime NCLEX

best before meals

H2 antagonists and proton pump inhibitors

cimetidine (Tagamet)

H2 receptor blockers - reduce but do not completely abolish acid secretion

1. A patient with a history of decreased renal function tells the nurse, "I have finally found an antacid that gives me great relief!" The nurse checks the antacid's content and finds that the antacid is a combination of aluminum hydroxide and magnesium hydroxide. What is the nurse's priority action at this time? Explain your answer.

The nurse's priority action is to educate the patient about which antacids are safe for patients with decreased renal function. Both calcium-and magnesium-based antacids are more likely to accumulate to toxic levels in patients with renal disease. Therefore, if antacids are used in renal patients, preparations that are only aluminum-based should be chosen because they are generally more easily excreted than other categories of antacid. Sodium-based antacids may cause fluid retention and metabolic changes, so they also must be avoided by patients with renal problems.

2. A patient tells the nurse, "I like taking antacids because they coat my stomach and protect my ulcer." What is the nurse's priority when answering the patient's question?

The priority is to explain to the patient how antacids work and how they are to be used for short-term relief only. Antacids do not coat the stomach. They elevate the gastric pH so that an acidic environment, which could cause more problems for patients with ulcers, does not exist. However, long-term use of antacids may mask symptoms of serious problems, such as gastric ulcers. In addition, overuse of antacids may cause acid rebound. Patients with chronic heartburn problems need to be checked thoroughly for the presence of more serious conditions.

2. The nurse will monitor a client taking an aluminum-containing antacid, such as aluminum hydroxide (Amphojel), for which adverse effect? a. Constipation b. Gastrointestinal (GI) upset c. Fluid retention d. Diarrhea

a Constipation Aluminum-and calcium-containing antacids cause constipation, magnesium-containing antacids cause diarrhea, and sodium-containing antacids cause sodium and fluid retention.

5. A patient who is taking oral tetracycline complains of heartburn and requests an antacid. Which action by the nurse correct? a. Give the tetracycline, but delay the antacid for 1 to 2 hours. b. Give the antacid, but delay the tetracycline for at least 4 hours. c. Administer both medications together. d. Explain that the antacids cannot be given while the patient is taking the tetracycline.

a Give the tetracycline, but delay the antacids for 1 to 2 hours.

1. The nurse will teach clients that antacids are effective in the treatment of hyperacidity based on which mechanism of action? a. Neutralizes gastric acid b. Decreases gastric pH c. Decreases stomach motility d. Decreases duodenal pH

a Neutralizing gastric acid Antacids work by neutralizing gastric acid, which would cause an increase in pH. They do not affect gastric motility.

magnesium-containing antacids

a type of antacid that can cause diarrhea

calcium-containing antacids

a type of antacid that may contribute to the development of kidney stones

6. When the nurse is administering a proton pump inhibitor (PPI), which actions by the nurse are correct? (Select all that apply.) a. Giving the PPI on an empty stomach b. Giving the PPI with meals c. Making sure the patient dose not crush or chew the capsules d. Instructing the patient to open the capsule and chew the contents for best absorption e. Administering the PPI only when the patient complains of heartburn

a, c Give the PPI on an empty stomach, making sure the patient dose not crush or chew the capsules

The nurse is caring for a patient diagnosed with cancer who experiences nausea and vomiting and who is prescribed ondansetron. After administering the medication, the nurse finds that the symptoms persist. What medication will the primary health care provider prescribe for the patient with this condition? a. Dronabinol b. Dolasetron c. Granisetron d. Promethazine

a. Dronabinol

A patient who is taking oral tetracycline complains of heartburn and requests an antacid. Which action by the nurse is correct? a. Give the tetracycline, but delay the antacid for 1 to 2 hours. b. Give the antacid, but delay the tetracycline for at least 4 hours. c. Administer both medications together. d. Explain that the antacid cannot be given while the patient is taking the tetracycline.

a. Give the tetracycline, but delay the antacid for 1 to 2 hours.

When the nurse is administering a proton pump inhibitor (PPI), which actions by the nurse are correct? (select all that apply) a. Giving the PPI on an empty stomach b. Giving the PPI with meals c. Making sure the patient does not crush or chew the capsules. d. Instructing the patient to open the capsule and chew the contents for best absorption. e. Administering the PPI only when the patient complains of heartburn.

a. Giving the PPI on an empty stomach c. Making sure the patient does not crush or chew the capsules.

