CHAPTER 57
A client has been diagnosed with peptic ulcer disease. Which potential causative factor will the nurse identify?
Renal dysfunction
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition?
Hepatic disease
The nurse is caring for a patient who has been prescribed a saliva substitute . The patient asks why this medication is necessary. What would be the most appropriate response?
"This medication helps people that have a condition that creates a lack of saliva."
When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?
Alopecia
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
An antacid has been added to the treatment regimen for a client on multiple medications. When is the best time for the nurse to administer the antacid?
At bedtime
A male client is taking cimetidine. Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?
Gynecomastia
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:
Gynecomastia
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?
Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
Omeprazole
After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?
Omeprazole
Pancrelipase would most likely be used to treat a patient with cystic fibrosis.
True
A 30-year-old female client is prescribed misoprostol. Which instruction should the nurse prioritize in the teaching session for this client?
Use a reliable contraceptive method.
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?
Use a reliable contraceptive.
An older adult has been taking calcium carbonate antacid tablets after each meal to treat acid reflux. The client previously achieved therapeutic effects by taking two to three tablets but now has to take four or five tablets. Which phenomenon will the nurse teach the client about?
acid rebound leading to medication tolerance
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.
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
The client will receive cimetidine 800 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 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
A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to
pork.
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?
Hepatic disease
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
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
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?
Closely monitor the patient for confusion and dizziness.
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
When teaching a client about an antacid containing aluminum, what would the nurse include?
Decreased risk for acid rebound
Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?
Drug-drug interactions
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
Gynecomastia
A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client?
Hip fractures
A client with a gastrointestinal (GI) disorder is prescribed the proton pump inhibitor omeprazole. Which information would the nurse include when instructing the client about this medication?
Instruct the client to swallow the capsule whole.
Client teaching should include what instruction about antacids?
Take antacid 1 hour before other medications.
A nurse is providing education to an adult female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching?
Use effective contraceptive measures.
Which client being treated for peptic ulcers or GERD will the nurse monitor most closely for potential drug-drug interactions as a result of therapy?
the client taking cimetidine
A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent?
1 to 2 weeks
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 aspirating stomach contents and measuring the pH
The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?
Constipation
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?
Hip fractures
A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the mid-epigastric 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 adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
Increased fracture risk
A client is diagnosed with an infection with H. pylori. The nurse anticipates the client will be prescribed which drug(s) in combination with an antibiotic? Select all that apply.
Lansoprazole Omeprazole
An older client has been prescribed omeprazole for the treatment of gastresophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?
Omeprazole
A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client?
Rebound acidity
The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what?
Renal dysfunction
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.
An older adult client has been on long-term proton pump inhibitor (PPI) therapy. The nurse practitioner should focus on what assessment related to adverse effects?
bone density
The health care provider has prescribed ranitidine for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client?
Headache