Pharm Ch 57 Drugs Affecting Gastrointestinal Secretions

Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection? Famotidine Calcium carbonate Sucralfate Omeprazole

omeprazole

A nurse is providing education to a 23-year-old female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching? Use effective contraceptive measures. Supplement therapy with magnesium antacids. Administer the drug one time per day. Report postmenopausal bleeding.

use effective contraceptive measures

A nurse is teaching a client about prescribed lansoprazole. The nurse instructs the client to take the drug at which time? 1 hour before eating at bedtime first thing on arising 2 hours after a meal

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 6 weeks 10 weeks 12 weeks

1 to 2 weeks

The nursing instructor is discussing the use of histamine2 receptor antagonists in the treatment of peptic ulcer disease. According to the instructor, which is a typical dosing schedule of famotidine during the first few weeks of treatment for gastric ulcer in patients with normal renal function? 10 mg bid 40 mg q.a.m. 20 mg bid 20 mg at bedtime

20 mg bid

A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame? 60 minutes 15 minutes 45 minutes 30 minutes

30 minutes

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

alopecia

A nurse is preparing to administer a drug that reduces the secretion of gastric acid by inhibiting the action of histamine at H2 receptors in the stomach. Which medication might the nurse be preparing to administer? Select all that apply. Lansoprazole Calcium carbonate Famotidine Ranitidine Esomeprazole

famotidine ranitidine

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

gynecomastia

A child is diagnosed with cystic fibrosis. Which medications will be prescribed for the client to be taken prior to consuming food? Cephalexin (Keflex) Pancrelipase (Cotazym) Vitamin D Cholestyramine (Questran)

pancrelipase (cotazym)

Client teaching should include what instruction about antacids? Take antacid 1/2 hour after other medications. Take antacid only at bedtime. Take antacid 1 hour before other medications. Take antacid with other medications.

take antacid 1 hour before other medications

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

true

Which statement by a patient receiving pancrelipase indicates that the patient has understood his instructions? "I must take the drug at bedtime for best results." "I'll take it first thing in the morning after getting up." "I should take the drug 1 hour before I eat." "I should take the drug with meals and snacks."

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

A client is in the intensive care unit and being administered ranitidine parenterally. How long will it take for ranitidine to reach peak blood levels? 1 hour 15 minutes 30 minutes 2 hours

15 minutes

For treatment of a gastric ulcer, what would the recommended dosing schedule of famotidine (Pepcid) be? 20 mg bid 10 mg bid 60 mg at bedtime 40 mg q AM

20 mg bid

Which of the following drugs are commonly used in combination with certain antibiotics in the treatment of H. pylori? Select all that apply: Ondansetron (Zofran) Promethazine (Phenergan) Metoclopramide (Reglan) Lansoprazole (Prevacid) Omeprazole (Prilosec)

Lansoprazole (Prevacid) Omeprazole (Prilosec)

Pancreatic enzymes are required for absorption of carbohydrates, protein, and fat. Replacement therapy is used when clients are in deficiency states. What conditions create a deficiency state for pancreatic enzymes? Chronic pancreatitis Pancreatic obstruction All choices are correct Cystic fibrosis

all choices are correct

A common drug regimen for eradication of H. pylori includes a proton pump inhibitor (PPI) and two antibiotics. What is one of the preferred antibiotics? Vancomycin Ketoconazole Amoxicillin Gentamicin

amoxicillin

The nurse is caring for four clients. Which client would benefit most from misoprostol, a synthetic prostaglandin E analog? An 83-year-old male with rheumatoid arthritis A 12-year-old male with obsessive-compulsive disorder A 46-year-old female with hypertension A 22-year-old pregnant female

an 83-year-old male with rheumatoid arthritis

Which of the following antacids may produce constipation and should be used cautiously in clients that have chronic constipation? Select all that apply: Sodium bicarbonate (Bellans) Magnesium oxide (Mag-Ox) Calcium carbonate (Mylanta) Magnesium hydroxide (Milk of Magnesia) Aluminum hydroxide (ALternaGEL)

calcium carbonate (mylanta) aluminum hydroxide (milk of magnesia)