The nurse is caring for a patient who has cancer and exhibits symptoms of nausea and vomiting. The patient has been prescribed radiation therapy and metoclopramide. What is the most appropriate nursing action in this situation? a. Instruct the patient to avoid taking anticholinergics and opiates. b. Administer dolasetron in the first 24 to 48 hours of radiation therapy. c. Inform the patient that blurred vision is an adverse effect of radiation therapy. d. Instruct the patient to avoid driving and other activities that require mental alertness.

a. Instruct the patient to avoid taking anticholinergics and opiates.

Besides treating nausea and vomiting, what are the uses of antidopaminergic drugs? Select all that apply. a. Treating anxiety b. Treating schizophrenia c. Treating intractable hiccups d. Treating nonproductive cough e. Treating delayed gastric emptying

a. Treating anxiety b. Treating schizophrenia c. Treating intractable hiccups

A nurse is caring for 4 clients who have peptic ulcer disease. The nurse should recognize that misoprostol is contraindicated for which of the following clients? a. a client who is pregnant b. a client who has osteoarthritis c. a client who has a kidney stone d. a client who has a urinary tract infection

a. a client who is pregnant ATI

A nurse is teaching a pt who has a duodenal ulcer and a new prescription for esomeprazole. Which of the following information should the nurse include in the teaching? (Select all that apply) a. take the medication 1 hr before meals b. limit NSAIDs when taking this medication c. expect skin flushing when taking this medication d. increase fiber intake when taking this medication e. chew the medication thoroughly before swallowing

a. take the medication 1 hr before meals b. limit NSAIDs when taking this medication (esomeprazole = PPI) ATI MS

constipation

adverse effect of aluminum- and calcium-containing antacids

kidney stones

adverse effect of calcium-containing antacids

hyperacidity (or acid rebound)

adverse effect of calcium-containing antacids when antacid use is discontinued

give antacids 1 to 2 hours before or after

allopurinol, tetracycline, thyroid hormones, captopril, corticosteroids, digoxin, antihistamines, phenytoin, isoniazid, nitrofurantoin, phenothiazines, salicylates

best after meals

antacids

compounds used to neutralize stomach acids

antacids

chelation

antacids chemical inactivation of other drugs that produces insoluble complexes

adsorption

antacids reduce the ability of other drugs to be absorbed by the body

aluminum-containing and calcium containing antacids

antacids that have constipating effects

4. A patient with a history of renal problems is asking for advice about which antacid he should use. The nurse will make which recommendation? a. "Patients with renal problems cannot use antacids." b. "Aluminum-based antacids are the best choice for you." c. "Calcium-based antacids are the best choice for you." d. "Magnesium-based antacids are the best choice for you."

b "Aluminum-based antacids are the best choice for you."

7. Which client statement demonstrates understanding of teaching by the nurse regarding the use of histamine 2 - receptor antagonists? a. "Because I am taking this medication, it is OK for me to eat spicy foods." b. "Smoking decreases the effects of this medication, so I should look into cessation programs." c. "I should take this medication 1 hour after each meal to maximally decrease gastric acidity." d. "I should increase bulk and fluids in my diet to prevent constipation."

b "Smoking decrease the effect of this medication, so I should look into cessation programs." Clients taking histamine 2 -receptor - blocking drugs should avoid spicy foods, extremes in temperatures, alcohol, and smoking. Diarrhea, not constipation, is a GI adverse effect. Whereas cimetidine should be taken with meals, famotidine can be taken without regard to meals.

10. The nurse will question an order for misoprostol (Cytotec) in which patient? a. A 21-year-old man with Zollinger-Ellison syndrome b. A 32-year-old pregnant woman with a urinary tract infection c. A 45-year-old woman with GERD d. A 64-year-old man with hypertension

b A 32-year-old pregnant woman with a urinary tract infection Misoprostol (Cytotec) is a prostaglandin E analog and is believed to inhibit gastric acid secretion and protect the gastric mucosa from injury by enhancing the local production of mucus. However, it is also an abortifacient and therefore is contraindicated in pregnancy. The drug may be useful in treating patients with Zollinger-Ellison syndrome (a hypersecretory syndrome) and GERD. Hypertension is not a contraindication for its use.

