pharmacology ch 40

Which antacids would the nurse identify as being contraindicated in clients with heart failure?

Sodium bicarbonate

Client teaching should include what instruction about antacids?

Take antacid 1 hour before other medications

A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pyloriinfection. What statement, made by the client, suggests that the client understands proper use of the drug?

"I need to swallow the drug whole."

female client is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux. Which statement made by the client indicates that she understood the teaching provided about taking these medications?

"I should take ranitidine 2 hours before or after my antacid dosage."

The client diagnosed with peptic ulcer disease states, "I've never been a really anxious type of person, so I never thought I'd develop ulcers." The nurse has responded with health education addressing the etiology of peptic ulcer disease (PUD). What causative factors should the nurse cite? Select all that apply

physiologic or psychological stress cigarette smoking infections nonsteroidal anti-inflammatory drugs

A client presents to the walk-in clinic reporting vomiting and burning in their mid-epigastria. The nurse suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the possible presence of:

infection with Helicobacter pylori.

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

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

Hepatic disease

A client is prescribed misoprostol. The nurse would expect to administer this drug by which route?

Oral

A client has been prescribed omeprazole by the primary care provider. When questioned by the nurse about the client's perceived effectiveness of the prescribed omeprazole, the client states, "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?

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

A client expresses concern about the legality of prescribed dronabinol(Marinol) for nausea. What is the nurse's bestresponse?

"Marijuana is legally allowed for medical use in some states."

An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?

"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

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

What is currently the most commonly used therapy for peptic ulcers?

Antibiotics and proton pump inhibitors

A nurse is preparing to administer a drug that reduces the secretion of gastric acid by inhibiting the action of histamine at H2receptors in the stomach. Which medication might the nurse be preparing to administer? Select all that apply.

Famotidine Ranitidine

A woman is prescribed a Histamine-2 (H2) antagonists. What information should the nurse provide the client concerning the use of this class of medication if a pregnancy should occur?

The safety of these drugs during pregnancy had not been established.

A client with ulcers has asked the nurse if it would be acceptable to take bismuth subsalicylate. Before recommending an over-the-counter (OTC) formulation of bismuth subsalicylate, the nurse should conduct which client assessment?

allergy status

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 most likely be resolved?

1 to 2 weeks

How long will it take for ranitidine to reach peak blood levels when administered parenterally?

15 minutes

The client prescribed nizatidine (Axid) chooses to take the medication once a day at bedtime. What dosage will the nurse administer?

150 to 300 mg

For treatment of a gastric ulcer, what would the recommended dosing schedule of famotidine (Pepcid) be?

20 mg bid

The nurse is assessing a 7 year-old client with a recent history of dyspepsia. The client's parents state that their provider recommended the use of over-the-counter ranitidine. What is the nurse's best action?

Contact the provider to question the use of this medication

Antacids are alkaline substances primarily used to directly neutralize gastric acid in the stomach to prevent/treat PUD, GERD, heartburn, and GI bleed. In the treatment of what medical diagnosis might aluminum-based antacids be used? Select all that apply.

chronic renal failure hyperphosphatemia

An older adult's 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

A client has been prescribed chlorpromazine hydrochloride for nausea. What assessment should the nurse perform before the drug is administered to the client?

Assess signs of fluid and electrolyte imbalances

A client has presented to the emergency department with a 48-hour history of spasticity, malaise and agitation. Arterial blood gas testing reveals that the client has metabolic alkalosis. What is the nurse's best assessment?

Assess the client's use of sodium bicarbonate and other antacids

When educating a client prescribed a histamine-2 antagonists, which of the following should be avoided? Select all that apply.

Cigarettes Alcohol Caffeine

The nurse is caring for a client who has been prescribed sucralfate for treatment of peptic ulcer disease. Which nursing diagnosis may relate specifically to administration of this medication?

Impaired Bowel Elimination: Constipation

Your 59-year-old client has peptic ulcer disease and is started on sucralfate (Carafate). What is a potential nursing diagnosis related to this medication?

Impaired bowel elimination: constipation

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 midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?

Infection with H. pylori

Which drug treats heartburn by neutralizing the acidity of the stomach by combining with hydrochloric acid (HCL) and increasing the pH of the stomach acid?

Magaldrate (Riopan)

The nurse is caring for a client with cystic fibrosis who has recently not been taking prescribed pancreatic enzymes recently. What is the primary assessment finding the nurse will see as a result of this noncompliance?

Malnutrition

An adult client with type 1 diabetes since age 4 tells the nurse that in the past 3 months he has experienced nausea, heartburn, and a persistent fullness after meals. He states that his blood sugar levels have been stable and his hemoglobin A1C level that morning was 6.8%. The client has been diagnosed with gastroparesis. Which medication would the physician most likely prescribe to treat this condition?

Metoclopramide

Which drugs treat heartburn by neutralizing the acidity of the stomach by combining with hydrochloric acid (HCl) and increasing the pH of the stomach acid?

aluminum hydroxide

A client with a diagnosis of peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications?

antacids

client with a diagnosis of peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications?

antacids

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 pregnant

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

Decreased risk for acid rebound

The nurse would administer cimetidine cautiously to a client with a history of which condition?

Diabetes

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

Diarrhea

Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect?

Digoxin

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

A client with a complex medical history states that the primary care provider has changed the client's proton pump inhibitor from omeprazole to esomeprazole. The client is unsure of the rationale for this change in medication and has raised this question with the nurse. What rationale is most plausible?

Esomeprazole has fewer drug interactions.

Which herbal products have been used as a homeopathic remedy for GI problems, including motion sickness, nausea, vomiting, and digestion? (Choose one)

Ginger

Which of the following would a nurse expect to administer if the goal of therapy is to block the release of hydrochloric acid in the stomach?

