Close-Outs Week 7 Flashcards
if pt is experiencing mild, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?
lifestyle/dietary changes and-
antacid, low-dose H2RA, or combination of the two
use a PPI or see Dr
if pt is experiencing moderate, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?
lifestyle/dietary changes and-
antacid or high-dose H2RA
use a PPI or see Dr
if pt is experiencing heartburn 2 or more times a week, what is the recommendation?
lifestyle/dietary changes and-
PPI daily for 14 days or H2RA as needed
what are notable exclusions for self-treatment of heartburn?
- HB lasting more than 3 months
- Severe HB or dyspepsia
- HB at night
- Difficulty/pain swallowing solid foods
- unexplained weight loss
- wheezing, coughing, choking
- continuous nausea, vomiting, or diarrhea
- chest pain with sweating, shortness of breath
- adults over 45 with new-onset dyspepsia
patient should not exceed __ days of self-treatment with a PPI and should not use again for __ months
14, 4
patient should not exceed __ days of self-treatment with an antacid or H2RA w/o consulting PCP
14
do not recommend bismuth subsalicylate to patients allergic to?
aspirin/salicylates
do not give calcium carbonate to pregnant woman taking prenatals because?
prenatals usually have calcium
antacid recommendation for heartburn: sodium bicarbonate
directions for use:
side effects:
do not use longer than __ consecutive days
if symptoms worsen over the next 14 days, what should you counsel patient:
- dissolve 2 tablets in 4oz of water every 4 hours as needed
- Nausea, bloating, or gas
- 14
- if symptoms persist contact dr
antacid recommendation for heartburn: calcium carbonate
directions for use:
side effects:
do not use longer than __ consecutive days
if symptoms worsen over the next 14 days, what should you counsel patient:
- chew 2-4 tablets as needed
- Nausea, bloating, or gas
- 14
- if symptoms persist contact dr
H2RA recommendation for heartburn: famotidine
directions for use:
side effects:
don’t take longer than:
counsel patient on symptoms worsening or not going away after 14 days:
- 1 tablet with full glass of water, up to 2 tablets daily
- Headache, constipation, or diarrhea
- 14 days
- if symptoms persist or worsen over 14 days contact dr
PPI recommendation for heartburn: omeprazole
directions for use:
side effects:
do not use again for _ months:
counsel if experiencing heartburn while on this medication or before the 4 month period:
- 1 tab with a full glass of water 30 minutes before morning meal, take daily for 14 days
- Headache or abdominal pain
- 4 months
- contact Dr if still experiencing heartburn after 14 days or heartburn comes back before 4 months
when evaluating a patient with constipation, what are the steps involved?
- determine cause of constipation (food/drugs)
- if prescription drug induced, contact Dr
- if likely caused by food, recommend high fluid-fiber intake and inc exercise if needed
- if fluid/fiber isn’t working, recommend a bulk former or hyper-osmotic
- if OTC products don’t work, see Dr
exclusions for self-treatment of constipation:
- fever
- nausea/vomiting
- chronic medical condition
- laxative use
- changes in bowel habits and weight loss
- symptoms persisting over 2 weeks or recur within 3 months
- anorexia
- under 2 years old
when using bulk-forming laxatives, patients should be counseled to?
drink plenty of water with the laxative
how to insert an enema:
- if administered by someone else, lay on left-side with knees bent or go into the knee-to-chest position
- if you are administering, lay on back and bring knees to chest and raise your buttocks.
- make sure enema tip is lubricated and the anal area as well
- gently insert 2-3 inches into rectum
- allow solution to flow into rectum slowly and retain it inside rectum for 1-5 minutes
how to insert a suppository:
- make sure it is firm enough to insert and cool it down
- unwrap it and dip into lukewarm water for a few seconds
- lay on left side with knees bent or go into the knee-to-chest position
- relax buttocks before inserting and then insert
- continue to lie down for a few minutes while holding the buttocks together
- avoid a bowel movement for roughly an hour after insertion
recommended bulk-forming agent: psyllium directions for use: time for effect: do not use longer than: side effects: counsel point about fluids
- swallow 5 capsules with 8oz of liquid (1 capsule at a time) up to 4 times a day
- usually 12 to 72 hours
- 7 days
- Gas or stomach cramping
- drink plenty of fluids while using
recommended hyperosmotic agent: polyethylene glycol directions for use: time for effect? do not use longer than? side effects?
- 17g in 4-8oz of liquid once daily
- may take 2 to 4 days
- 14 days
- Nausea, cramping, or gas
recommended emollient agent: docusate sodium directions for use: time for effect: side effects: do not use longer than:
- 50-300mg qd
- may take 1 to 2 days
- Stomach pain, diarrhea, or cramping may occur
- 7 days
what is the best recommended otc product for constipation?
bulk-forming agents
best products for quick relief of constipation?
bulk-forming agents
best products for opioid caused constipation?
emollients
best products for use after surgery and prevent straining?
emollients
for pregnancy, what recommendations are given for constipation?
do not recommend OTC products. instruct pt to consume more fiber and drink more fluids. OTC medications are used if non-pharm doesnt work
flaxseed is a good complementary therapy for?
constipation