3. Which is the correct action when the nurse is administering sucralfate? a. Giving the drug with meals b. Giving the drug on an empty stomach c. Instructing the patient to restrict fluids d. Waiting 30 minutes before administering other drugs

b Giving the drug on an empty stomach

6. What is the mechanism of action for Famotidine (Pepcid)? a. It forms a protective coating against gastric acid, pepsin, and bile salts. b. It competes with histamine for binding sites on the parietal cells c. It irreversibly binds to the hydrogen-potassium-adenosine triphosphate (ATPas) pump. d. It causes a decrease in stomach pH, reducing stomach acidity.

b It competes with histamine for binding sites on the parietal cells. Histamine receptor-blocking drugs decrease gastric acid by competing with histamine for binding sites on the parietal cells.

8. How will the nurse describe the action of proton pump inhibitors (PPIs)? a. They form a protective barrier that can be thought of as a liquid bandage. b. They irreversibly bind to the hydrogen-potassium-ATPase pump. c. They compete with histamine for binding sites on the parietal cells d. They help to neutralize acid secretions to promote gastric mucosal defensive mechanisms.

b They irreversibly bind to the hydrogen-potassium-ATPase pump. PPIs work to block the final step in the acid-secreting mechanisms of the proton pump. They do this by irreversibly binding to the ATPase pump, H+/K+/ATPase, the enzyme for this step.

A patient with a history of renal problems is asking for advice about which antacid he should use. The nurse will make make which recommendation? a. Patients with renal problems cannot use antacids. b. Aluminum-based antacids are the best choice for you. c. Calcium-based antacids are the best choice for you. d. Magnesium-based antacids are the best choice for you.

b. Aluminum-based antacids are the best choice for you.

The primary health care provider prescribes dronabinol as a second-line antiemetic drug for the treatment of nausea and vomiting associated with chemotherapy in a patient who has cancer. Which action will the nurse perform before administering the medication to the patient? a. Assess baseline vital signs and age b. Assess motor and cognitive abilities c. Assess nutritional wasting syndrome d. Assess imbalance between neurotransmitters

b. Assess motor and cognitive abilities

Medication "X" is effective in patients who have cancer and experience nausea and vomiting associated with chemotherapy. During postmarketing surveillance, the drug is found to produce ventricular dysrhythmias. What recommendations do the U.S. Food and Drug Administration (FDA) make for such a medication? a. Prescribe for the treatment of nausea and vomiting in geriatric patients. b. Avoid prescribing for patients who have been prescribed chemotherapy. c. Avoid prescribing for patients with hypertension and cardiac arrhythmia. d. Prescribe in low doses for the treatment of nausea associated with chemotherapy.

b. Avoid prescribing for patients who have been prescribed chemotherapy.

Which is the correct action when the nurse is administering sucralfate? a. Giving the dug with meals. b. Giving the drug on an empty stomach c. Instructing the patient to restrict fluids d. Waiting 30 minutes before administering other drugs

b. Giving the drug on an empty stomach

A pregnant woman asks the nurse about taking an antacid for indigestion. What's the nurse's best response? a. You won't be allowed to take an antacid while you are pregnant. b. Let's check with your obstetrician to see what is recommended? c. Go ahead and use an aluminum-based antacid. d. sodium-bicarbonate would be the safest choice.

b. Let's check with your obstetrician to see what is recommended?