Which agent is associated with antiandrogenic effects? Nizatidine Ranitidine Cimetidine Famotidine

cimetidine

Which agent would a nurse identify as the prototype histamine-2 receptor antagonist? Nizatidine Ranitidine Cimetidine Famotidine

cimetidine

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs? Hypertension Hypoxia Gynecomastia Seizures

gynecomastia

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? fluid volume excess venous thromboembolism rebound gastroesophageal reflux disease (GERD) hemorrhage

hemorrhage

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

hepatic disease

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: cause diarrhea. interfere with the metabolism of other drugs. result in hypotension. cause macular rash and cough.

interfere with the metabolism of other drugs

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication? H2RAs Antacids Proton pump inhibitors Sucralfate

proton pump inhibitors

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? Eats spicy food at least twice a week. Is 15 pounds over ideal weight Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily. Has a stressful job as a air traffic controller.

self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily

A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency? By measuring the pH of urine after each void By aspirating stomach contents and measuring the pH By swabbing the client's buccal mucosa and testing for pH daily By assessing the pH of a 24-hour urine sample

by aspirating stomach contents and measuring the pH

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

constipation

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? Risk for injury related to the side effects of the drug therapy Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes Alterations in elimination related to the disease process Alteration in comfort related to the drug therapy and the adverse effect of a headache

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

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. hypocalcemia. metabolic acidosis. hypercholesterolemia.

metabolic alkalosis

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 The same as the average prescribed dose No antacids, because they are contraindicated in the elderly Larger than the average prescribed dose

smaller than average prescribed dose

A client has been prescribed omeprazole by the primary health care provider. When the nurse asks whether the medication is providing relief, the client replies, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond? "That's good, but remember that you shouldn't take it on days when you're not having any symptoms." "I'm glad it's working for you, but you'll probably find it works even better if you take it after eating." "That's great. If you find later that it's not working as well, you might want to try taking it at bedtime." "I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."

"i'm glad to hear that. it sounds like you're taking it exactly like it should be taken."

A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? "You should eat several small meals each day rather than three larger meals." "Take each dose of ranitidine with an antacid of your choice." "This drug will help to eliminate the bacteria in your stomach that caused your ulcer." "Quitting smoking will significantly increase the chance that this drug will heal your ulcer."

"quitting smoking will significantly increase the chance that this drug will heal your ulcer."

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 protects ulcer craters decreases pepsin production assists in eliminating the bacteria

decreases production of gastric secretions

Saliva substitute is absorbed systemically. False True

false

A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic? Sucralfate Magaldrate Cimetidine Omeprazole

omeprazole

A patient is prescribed esomeprazole. The nurse would understand that this drug would be given by which route? (Select all that apply.) Topically Intramuscular Subcutaneous Transdermal Oral Intravenous

oral intravenous

A client is prescribed cimetidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has: renal disease. pulmonary disease. migraine headaches. diabetes mellitus.

renal disease

A nurse in a health care facility is caring for a patient who is administered milk of magnesia to control constipation. Which nursing diagnosis should the care plan for this patient include? Impaired physical mobility Disturbed sensory perception Ineffective tissue perfusion Risk for imbalanced fluid volume

risk for imbalanced fluid volume

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." "It is important that I take the drug after each meal." "I should crush the medication and mix it into apple sauce." "I'll have to stop using antacids."

"i need to swallow the drug whole."

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful? "I need to avoid sugarless lozenges." "I need to limit my fluid intake." "I may need something to control diarrhea." "I should eat a high-fiber diet."

"i should eat a high-fiber diet."

Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in clients who: are hypertensive. are pregnant. have arthritis. have diabetes.

are pregnant

A group of students are reviewing the signs and symptoms of systemic alkalosis that can occur as a result of using sodium bicarbonate. The students demonstrate a need for additional teaching when they identify which as a possible manifestation? Constipation Tetany Muscle twitching Confusion

constipation

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? Urinary frequency Nausea Fatty stools Constipation

constipation

When teaching a client about an antacid containing aluminum, what would the nurse include? Increased risk for hyperphosphatemia Increased risk for diarrhea Decreased risk for calcium imbalance Decreased risk for acid rebound

decreased risk for acid rebound

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? Swallow the tablet one hour before eating. Administer the drug one hour before travel. Do not chew, open, or crush the tablet. Use a reliable contraceptive.

use a reliable contraceptive