Pharmacology Chapter 57

What histamine-2 antagonist might the nurse administer to a child?

Famotidine

A male client is taking cimetidine. Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?

Gynecomastia

The nurse is providing education for a patient with peptic ulcer disease resulting from chronic nonsteroidal anti-inflammatory drug (NSAID) use who will begin a prescription of misoprostol (Cytotec). The nurse evaluates that the patient understands the actions of this drug when he or she says it does what?

Protects the stomach's lining

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

You will need to use a barrier-type contraceptive

What classification of drugs does the nurse administer to treat peptic ulcers by suppressing the secretion of hydrochloric acid into the lumen of the stomach?

Proton pump inhibitors

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

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

Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?

Drug-drug interactions

The patient will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse will inform the patient that common adverse effects related to this medication include what?

Headache

A client has been prescribed omeprazole by the primary health care provider. When the nurse asks whether the medication is providing relief, the client replies, "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."

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 a patient who has been prescribed a saliva substitute (Salivart). 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."

The nurse is preparing a patient for discharge with a prescription for sucralfate (Carafate) and teaches the patient to take the medication when?

1 hour before or 2 hours after meals and at bedtime

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?

1-2 Weeks

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

150 to 300mg

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

An adult patient is prescribed cimetidine (Tagamet). A nurse will instruct the patient that an appropriate dosage and frequency of cimetidine is what?

800 mg PO at bedtime

What would the nurse consider an indication for the use of antacids? (Select all that apply.)

A) Gastric hyperacidity B) Gastritis C) Peptic esophagitis D) Hiatal hernia

What nursing interventions are included in the plan of care for a patient receiving antacids to relieve GI discomfort?

Administer the antacid 1 hour before or 2 hours after other oral medications.

A patient comes to the clinic complaining of acid indigestion and tells the nurse he is tired of buying over-the-counter (OTC) antacids and wants a prescription drug to cure the problem. What would the nurse specifically assess for?

Alkalosis

A patient with a duodenal ulcer is receiving sucralfate for short-term treatment. What will the nurse advise the patient to avoid?

Aluminum salts

When caring for a patient diagnosed with a peptic ulcer, the nurse administers omeprazole (Prilosec) along with what antibiotic to eradicate Helicobacter pylori?

Amoxicillin

Which of these patients would the nurse expect to be the best candidate for misoprostol (Cytotec)?

An 83-year-old man with rheumatoid arthritis

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

What drug combination will the nurse normally administer most often to treat a gastric ulcer?

Antibiotics and proton pump inhibitors

The nurse develops a discharge teaching plan for a patient who was prescribed pancreatic enzyme replacement and includes what important teaching point?

Avoid spilling the powder on the skin because it may be irritating.

The nurse would assess patients with what condition to determine whether there is a need for a saliva substitute? (Select all that apply.)

B) Stroke C) Cancer receiving chemotherapy or radiation therapy E) Chronic dry mouth

What priority teaching point does the nurse include when instructing patients about the use of antacids?

Be aware of risk of acid rebound with long-term use.

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

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 should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?

Constipation

A patient has been prescribed esomeprazole (Nexium). What statement by the patient does the nurse evaluate as indicating that he or she has a good understanding of his newly prescribed drug?

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

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

Malnutrition

What H2 antagonist would the nurse consider the drug of choice for a patient with advanced liver failure?

Nizatidine

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

What symptoms would the nurse find to be consistent with a diagnosis of a peptic ulcer?

Pain a few hours after eating

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

he clinic nurse is caring for a 78-year-old male patient who is taking a proton pump inhibitor. What condition is this patient at increased risk for developing?

Pernicious anemia

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. After reviewing the client's current list of medications, the nurse should report which medication because concurrent use may increase blood levels of omeprazole?

Phenytoin Clarithromycin

A client is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale for adding bismuth to the client's medication regimen?

Provides antibacterial effects

What action does the histamine-2 antagonist administered by the nurse have on the human body that will help to prevent peptic ulcer disease?

Reduces the amount of hydrochloric acid secreted

The nurse administers ranitidine (Zantac) cautiously to patients with evidence of what conditions?

Renal disease

The 59-year-old patient has peptic ulcer disease and is started on sucralfate (Carafate). What is an appropriate nursing diagnosis related to this medication?

Risk for constipation related to GI effects

The nurse is caring for a patient requiring digestive enzyme replacement therapy and establishes what appropriate nursing diagnosis for this patient?

Risk for imbalanced nutrition

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 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

Client teaching should include what instruction about antacids?

Take antacid 1 hour before other medications.

After providing teaching to a patient prescribed lansoprazole (Prevacid), the nurse evaluates the patient understands the action of this medication when the patient makes what statement?

The medication inhibits acid secretions.

The nurse questions an order for a proton pump inhibitor when the patient is known to take what other medication?

Theophylline

Pancrelipase would most likely be used to treat a patient with cystic fibrosis.

True

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.

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 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

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 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, 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

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

Are you experiencing diarrhea?

A patient presents to the walk-in clinic complaining of vomiting and burning in his or her mid- epigastria. The nurse suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the physician is likely to order a diagnostic test to detect the possible presence of what?

Infection with Helicobacter pylori

The nurse would question an order for misoprostol if the patient was diagnosed with what condition?

Pregnancy

The nurse, caring for a patient with cystic fibrosis, administers pancreatic enzymes on what schedule?

With meals and snacks

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

20 mg b.i.d

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?

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 female client has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?

"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."

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

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

Alopecia

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.

When comparing the histamine-2 antagonists to each other the nurse recognizes that cimetidine (Tagamet) is more likely to cause which adverse effect?

Gynecomastia

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

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

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 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 diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?

Proton pump inhibitors