Ch.57: Drugs Affecting GI secretions

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

30 minutes

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?

Proton pump inhibitors

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?

"I need to swallow the drug whole."

The nurse is caring for a patient who has been prescribed a saliva substitute . The patient asks why this medication is necessary. What would be the most appropriate response?

"This medication helps people that have a condition that creates a lack of saliva."

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?

"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."

A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?

1 hour before eating

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

A 32-year-old female executive comes to the clinic with severe heartburn. The health care provider prescribes omeprazole (Prilosec). The client asks the nurse when the pain will go away. What is an appropriate response by the nurse?

Acid-inhibiting effects occur within 2 hours.

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

Alopecia

Which would a nurse anticipate as having antiandrogenic effects?

Cimetidine

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.

An older adult has been taking a calcium-based antacid on an increasingly frequent basis. When teaching this client, the nurse should include suggestions for the prevention of which adverse effect?

Constipation

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?

Constipation The nurse should warn a client taking aluminum- and calcium-containing antacids about constipation, which can be associated with taking products containing either medication. Client taking magnesium- and sodium-containing antacids can have diarrhea. Dehydration can be seen with the use of diuretics. Increased flatulence can be seen with the use of fiber laxatives such as Metamucil.

A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?

Hepatic disease

When teaching a client about an antacid containing aluminum, what would the nurse include?

Decreased risk for acid rebound

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?

Decreases production of gastric secretions

Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?

Drug-Drug Interactions

Which medication reduces 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 Lansoprazole The proton pump inhibitors, like esomeprazole and lansoprazole, reduce the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate enzyme system of the gastric parietal cells. Famotidine (Pepcid) and ranitidine are both histamine H2 antagonists decreasing stomach acid by inhibiting the action of H2 receptors in the stomach. Calcium carbonate is an acid neutralizer that reduces the pH of the acid in the stomach and duodenum.

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

Gynecomastia

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?

Headache

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 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?

Infection with H. pylori

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

After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?

Omeprazole

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

The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what?

Renal dysfunction

A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the client's safety. What would be an appropriate nursing diagnosis?

Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations

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 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

Client teaching should include what instruction about antacids?

Take antacid 1 hour before other 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 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

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 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 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 anit-inflammatory drug (NSAID) daily

The nurse should be aware that ranitidine achieves a therapeutic effect by which means?

inhibiting the secretion of gastric acid The histamine2 receptor antagonists (H2RAs) inhibit both basal secretion of gastric acid and the secretion stimulated by histamine, acetylcholine, and gastrin. These drugs, such as ranitidine, do not change the pH of secretions, bind to the proton pumps, or decrease gastric motility.

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 client is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale for adding bismuth to the client's medication regimen?

provides antibacterial effects

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

true