Pharmacology, Chapter 57: Drugs Affecting GI Secretions
A nurse is teaching a 47-year-old client about omeprazole, which the physician has 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."
Ms. Kime is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux. Which statement made by the patient indicates that she understood the teaching provided about taking these medications?
"I should take ranitidine 2 hours before or after my antacid dosage."
The nurse should warn a patient taking magnesium and sodium containing antacids about which adverse effect?
Diarrhea
The nurse is caring for four patients. Which patient would benefit most from misoprostol, a synthetic prostaglandin E analog?
An 83-year-old male with rheumatoid arthritis
The nurse is teaching a 31-year-old patient about lansoprazole, which the physician has prescribed for treatment of gastric ulcer. By what mechanism of action does lansoprazole help treat the disease?
By inhibiting acid secretion
Which agent would a nurse identify as the prototype histamine-2 receptor antagonist?
Cimetidine
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 patient taking aluminum and calcium-containing antacids about which adverse effects?
Constipation
When teaching a patient about an antacid containing aluminum, what would the nurse include?
Decreased risk for acid rebound
What 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 (Nexium) Lansoprazole (Prevacid)
True or false? Saliva substitute is absorbed systemically.
False
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
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
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
Increased fracture risk
A 25-year-old client arrives at the walk-in clinic reporting vomiting and a burning sensation in the midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?
Infection with H. pylori
A client has a history of liver dysfunction. Which histamine-2 receptor antagonist would the nurse expect to be prescribed?
Nizatidine
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
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)
A patient 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
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 female client presents to the physician'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
Ranitidine is a histamine2 receptor antagonist (H2RA) prescribed for treatment of peptic ulcer disease and gastric reflux. Dosage of ranitidine must be reduced in patients with what condition?
Renal disease
The patient has Maalox ordered for administration before meals. Which of the following conditions is contraindicated with the administration of Maalox?
Renal dysfunction
A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the patient's safety. Which of the following would be an appropriate nursing diagnosis?
Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations
A 75-year-old client is treating his ulcer with antacids. Based on the client's age, the nurse expects the physician to prescribe a dose of antacid that compares with the average prescribed dose in what way?
Smaller than the average prescribed dose
Which antacid is contraindicated in patients with congestive heart failure?
Sodium bicarbonate (Bellans)
True or false: Pancrelipase would most likely be used to treat a patient with cystic fibrosis.
True
True or false? The patient receiving omeprazole should swallow the tablet whole with a large glass of water.
True
True or false? The use of calcium carbonate is associated with the development of acid rebound.
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.
A 23-year-old female patient is prescribed misoprostol (Cytotec). Which patient teaching intervention is most important?
Use effective contraceptive measures
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 patients who:
are pregnant.
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.
The nurse is administering an H-2 receptor antagonist to a patient with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug:
provides protection of the stomach lining via acid blockage.
A patient is in the intensive care unit and being administered ranitidine (Zantac) parenterally. How long will it take for ranitidine (Zantac) to reach peak blood levels?
15 minutes
The physician has prescribed ranitidine for a patient in your unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the patient?
Headache