Histamine-2 receptor antagonist

Which statement made by a client currently being treated for several medical conditions requires additional medication education by the nurse concerning the use of calcium salts?

I take an antacid with my morning medications to minimize their effect on my stomach

A client is started on metoclopramide for the treatment of diabetic gastroparesis. Which adverse effect is specific to this drug therapy?

Muscle rigidity

Why might a proton pump inhibit (PPI) be preferable to an a histamine2 receptor antagonists (H2RA) for the treatment of gastroesophageal reflux disease (GERD)? Select all that apply.

PPIs facilitate faster healing. PPIs act for a longer period of time. PPIs suppress acid more effectively.

A client is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication?

Peptic ulcer disease

Which teaching intervention is mostimportant to share with the client prescribed misoprostol?

Use effective contraceptive measures.

Which client is at risk for the development of an acute ulcer? select all that apply.

A client on a mechanical ventilator for 5 days A client with 2nd degree burns over 50% of the body A client who experienced a stroke A client who is diagnosed with jaundice

What is the most likely reason esomeprazole (Nexium) has been prescribed for a client who has a diagnosis of H. Pylori and is taking antiplatelet drugs?

Prevention of bleeding

The nurse is providing client education for a client with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The client has been newly prescribed misoprostol (Cytotec). What would the nurse be most accurate in informing the client about the drug?

Protects the stomach's lining

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

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 anti-inflammatory drug (NSAID) daily.

The nurse is caring for a 27-year-old female client who has just been prescribed misoprostol. What is a priority teaching point for this client?

The need to use a barrier-type contraceptive

A male client arrives at his sick call reporting chronic abdominal pain. Having a 40-pack year history, he reports his smoking has decreased to approximately 20 packs/year. The health care provider, after thorough assessment and evaluation and labs, prescribes a treatment regimen for a duodenal ulcer caused by H. pylori infection. What type of medication might be used to treat the ulcer?

Two antimicrobials and either a PPI or H2RA

How should the critical care nurse mostaccurately titrate the dose and frequency of administration of an intragastric drip of an antacid through a nasogastric tube?

by aspirating stomach contents and measuring the pH

The nurse practitioner instructs the client to use over-the-counter ranitidine instead of cimetidine. What risk is decreased when using ranitidine rather than cimetidine?

drug-to-drug interaction

The client will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse should inform the client that common side effects related to this medication include:

headache

The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction?

hemorrhage

The nurse is teaching a client about lansoprazole prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease?

inhibiting acid secretion

nurse assesses a client for signs and symptoms of tardive dyskinesia when the client is receiving which drug?

metoclopramide

The nurse is caring for an adult client presenting with recent heartburn, which the client treated with over-the-counter omeprazole 20 mg PO daily. The nurse reviews the client's current list of medications and should report which medication as having a potential drug interaction with the omeprazole? Select all that apply.

phenytoin atenolol

The nurse is administering an H-2 receptor antagonist to a client with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug:

provides protection of the stomach lining via acid blockage.

client with a history of peptic ulcer disease has responded well to treatment with a histamine-2 antagonist. This client is most likely experiencing:

reduction in the quantity of hydrochloric acid secreted.

What type of medication might be included in the medication therapy to treat a peptic ulcer by serving as a barrier to gastric secretions?

sucralfate

A client comes to the clinic reporting an acid stomach. The client tells the nurse that it seems like the client is always buying OTC antacids and wants a prescription to "cure the problem." The nurse should assess the client for:

systemic alkalosis.

A nurse is caring for a client experiencing stomach hyperacidity. The health care provider has prescribed aluminum carbonate gel. The nurse would administer this drug cautiously to the client with which condition?

upper GI bleeding

The nurse admits a client who reports having taken a proton pump inhibitor for more than a decade. What assessment question will the nurse ask this client?

"Are you experiencing diarrhea?"

A client has been prescribed esomeprazole (Nexuim). What statement by the client indicates that the client has a good understanding of the newly prescribed drug?

"I need to swallow the drug whole and not chew the capsules."

The nurse is educating a client diagnosed with peptic ulcer disease about the prescribed medications aluminum hydroxide-magnesium hydroxide-simethicone mixture and ranitidine. Which statement made by the client indicates the need for further clarification?

"To decrease interactions with other drugs I take, I will take the drug 30 minutes before taking the rest of my meds."

A client has a magnesium-based antacid prescribed for administration as needed. Which condition contraindicates the administration of this classification of medications?

renal dysfunction

A client taking ginger for motion sickness reports heartburn. What is the nurse's bestresponse?

"Adverse effects are rare, but heartburn has been reported by some individuals taking ginger."

The nurse is caring for a client who is prescribed esomeprazole. The client informs the nurse that he is also taking sucralfate. The nurse would anticipate which effect as a possibility when these two drugs are administered?

decreased absorption of the esomeprazole

A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the client for:

depression

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

inhibiting the secretion of gastric acid

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.

The client, recently diagnosed with peptic ulcer disease, states achieving adequate symptom relief with the use of over-the-counter (OTC) antacids but has asked the nurse about the optimal schedule for taking these drugs. What action should the nurse recommend?

one hour and three hours after each meal and at bedtime

A client is prescribed ranitidine 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.

A client who is postoperative day one following a metatarsal amputation is experiencing nausea and vomiting. Consequently, the nurse has administered an intravenous dose of metoclopramide. This drug will relieve the client's nausea by:

stimulating the motility of the client's upper GI tract.

A client, with recent abdominal pain and a 40-pack per year smoking history, is prescribed a treatment regimen for a diagnosis of duodenal ulcer. What important teaching would the nurse include in relation to treatment?

smoking effects on the healing of ulcers