A nurse is teaching a client who has a new prescription for omeprazole for management of heartburn. Which of the following information should the nurse include in the teaching? a. take this medication at bedtime b. this medication decreases the production of gastric acid c. take this medication 2 hrs after eating d. this medication can cause hyperkalemia

b. this medication decreases the production of gastric acid (omeprazole = PPI) ATI

Which nursing intervention helps prevent complications in a patient who is scheduled for a tonsillectomy and has been prescribed metoclopramide? a. Providing a fiber-rich diet to the patient b. Monitoring the patient's blood pressure c. Providing a potassium-rich diet to the patient d. Monitoring the patient's thyroid hormone levels

b. Monitoring the patient's blood pressure

Which patient should be advised to limit or avoid use of sodium bicarbonate as an antacid? a. a patient who is 6 months pregnant. b. a patient with hypertension c. a patient with heart failure d. a patient with gout e. a patient with scleroderma

b. a patient with hypertension c. a patient with heart failure

A patient with renal failure wants to take an antacid for "sour stomach." The nurse needs to consider that some antacids may be dangerous when taken by patients with renal failure and will recommend which type of antacid? a. activated charcoal b. aluminum-containing antacids c. calcium-containing antacids d. magnesium-containing antacids

b. aluminum-containing antacids

The nurse is administering a proton pump inhibitor during morning medication rounds. Which statement about proton pump inhibitors are true? a. they should be taken 1 hour before antacids b. they should be taken 30 to 60 minutes before meals c. they should be taken with meals d. they are part of the treatment of patients with H. pylori infections e. there are very few adverse effects with these drugs

b. they should be taken 30 to 60 minutes before meals d. they are part of the treatment of patients with H. pylori infections e. there are very few adverse effects with these drugs

9. PPIs have the ability to almost totally inhibit gastric acid secretion. Because of this possibility, the use of the medication can lead to what condition? a. Gastric ulcer formation b. Gastroesoophageal reflux disease (GERD) c. Achlohydria d. Diverticulosis

c Achlohydria Becasue PPIs stop the final step of acid secretion, they can block up to 90% of acid secretion, leading to achlorhydria (without acid).

12. How dose sucralfate (Carafate) achieve a therapeutic effect? a. By inhibiting the production of gastric acid secretion b. by enhancing gastric absorption c. By forming a protective barrier over the gastric mucosa d. By neutralizing gastric acid

c By forming a protective barrier over the gastric mucosa Sucralfate has a local effect only on the gastric mucosa. If forms a protective barrier that can be thought of as a liquid protective bandage in the stomach. This liquid bandage adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.

11. The nurse would teach a client prescribed simethicone (Mylicon) to avoid which substance? a. Over-the-counter antacids b. Histamin 2- receptor antagonists c. Carbonated beverages d. Milk and dairy products

c Carbonated beverage Simethicone is used to decrease gas and belching. both of which can be aggravated or caused by ingesting carbonated beverages. It may be given in combination with other medications used to decrease acidity.

2. When evaluating the medication list of a patient who will be starting therapy with an H2 receptor antagonist, the nurse is aware that which drug may interact with it? a. codeine b. pencillin c. Phenytoin d. acetaminophen

c Phenytoin

8. The nurse is preparing to administer the first dose of misoprostol (Cytotec) for a patient who has been diagnosed with a gastric ulcer. What condition would be a contraindication to this medication? a. Hypothyroidism b. Type 2 diabetes mellitus c. Pregnancy d. Hypertension

c Pregnancy

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. What instructions should the nurse include? a. "Take the medication on an empty stomach for full effectiveness." b. "You may discontinue this medication when stomach discomfort subsides." c. "Report yellowing of the skin." d. "Store the medication in the refrigerator."

c. "Report yellowing of the skin." (ranitidine can be hepatotoxic and cause jaundice. client should report any yellowing of the eyes or skin to provider) ATI

The nurse will question an order for misoprostol (Cytotec) in which patient? a. A 21-year-old man with Zollinger-Ellison syndrome b. A 64-year-old man with hypertension c. A 32-year-old pregnant woman with a urinary tract infection d. A 45-year-old woman with GERD

c. A 32-year-old pregnant woman with a urinary tract infection (misoprostol is a prostaglandin E analogue and an abortifacient, therefore is contraindicated in pregnancy) Pharm

The nurse determines a patient has experienced the beneficial effects of therapy with famotidine when which symptom is relieved? a. Nausea b. Belching c. Epigastric pain d. Difficulty swallowing

c. Epigastric pain (Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric pain.) MS ch 41

