Week 5: Drugs for Gastrointestinal Problems

While studying for a test, a nursing student asks the nurse why misoprostol should not be given in pregnant women. What is the best response by the nurse?

"Misoprostol can induce uterine contractions and miscarriage if given during pregnancy."

The LPN is caring for a patient that is prescribed a calcium carbonate-based antacid. Which of the following statements by the patient suggests a need for more teaching?

"My antacid neutralizes the acid in my stomach."

A patient with chronic constipation is prescribed psyllium (Fiberall). Which of the following statements by the patient shows a need for more teaching?

"This drug will replace my need for dietary fiber, so I can eat fewer fruits and vegetables."

The patient has been taking a phenothiazine drug for nausea. The patient tells the nurse she has a pinkish red color to her urine. Which is the most appropriate response from the nurse?

"This is an expected response to the drug."

Which of the following patients are most likely to require a stool softener for the management of bowel movements? (Select all that apply.)

- A 62-year-old patient who recently underwent open heart surgery to replace a heart valve. - An 84-year-old woman who has moved into a skilled nursing facility after having a stroke. -A 34-year-old pregnant woman with constipation who has a prescription from her healthcare provider.

S.Y. is a 37-year-old male with a history of irritable bowel syndrome (IBS). He reports having a flare-up of symptoms with cramping, and diarrhea. The healthcare provider prescribes dicyclomine (Bentyl) to relieve the bowel spasms. One week later, Mr. Y. states his symptoms are greatly improved. To reduce the further risk of constipation and reduce symptoms of IBS, the provider has prescribed psyllium (Metamucil) 1 rounded teaspoon once a day. Which of the following statements should be included in patient teaching. (Select all that apply.)

- Check to make sure the patient doesn't have any allergy to psyllium - These drugs usually work between 12 hours to 3 days - To improve taste, psyllium may be mixed with fruit juices or milk - Make sure to take each dose with at least 8 ounces of fluid

M.K. is an 80-year-old female who has been taking over-the-counter (OTC) famotidine for indigestion for 2 weeks without significant relief. She decided to contact her healthcare provider because the symptoms were worsening. She is admitted to the hospital with increasing abdominal pain for the last 5 days. Her admission diagnosis is GERD and she is scheduled for an esophagogastroduodenoscopy (EGD) to rule out peptic ulcer disease. She is to begin therapy with the oral proton pump inhibitor omeprazole. The LPN documents these findings as part of her admission assessment. (Select all that apply.)

- Heart rate = 106 beats per minute (bpm) and regular - Reports feeling usually tired today - Blood pressure = 96/52 mmHg - Skin cool and moist to touch - States that her abdominal pain is currently a 7 (on a 0-10 pain intensity scale) - Respirations = 22 breaths per minute

A nurse is teaching a patient about the loperamide prescribed for acute diarrhea. Which of the following statements should be included in the patient teaching? (Select all that apply.)

- If your diarrhea does not stop after 48 hours, notify your healthcare provider. - Make sure you take 4 mg (2 tablets) initially, then 2 mg by mouth after each unformed stool. Do not exceed 8 tablets per day. - Loperamide will reduce the number of liquid stools that you are experiencing. -Loperamide helps decrease the motility of your bowel so there is more time for the body to absorb water and you will have a more formed stool.

A 47-year-old patient tells the nurse that they have been taking over-the-counter famotidine for over 2 weeks without relief of symptoms of reflux. What is the best action for the nurse?

- Tell the patient to contact their healthcare provider for evaluation of the symptoms - Tell the patient that over-the-counter famotidine can be used for a maximum of two weeks only.

A patient is to receive misoprostol (Cytotec) 50 mcg by mouth four times a day with meals and at bedtime to prevent NSAID-induced gastric ulcers. The tablet is available in 100-mcg tablets (scored). How many tablets will the patient receive with each dose?

1/2 tablet

A patient is to receive 4 mg of ondansetron (Zofran) IM as a single dose after surgery for nausea and vomiting. Ondansetron is available 2 mg/mL. How many milliliters will the patient receive?

2 mL

The patient is to receive nizatidine (Axid) 300 mg orally at bedtime to treat gastric ulcer caused by H. pylori. The drug is available in 150-mg tablets. How many tablets should the patient receive?

2 tablets

A patient is to receive sucralfate (Carafate) 1 g per gastronomy-tube four times daily. Sucralfate is available as an oral suspension 1 g/10 mL. How many mL will the patient receive each day?

40 mL each day

A patient is prescribed oral nabilone for symptoms of nausea and vomiting secondary to chemotherapy. What is first action essential for the LPN prior to administering the nabilone?

Be fully aware of the state and agency policies for administering cannabinoids prior to administering any medically based marijuana (natural or synthetic).

A patient with chemotherapy-related nausea and vomiting is prescribed dolasetron (Anzemet). When you are giving morning drugs, you notice that she is taking a selective serotonin reuptake inhibitor for chronic depression. What is your best action?

Hold the dolasetron and contact the healthcare provider to notify him or her that the patient takes the antidepressant.

A 72-year-old man had recent episodes of confusion. The LPN discovers that the man recently started taking over-the-counter famotidine (Pepcid) for his "heartburn." What is the best action for the LPN?

Tell the daughter to contact the patient's healthcare provider because this is a common adverse effect of famotidine.