PrepU Pharm Chapter 37

When comparing the H2RAs to each other, you would find that cimetidine (Tagamet) is more likely to cause which adverse effect?

Gynecomastia

A client 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."

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

Digoxin

The health care provider has prescribed sucralfate for a client with a gastric ulcer. The client asks how long he must take this medication. What is the nurses best response to this client?

"You will need to take this medication for 4 to 8 weeks to ensure healing has occurred."

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

Amoxicillin

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

A 35-year-old man is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the health care provider is prescribing a proton pump inhibitor. Why might the provider prescribe a PPI rather than an H2RA?

PPIs suppress acid more strongly and for a longer time.

Ranitidine (Zantac) should be cautiously administered to individuals with evidence of which of the following conditions?

Renal disease

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 30-year-old non pregnant patient is prescribed misoprostol. Which of the following should the nurse instruct the patient as part of the teaching plan?

use a reliable contraceptive

A female client is currently taking sucralfate and has been given a prescription for ciprofloxacin for treatment of a urinary tract infection. The nurse will inform the client that she should take her medication in what way?

"Take the ciprofloxacin 2 hours before the sucralfate."

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

1 hour before eating

The nurse at a long-term care facility administers proton pump inhibitors to several residents. Which client should the nurse monitor for increased effects of his or her other medications?

A client with atrial fibrillation who takes warfarin

Occasionally, a bismuth preparation is added to the treatment regimen for duodenal ulcers. What are bismuth's effects against H. pylori organisms.

All of these

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

Which agent is associated with antiandrogenic effects?

Cimetidine

Which agent would a nurse identify as the prototype histamine-2 receptor antagonist?

Cimetidine

Which would a nurse anticipate as having antiandrogenic effects?

Cimetidine

Which medication reduces the secretions 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 is taking an antacid that contains aluminum salts. The nurse would monitor the client for:

Hypophosphatemia

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.

Mr. Palmer is scheduled to receive ranitidine at 9:00 am this morning. What is a correct explanation of the pharmacodynamics of ranitidine?

It inhibits both daytime and nocturnal basal gastric acid secretions as well as gastric acid secretion.

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

Omeprazole

The following data identified during a nursing assessment and interview. When considering risks for the development of peptic ulcer, which situation should the nurse discuss with the client?

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

A female client's diagnoses include diabetes mellitus, gastric ulcer disease, and chronic renal disease. When the nurse reviews her medication with her, the nurse discover that she self-administers antacids containing magnesium. What statement is true about antacids containing magnesium?

They are contraindicated for clients with renal disease

What is the rationale for using two antimicrobials when treating a Helicobacter pylori infection?

Two antimicrobials are needed prevent the emergence of drug-resistant H. pylori organisms

Of the commonly used antacids, which is rarely used in the treatment of peptic ulcer disease (PUD) because of its effect on gastrin release

calcium compounds

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 42-year-old was is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is:

headache

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

hemorrhage

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

A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:

serum phosphate level

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

Alopecia

The nurse is talking with nursing students about the drugs that affect the gastrointestinal secretions. What group of drugs would the nurse tell the students is used to treat peptic ulcers by suppressing the secretion of hydrochloric acid into the lumen of the stomach?

Proton pump inhibitors