When caring for an older adult patient diagnosed with peptic ulcer disease and receiving each of the following medications, the nurse would relate the onset of confusion as a possible side effect to which medication? a. antacids b. carafate c. H2 antagonists d. Cytotect

c. H2 antagonists

The nurse is caring for a patient who has cancer who has been prescribed anticancer medication. The primary health care provider has prescribed ondansetron in combination with other medications to prevent nausea and vomiting. Which medications may be added to the patient's regimen for prevention of nausea and vomiting? Select all that apply .a. Atenolol b. Morphine c. Lorazepam d. Dronabinol e. Dexamethasone

c. Lorazepam d. Dronabinol e. Dexamethasone

A 74-yr-old female patient with osteoporosis is diagnosed with gastroesophageal reflux disease (GERD). Which over-the-counter medication to treat GERD should be used with caution? a. Sucralfate b. Cimetidine c. Omeprazole d. Metoclopramide

c. Omeprazole (long-term use or high doses of PPIs may increase the risk of fractures of the hip, wrist, and spine) MS ch 41

The primary health care provider prescribes aprepitant to a patient for the treatment of nausea and vomiting. Which drugs will the nurse expect to be added to the treatment plan to enhance the antiemetic effect? Select all that apply. a. Warfarin b. Verapamil c. Ondansetron d. Dexamethasone e. Methylprednisolone

c. Ondansetron d. Dexamethasone e. Methylprednisolone

Which class of drugs is used along with commonly prescribed antiemetics to prevent nausea and vomiting associated with chemotherapy? Select all that apply. a. Anxiolytics b. Corticosteroids c. Serotonin blockers d. Tetrahydrocannabinoids e. Phosphorated carbohydrate solutions

c. Serotonin blockers d. Tetrahydrocannabinoids e. Phosphorated carbohydrate solutions

A patient with peptic ulcer disease will be starting medication therapy. He tells the nurse that he smokes and wonders if that will affect his treatment. Which is the nurse's best response? a. Smoking has no effect on these medications. b. The actions of antacids are less potent when you smoke. c. Smoking has been known to decrease the effectiveness of H2 blockers. d. Smoking has been shown to increase the adverse effects of H2 blockers.

c. Smoking has been known to decrease the effectiveness of H2 blockers.

A nurse is teaching a client who is taking sucralfate PO for peptic ulcer disease and has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include? a. take an antacid with the sucralfate b. take sucralfate with a glass of milk c. allow a 2-hr interval between these medications d. chew the sucralfate thoroughly before swallowing

c. allow a 2-hr interval between these medications (sucralfate can interfere with the absorption of phenytoin) ATI

When evaluating the medication list of a patient who will be starting therapy with an H2 receptor antagonist, the nurse is aware that which drug may interact with it? a. codeine b. penicillin c. phenytoin d. acetaminophen

c. phenytoin

A nurse is providing discharge teaching to a pt who has a new prescription for aluminum hydroxide. Which of the following information should the nurse include in the teaching? a. take the medication with food b. monitor for diarrhea c. wait 1 hr before taking other medications d. maintain a low-fiber diet

c. wait 1 hr before taking other medications (don't take oral medications within 1 hr of antacids) ATI MS

A 30-year-old patient is taking simethicone for excessive flatus associated with diverticulitis. During a patient teaching session, the nurse explains the mechanism of action of simethicone by saying: a. "It neutralize gastric pH, thereby preventing gas." b. "It buffers the effects of pepsin on the gastric wall." c. "It decreases gasgtric acid secretion and thereby minimizes flatus." d. "It causes mucus-coated gas bubbles to break into smaller ones."

d "It causes mucus-coated gas bubbles to break into smaller ones."

3. For a client with chronic renal failure, the nurse MOST likely will question a prescription for which type of antacid? a. Aluminum-containing antacids b. Calcium-containing antacids c. Sodium-containing antacids d. Magnesium-containing antacids

d Magnesium-containing antacids Magnesium-containing antacids can cause hypermagnesemia in clients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in clients with chronic renal failure. Sodium-and aluminum-containing antacids are chemically more easily excreted in clients with renal compromise. although calcium-containing antacids may accumulate in the bloodstream of clients with renal failure, they may also be appropriate because these patients may be hypocalcemic.

4. What condition will the nurse monitor for with a client using sodium bicarbonate to treat gastric hyperacidity? a. Hypercalcemia b. Hyperkalemia c. Metabolic acidosis d. Metabolic alkalosis

d Metabolic alkalosis Solutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum potassium and serum calcium would decrease, not increase, with alkalosis.

