Gastrointestinal System

The nurse is preparing to give a client directions for proper use of aluminum hydroxide tablets. Which instruction should the nurse provide to the client? 1."Take the tablet at the same time as an antacid." 2."Swallow the tablet whole with a full glass of water." 3."Take each dose with a laxative to prevent constipation." 4."Chew the tablet thoroughly and then drink 8 ounces of water."

"Chew the tablet thoroughly and then drink 8 ounces of water." Rationale: Aluminum hydroxide tablets are an antacid and should be chewed thoroughly before swallowing to prevent them from entering the small intestine undissolved. An antacid should not be taken with the medication to prevent additive and interactive effects. Constipation is a side or adverse effect of the use of aluminum products, but the client should not take a laxative with each dose. This would promote laxative abuse and should be avoided if less habit-forming means can be used.

The nurse administers ondansetron to a client. Which statement by the client indicates that this medication has been effective? 1."My headache is gone." 2."I no longer feel nauseous." 3."The dizziness has stopped." 4."The pain at my incision has decreased."

"I no longer feel nauseous." Rationale: Ondansetron is an antiemetic used in the treatment of nausea and vomiting. All of the other options are incorrect. Headache and dizziness are side effects of ondansetron. It is not used to treat pain.

The client has begun taking misoprostol. Which statement by the client indicates that the misoprostol is effective? 1."I have fewer joint aches." 2."My joint mobility has improved." 3."I no longer have pain above my stomach." 4."I am no longer experiencing constipation."

"I no longer have pain above my stomach." Rationale: Misoprostol is a gastric protectant and is given specifically to prevent gastric mucosal injury. Constipation is not associated with the use of this medication. Fewer joint aches and improved joint mobility are incorrect and are not intended effects of the medication.

A client diagnosed with peptic ulcer disease is prescribed an over-the counter antacid suspension containing aluminum hydroxide, magnesium hydroxide, and simethicone. What should the nurse include in the client instructions for time of administration of this medication? 1. Just before each meal 2. An hour before breakfast 3. Immediately after each meal 4. 1 and 3 hours after meals

1 and 3 hours after meals Rationale: Antacids are alkaline compounds that neutralize stomach acid. The objective of peptic ulcer therapy is to promote healing in addition to relieving pain. Consequently, antacids should be taken on a regular schedule, not just in response to discomfort. In the usual dosing schedule, antacids are administered 7 times a day: 1 and 3 hours after each meal and at bedtime. Thus, option 4 is the correct option. Options 1, 2, and 3 are incorrect because they are either not the correct timing or not often enough as recommended.

The nurse determines the client needs further instruction on cimetidine if 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."

The nurse is giving the client directions for proper use of aluminum hydroxide tablets. What should the nurse tell the client? 1. Swallow the tablets whole with a full glass of water. 2. Take the tablets at the same time as other medications. 3. Take each dose with a laxative to prevent constipation. 4. Chew the tablets thoroughly and follow with 4 oz of water.

Chew the tablets thoroughly and follow with 4 oz of water. Rationale: Aluminum hydroxide tablets should be chewed thoroughly before swallowing. This prevents them from entering the small intestine undissolved. They should not be swallowed whole. Antacids should be taken at least 1 hour apart from other medications to prevent interactive effects. Constipation is a side effect of the use of aluminum products, but it is not correct for the client to take a laxative with each dose. This promotes laxative abuse. The client should first try other means to prevent constipation.

An older client recently has been taking cimetidine. The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1.Tremors 2.Dizziness 3.Confusion 4.Hallucinations

Confusion

The client with peptic ulcer disease is prescribed medication therapy. The nurse explains the medications to the client and explains that sucralfate will help to heal the ulcer by doing what? 1. Eradicate Helicobacter pylori. 2. Reduce gastric acidity. 3. Treat bacterial infection. 4. Enhance mucosal defenses.

Enhance mucosal defenses.

A client who has been chronically taking acetylsalicylic acid (aspirin) for arthritis has been given a prescription for misoprostol. The nurse determines that the new medication is effective if the client states relief from which problem? 1.Diarrhea 2.Bleeding 3.Joint aches 4.Epigastric pain

Epigastric pain Rationale: A client who chronically uses aspirin is prone to gastric mucosal injury, which causes epigastric pain as a symptom. Misoprostol is a gastric protectant specifically given to prevent this occurrence. Diarrhea can be a side effect of the medication, but it is not an intended effect. Bleeding and joint aches are not relieved by misoprostol.

A client who is in the postanesthesia care unit (PACU) has received a dose of ondansetron. The nurse evaluates that an adverse effect is occurring if which problem arises? 1.Headache 2.Incisional pain 3.Urinary retention 4.Nausea and vomiting

Headache Rationale: Ondansetron is an antiemetic used for relief of postoperative nausea and vomiting and nausea and vomiting associated with chemotherapy. Adverse effects include headache, dizziness, intravenous site irritation, dysrhythmias, dysphoria, dystonia, dry mouth, and sedation. Options 2 and 3 are not related to this medication, and option 4 is the indication for this medication.

A client has been taking omeprazole 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

Heartburn Rationale: Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation, often called heartburn by clients. Omeprazole is not used to treat the conditions identified in options 1, 3, and 4.

A client has received a dose of dimenhydrinate. The nurse should observe relief of what sign or symptom to evaluate that the medication has been effective? 1.Chills 2.Headache 3.Nausea and vomiting 4.Buzzing sound in the ears

Nausea and vomiting Rationale: Dimenhydrinate is used to prevent and treat the symptoms of dizziness, vertigo, nausea, and vomiting that accompany motion sickness. The other options are incorrect reasons for administering the medication.

A client who uses nonsteroidal anti-inflammatory drugs (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 white blood cell count

Relief of epigastric pain Rationale: The client who uses NSAIDs is prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent this occurrence in clients taking NSAIDs frequently. Diarrhea can be a side effect of the medication but is not an intended effect. Options 3 and 4 are unrelated to the purpose of misoprostol.

The nurse instructs a client taking aluminum hydroxide that a common side or adverse effect associated with administration of this medication is which effect? 1.Cramping 2.Headache 3.Constipation 4.Muscle weakness

constipation Rationale: Aluminum-containing antacids are constipating, so the client should be instructed to take a stool softener or additional bulk-type laxatives to relieve this uncomfortable side effect. Cramping, headache, and muscle weakness are not side or adverse effects of this medication.