pharm prep u ch 37
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 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
The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction?
hemorrhage
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
increased fracture risk
What is the rationale for using two antimicrobials when treating a Helicobacter pylori infection?
two antimicrobials are needed to prevent the emergence of drug-resistant H. pylori organisms.
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."
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."
A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The client states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this client's statement?
"Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn."
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."
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."
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 nurse's best response to this client?
"You will need to take this medication for 4 to 8 weeks to ensure healing has occurred."
A client has been prescribed 200 micrograms of misoprostol to be taken 4 times a day orally for the prevention of gastric ulcers. The drug is available in 100 microgram tablets. How many tablets should the nurse administer to the client each time?
2 tablets
The nursing instructor is discussing the use of histamine2 receptor antagonists in the treatment of peptic ulcer disease. According to the instructor, which is a typical dosing schedule of famotidine during the first few weeks of treatment for gastric ulcer in patients with normal renal function?
20 mg bid
The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?
Constipation
When comparing the H2RAs to each other, you would find that cimetidine (Tagamet) is more likely to cause which adverse effect?
Gynecomastia
Why are histamine2 receptor antagonists preferred in the treatment of upper gastrointestinal (GI) disorders over traditional histamine1 receptor antagonists?
Histamine1 receptor antagonists do not block histamine effects on gastric acid production.
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.
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
Which of the following drugs are commonly used in combination with certain antibiotics in the treatment of H. pylori? Select all that apply:
Omeprazole (Prilosec), Lansoprazole (Prevacid)
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.
A female client's diagnoses include diabetes mellitus, gastric ulcer disease, and chronic renal disease. When the nurse reviews her medications 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.
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.
A 42-year-old man 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
A common drug regimen for eradication of H. pylori includes a proton pump inhibitor (PPI) and two antibiotics. What is one of the preferred antibiotics?
amoxicillin
The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:
an hour before meals.
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.
The nurse is caring for a patient who is going home on sucralfate (Carafate). The nurse would teach the patient to take sucralfate:
before meals.
Because of the possible adverse effects of long-term proton pump inhibitor (PPI) use, the nurse practitioner should focus on what assessment in a 72-year-old client?
bone density
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
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
Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect?
digoxin
Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?
drug-drug interactions
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 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
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
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.
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
omeprazole
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
A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?
proton pump inhibitors
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
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 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.
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?
smaller than the average prescribed dose.
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