5. Which nursing diagnosis is appropriate for a patient receiving famotidine (Pepcid)? a. Ineffective peripheral tissue perfusion related to hypertension b. Risk for infection related to immunosuppression c. Impaired urinary elimination related to retention d. Risk for injury related to thrombocytopenia

d Risk for injury related to thrombocytopenia. A serious side effect of famotidine is thrombocytopenia, which is manifested by a decrease in platelet count and an increased risk of bleeding. The patient receiving famotidine may experience hypotension as an adverse effect, not hypertension. Famotidine dose not cause immunosuppression or urinary retention.

A 30-year-old patient is taking simethicone for excessive flatus associated with diverticulitis. During a patient teaching session, the nurse explains the mechanism of action of simethicone by saying: a. It neutralizes gastric pH, thereby preventing gas. b. It buffers the effects of pepsin on the gastric wall. c. It decreases gastric acid secretion and thereby minimizes flatus. d. It causes mucous-coated gas bubbles to break into smaller ones.

d. It causes mucous-coated gas bubbles to break into smaller ones.

The nurse is caring for a patient with cancer who is experiencing nausea and vomiting. The patient has been prescribed the drug dronabinol. What would be a possible reaction in the patient after administration of the medication? a. Reduced symptoms of vertigo b. Reduced symptoms of rhinitis c. Reduced symptoms of sedation d. Reduced symptoms of glaucoma

d. Reduced symptoms of glaucoma

A patient reports nausea and vomiting associated with chemotherapy. Which class of drugs is helpful in this condition?a. Antihistamines b. Anticholinergics c. Antidopaminergics d. Serotonin blockers

d. Serotonin blockers

Which drug class would be used as first-line therapy for GERD that has not responded to customary medical treatment? a. H2 blockers b. antacids c. mucosal protectants d. proton pump inhibitors

d. proton pump inhibitors (omeprazole)

smoking

decreases the effectiveness of cimetidine

A patient on chemotherapy is using ondansetron (Zofran) for treatment of nausea. The nurse will instruct the patient to watch for which adverse effect of this drug?

diarrhea

omeprazole drug interactions

diazepam, phenytoin, warfarin

H2 receptor antagonists

drugs known as H2 blockers that reduce acid secretion in the stomach

omeprazole indications

erosive esophagitis, GERD, duodenal and gastric ulcers, NSAID ulcers, hypersecretory conditions

sucralfate

generic name for a cytoprotective drug

quinolones (ciprofloxacin)

give antacids 2 hours before or 2 hours after to prevent significant harm

misoprostol adverse effects

headache; GI distress; vaginal bleeding (abortifacient - pregnancy category X)

bicarbonate

helps buffer the acidity of hydrochloric acid

cimetidine adverse effects

impotence & gynomastia (may increase secretion of prolactin from anterior pituitary); hypotension

omeprazole adverse effects

long-term use associated with C. diff; osteoporosis; pneumonia

avoid this type of antacids in patients with renal failure

magnesium

intrinsic factor

necessary for B12 absorption

prostaglandins

prevent histamine from binding to its corresponding parietal cell receptors

misoprostol (Cytotec)

prostaglandin analogue - reduces gastric ulcers with use of NSAIDs

omeprazole (Prilosec)

proton pump inhibitor - prevents the movement of hydrogen ions from parietal cells into the stomach

antacids contraindication

severe renal failure or electrolyte disturbances & GI obstruction

antacids mechanism of action

stimulating mucous secretion, prostaglandins, and bicarbonate from the cells inside the gastric glands

antacids indication

the acute relief of symptoms associated with peptic ulcer, gastritis, gastric hyperactivity, and heartburn

Helicobacter pylori

the cause of many peptic ulcers

parietal cells

the cells responsible for producing and secreting hydrochloric acid in the stomach

primary drug effect of antacids

the reduction of the symptoms associated with various acid-related disorders, such as pain and reflux

omeprazole & antibiotics

used together to treat H. pylori infections

antacids when pregnant

usually safe; check with HCP first

cimetidine drug interactions

warfarin, lidocaine, phenytoin, theophylline