Gastrointestinal System Flashcards
Antacids Examples
Aluminum hydroxide
Magnesium hydroxide (Milk of Magnesia)
Sodium Bicarbonate
Aluminum Hydroxide Complications
constipation
hypophosphatemia
Magnesium Hydroxide Complications
Diarrhea
Renal Impairment
Hypermagnesemia
Sodium Bicarbonate Complications
Constipation
Antacids Indications
peptic ulcer disease
GERD
Antacids Precautions
prolonged use can result in hypophosphatemia
can decrease medication absorption
Antacids Administration
use only aluminum based preparations in renal impairment
other medications should be taken 1 hr before or after antacids
older adults with poor nutritional status are at increased risk of hypophosphatemia
do not self prescribe antacids for longer than 2 weeks
Proton Pump Inhibitors Examples
Omeprazole
Lansoprazole
Rabeprazole sodium
Esomeprazole
Proton Pump Inhibitors Indications
gastric and duodenal ulcers
GERD
Zollinger-Ellison syndrome
Proton Pump Inhibitors Precautions
contraindicated during lactation
use caution with COPD
Proton Pump Inhibitors Complications
increased risk of osteoporosis with long term use
pneumonia in COPD clients
acid rebound
Proton Pump Inhibitors Administration
Seek appropriate care even when taking OTC preparations take prior to eating do not crush, chew, break tablets notify prescriber of signs of GI bleed modify diet as prescribed
Histamine 2 Receptor Antagonists Examples
Ranitidine Hydrochloride
Cimetidine
Nizatidine
Famotidine
Histamine 2 Receptor Antagonists Indications
Gastric and duodenal ulcers
GERD
Zollinger-Ellison syndrome
Histamine 2 Receptor Antagonists Precautions
Contraindicated during lactation
use caution in COPD
Histamine 2 Receptor Antagonist Complications
decreased libido/impotence
lethargy
depression
confusion
Histamine 2 Receptor Antagonist Administration
Seek appropriate care even when taking OTC preparations take prior to eating do not crush, chew, break tablets notify prescriber of signs of GI bleed modify diet as prescribed
Sucralfate Classification
Mucosal Protectats
Sucralfate Indications
gastric and duodenal ulcers
GERD
Sucralfate Precautions
chronic renal failure
Sucralfate Administration
administer on an empty stomach at least 1 hr before meals
Do not administer within 30 min of antacids
Antiemetics Indications
nausea/vomiting
Antiemetics Examples
promethazine
metoclopramide
ondansetron
scopolamine
Promethazine Complications
drowsiness
anticholinergic effects
severe respiratory depression in children <2
EPS
potentiates effects when given with narcotics
Promethazine Precautions
cardiovascular disease
hepatic disease
Promethazine Administration
monitor vital signs
safety precautions
give IM in large muscles
Metoclopramide Complications
drowsiness diarrhea restlessness EPS tardive dyskinesia
Metoclopramide Precautions
seizures
cardiovascular disease
pheochromocytoma
Metoclopramide Administration
Instruct client about rapid GI emptying
discontinue with signs of EPS
Ondansetron Complications
Headache
EPS
Ondansetron Interventions
Administer tablets 30 min prior to chemotherapy and 1-2 hr before radiation
Ondansetron Precautions
risk for dysrhythmia
do not administer to clients with prolonged QT interval
Scopolamine Complications
blurred vision
sedation
anticholinergic effects
Scopolamine Precautions
increased mydriatic effect causes increased occular pressure
use caution with glaucoma
Scopolamine Interventions
apply transdermal patches behind ear
use lubricating eye drops
Antidiarrheals Examples
Diphenoxylate plus atropine
Loperamide
Paregoric
Antidiarrheals Indications
management of diarrhea
Antidiarrheals Precautions
increased risk of megacolon for clients who have IBS
contraindicated in clients with COPD (paregoric)
Antidiarrheals Complications
constipation
drowsiness
dry mouth
blurred vision
Antidiarrheals Administration
monitor fluid and electrolyte status
avoid caffeine intake
Stool Softeners/Laxatives Examples
Psyllium
Docusate sodium
Bisacodyl
Magnesium hydroxide (Milk of Magnesia)
Psyllium Indication
decrease diarrhea (bulk forming)
Ducosate Sodium Indication
relieve constipation (surfactant)
Bisacodyl Indication
preprocedure colon evaculation (stimulant)
Magnesium hydroxide (Milk of Magnesia) Indication
Prevent painful elimination (low dose osmotic)
Promote rapid evacuation (high dose osmotic)
Stool Softeners/Laxatives Precautions
contraindicated in clients with fecal impaction, bowel obstruction
most laxatives are contraindicated in clients with ulcerative colitis and diverticulitis (psyllium may be used)
Stool Softeners/Laxatives Complications
fluid and electrolyte imbalances
GI irritation
can lead to toxic levels of magnesium
fluid retention (laxatives with sodium)
Stool Softeners/Laxatives Administration
Contraindicated with fecal impaction, bowel obstruction, acute surgical abdomen
encourage regular exercise and promote regular bowel elimination
monitor for chronic laxative use/abuse
provide adequate fluid and fiber intake to avoid obstruction
