Chapter 43 Flashcards
The patient’s health care provider prescribes rabeprazole to a patient. The nurse recognizes that this drug is effective for the patient because it belongs to which drug class?
A) antiinfective agent
B) proton pump inhibitor
C) antacid
D) histamine 2 blocker
B) proton pump inhibitor
The drug rabeprazole is classified as a proton pump inhibitor.
The nurse is caring for a patient who is taking sucralfate for treatment of a duodenal ulcer. Which assessment requires action by the nurse?
A) a sodium level 140 mEq/L
B) absent bowel sounds, hard abdomen
C) urinary output of 30 mL/h
D) a calcium level 8.5 mg/dL
B) absent bowel sounds, hard abdomen
As sucralfate is not systemically absorbed, there are few adverse effects. Constipation is an adverse effect of sucralfate, so the absence of bowel sounds and a hard abdomen would require immediate action from the nurse. The sodium level listed is considered to be within the normal range; 30 mL/h is a normal urinary output.
The patient has been prescribed a treatment regimen that includes nizatidine. Which statement by the patient indicates a therapeutic outcome?
A) “I don’t have any more stomach pain”
B) “my constipation has been relieved”
C) “I don’t have such frequent headaches”
D) “my anxiety has been under control”
A) “I don’t have any more stomach pain”
Nizatidine is used to treat stomach ulcers and to prevent their recurrence.
The health care provider prescribes lansoprazole (Prevacid) for a patient. Which assessment indicates to the nurse that the medication has had a therapeutic effect?
A) the patient has no diarrhea
B) the patient has no gastric pain
C) the patient has no esophageal pain
D) the patient is able to eat
C) the patient has no esophageal pain
Lansoprazole is a proton pump inhibitor that is effective in suppressing gastric acid secretions. An absence of esophageal pain (heartburn) would be an indication that the patient does not have reflux esophagitis.
A patient has been prescribed aluminum hydroxide and has received patient teaching. Which statement by the patient indicates an understanding of the instructions?
A) “I will take aluminum hydroxide at mealtime”
B) “I will drink 2 ounces of water after taking aluminum hydroxide”
C) “I will take aluminum hydroxide within 30 min of my other medications”
D) “I will take a laxative if I develop constipation”
B) “I will drink 2 ounces of water after taking aluminum hydroxide”
The patient should drink 2 ounces of water after taking aluminum hydroxide to ensure the drug reaches the stomach. Aluminum hydroxide should not be taken at mealtime, as it slows gastric emptying time. Aluminum hydroxide should not be taken within 1-2 hours of other oral medications. The patient should contact the health care provider if constipation develops, as the antacid may need to be changed; self-treatment should be avoided.
What information will the nurse include in a teaching plan for the patient who is prescribed sucralfate?
A) “this medication will neutralize gastric acid”
B) “this medication will enhance gastric absorption of meals”
C) “this medication will form a protective barrier over the gastric mucosa”
D) “this medication will inhibit gastric acid”
C) “this medication will form a protective barrier over the gastric mucosa”
Sucralfate affects the gastric mucosa. It forms a paste-like substance in the stomach, which adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.
The health care provider has prescribed lansoprazole for the patient. Within 30 min of receiving the first dose of the medication, the patient experiences shortness of breath and develops a rash on his skin. What does the nurse expect that the patient is experiencing?
A) unexpected side effect of the medication
B) toxic level of the medication
C) allergic reaction to the medication
D) typical side effect of the medication
C) allergic reaction to the medication
The patient’s symptoms are indicative of an allergic reaction to the medication.
What is a priority nursing intervention when administering ranitidine?
A) administer just before meals
B) administer right after eating
C) administer 1-2 hours after meals
D) administer during meals
A) administer just before meals
Ranitidine should be given just before meals to decrease food-induced acid secretion or at bedtime.
Which statement demonstrates to the nurse that the patient understands instructions regarding the use of histamine 2-receptor antagonists?
A) “since I am taking this medication, it is all right for me to eat spicy foods”
B) “smoking decreases the effects of the medication, so I should try a cessation program”
C) “I should take this medication 1 h after each meal to decrease gastric acidity”
D) “I should decrease bulk and fluids in my diet to prevent diarrhea”
B) “smoking decreases the effects of the medication, so I should try a cessation program”
The patient should still take other measures to help prevent acid reflux such as avoiding spicy foods. The drug should be taken just before meals or at bedtime to decrease food-induced acid secretion.
The nurse is caring for a patient who is experiencing gastric distress from the long-term use of aspirin for treatment of arthritis. Which intervention does the nurse anticipate that the provider may order?
A) stop all aspirin therapy
B) administer misoprostol
C) instruct the patient to take the aspirin with milk
D) instruct the patient to take the aspirin on an empty stomach
B) administer misoprostol
Misoprostol is indicated for the prevention of NSAID-induced ulcer. It may be taken during NSAID therapy, including with aspirin. The patient may not be able to be completely taken off of all aspirin products; there is no evidence to support the need to take the aspirin with milk. Certain drugs like NSAIDs, which include aspirin, should be taken with food.
Which medications are most likely to be included in a dual drug therapy program for peptic ulcer disease from H. pylori?
A) omeprazole and clarithromycin
B) tetracycline and metronidazole
C) ranitidine and amoxicillin
D) ciprofloxacin and sucralfate
A) omeprazole and clarithromycin
Clarithromycin specifically targets H. pylori bacteria.
A patient with peptic ulcer disease is noted to have a positive breath test for H. pylori. The nurse would anticipate treating the patient with:
A) antacids and narcotics
B) pepsin inhibitors and antiemetics
C) proton pump inhibitors and antibiotics
D) emetic agents and tranquilizers
C) proton pump inhibitors and antibiotics
The antibiotics are needed to kill the H. pylori which are a type of bacteria commonly associated with the formation of peptic ulcers.
An older adult patient reports taking aluminum hydroxide on a daily basis to relieve symptoms of gastroesophageal reflux disease. The nurse needs to evaluate for which condition?
A) constipation
B) diarrhea
C) flatulence
D) abdominal pain
A) constipation
Aluminum can cause constipation.
When administering the histamine 2 blocker ranitidine, the nurse will:
A) monitor laboratory results because ranitidine decreases the effect of oral anticoagulants
B) separate ranitidine and antacid dosage by at least 1 hour if possible
C) teach the patient to avoid foods rich in vitamin B12
D) expect a reduction in the patient’s pain to occur after 5 days of therapy
B) separate ranitidine and antacid dosage by at least 1 hour if possible
The nurse should expect a reduction in the patient’s pain to occur after 1 to 2 weeks of drug therapy. The patient should also be taught to increase intake of foods rich in vitamin B12 to avoid deficiency as a result of drug therapy.
A patient with a gastric ulcer is ordered sucralfate. This medication works to:
A) calm the patient to reduce acid production
B) block the histamine 2 receptors
C) neutralize the gastric acids
D) coat the gastric lining
D) coat the gastric lining
