Pharm Final: GI
A client prescribed omeprazole for gastroesophageal reflux disease reports a new occurrence of significant diarrhea. Which response by the nurse is most appropriate? 'Stop taking your omeprazole.' 'This is a normal side effect of omeprazole.' 'We are going to collect a stool sample for testing.' 'Antidiarrheal medication can be used to decrease this.'
'We are going to collect a stool sample for testing.' • 1. Diarrhea? Get Stool Sample, C-Diff Risk heightened
A female client with rheumatoid arthritis takes ibuprofen (Motrin) 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching? A. Use contraception during intercourse. B. Ensure the Cytotec is taken on an empty stomach. C. Encourage oral fluid intake to prevent constipation. D. Take Cytotec 30 minutes prior to Motrin.
A mis "with my preg" oprostol
A client calls the clinic and states to the triage nurse: "I had an upset stomach and took Pepto-Bismol and now my tongue looks black. What's happening to me?" What would be the nurse's best response? A "This is a common and temporary side effect of this medication." B "How long have you had an upset stomach?" C "Come to the clinic so you can be seen by the health care provider." D "Are your stools also black?"
A • Getting a temporary black tongue is OK, not to worry.
The nurse is providing teaching to the client taking metoclopramide. Serious side effects that should be reported to the provider are included in the teaching plan. Which of the following side effects is the priority? A Involuntary muscle movements B Report of increased fatigue C Onset of headaches D Difficulty with sleep
A Involuntary muscle movements • May Cause permanent Tardive Dyskinesia
The nurse is preparing to administer a prescribed dose of lactulose to a client who has cirrhosis. Which lab value will the nurse monitor to evaluate the therapeutic effect of the medication? A Glucose B Ammonia C Potassium D Bicarbonate
B Ammonia
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is performing as intended? A. An increase in urine output. B. Two or three soft stools per day. C. Watery, diarrhea stools. D. Increased serum bilirubin.
B. Two or three soft stools per day.
A client is scheduled for discharge after surgery. The medical record indicates that the client has not had a bowel movement since before surgery, which was 4 days ago. Which prescribed medication will the nurse administer to ensure a bowel movement before discharge? Lactulose Docusate sodium Bisacodyl suppository Psyllium
Bisacodyl suppository Bullet • 1) Stimulates Peristalsis Quickly
A nurse administers cimetidine to a 79-year-old male with a gastric ulcer. Which parameter may be affected by this drug and should be closely monitored by the nurse? A Blood pressure B Liver enzymes C Mental status D Hemoglobin
C "acid blocking -tidine" • Watch for mental status changes in older folks
Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? A. Loperamide (Imodium). B. Probanthine (Propantheline). C. Bismuth subsalicylate (Pepto Bismol). D. Diphenoxylate hydrochloride with atropine (Lomotil).
C Contraindications: • 2. Taking High Dose Aspirin • 3. Salmonella Infection
The nurse is assessing a client who began taking omeprazole a month ago. Which finding by the nurse, indicates that the drug has had the desired effect? A Blood pressure readings are lower B Feelings of depression are not as severe C Chronic pain level is markedly decreased D Heartburn discomfort is lessened
D Heartburn discomfort is lessened "Proton Pump"-prazole • Heartburn and GERD will lessen with this drug.
The nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective? Decreased amylase Decreased ammonia Increased potassium Increased hemoglobin
Decreased ammonia
A health care provider prescribes famotidine for a client with dyspepsia. Which statement is important to include in a teaching session about famotidine? Lowers the stress level Neutralizes gastric acidity Reduces gastrointestinal peristalsis Decreases secretions in the stomach
Decreases secretions in the stomach "acid blocking -tidine"
A health care provider prescribes bed rest, loperamide, and esomeprazole for a client who just had major surgery. After several days of this regimen, the client complains of diarrhea. Which treatment strategy would the nurse conclude is the cause of the diarrhea? Loperamide Esomeprazole Bed rest Diet alteration
Esomeprazole "Proton Pump"-prazole • 1. Diarrhea? Get Stool Sample, C-Diff Risk heightened
Which mechanism is specifically responsible for the action of the medication ranitidine? Inhibiting proton pumps Promoting the release of gastrin Regenerating the gastric mucosa Inhibiting the histamine at H 2 receptors
Inhibiting the histamine at H 2 receptors "acid blocking -tidine" • H2 Receptor Blocker that decreases stomach acid
Which potential side effect of docusate sodium would a nurse include in discharge teaching of a client who had repair of an inguinal hernia? Rectal bleeding Fecal impaction Nausea and vomiting Mild abdominal cramping
Mild abdominal cramping • Mild Abd. Cramping is a side effect
Which medication for treatment of gastroesophageal reflux disease would be contraindicated in the pregnant client? Ranitidine Misoprostol Esomeprazole Calcium carbonate
Misoprostol mis "with my preg" oprostol • Contraindicated in pregnancy • 2. Can cause chemical abortion
Which medication is classified as an H 2 receptor antagonist? Select all that apply. One, some, or all responses may be . Nizatidine Ranitidine Famotidine Lansoprazole Metoclopramide
Nizatidine, Ranitidine, Famotidine "acid blocking -tidine"
Which information would the nurse include when teaching a client about the administration of ranitidine? Ranitidine increases gastrointestinal peristalsis. Ranitidine reduces gastric acidity in the stomach. Ranitidine neutralizes the acid that is present in the stomach. Ranitidine stops the production of hydrochloric acid in the stomach.
Ranitidine reduces gastric acidity in the stomach. • H2 Receptor Blocker that decreases stomach acid "acid blocking -tidine"
Which action is responsible for the therapeutic effect of docusate sodium? Lubricates the feces Creates an osmotic effect Stimulates motor activity Softens the feces
Softens the feces • Softens Stools via pulling fluid into large intestine
A health care provider prescribes bisacodyl for a client with constipation. The nurse explains to the client that this medication acts by which mechanism? Producing bulk Softening feces Lubricating feces Stimulating peristalsis
Stimulating peristalsis Bullet 1) Stimulates Peristalsis Quickly
A client is to receive metoclopramide intravenously 30 minutes before initiating chemotherapy for cancer of the colon. The nurse explains that metoclopramide is given for which purpose? To stimulate production of gastrointestinal (GI) secretions To stimulate peristalsis of the upper gastrointestinal (GI) tract To prolong excretion of the chemotherapeutic medication To increase absorption of the chemotherapeutic medication
To stimulate peristalsis of the upper gastrointestinal (GI) tract Stimulates peristalsis