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Pharm > GI + Liver > Flashcards

GI + Liver Flashcards

1
Q

Sodium bicarbonate

A
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2
Q

Cimetidine

A
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3
Q

Omeprazole

A
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4
Q

Sucralfate

A
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5
Q

Ondansetron

A
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6
Q

Docusate

A
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7
Q

Bisacodyl

A
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8
Q

Polyethylene glycol

A
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9
Q

Loperamide

A
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10
Q

Lactulose

A
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11
Q

What are common disorders of the upper GI?

A

— heartburn
— GERD
— peptic ulcer disease
— duodenal ulcer

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12
Q

Which drugs are for upper GI secretions?

A

— sodium bicarbonate
— cimetidine
— Omeprazole
— Sucralfate

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13
Q

Drugs used for GI motility:

A

— docusate
— Bisacodyl
— polyethylene glycol
— loperamide

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14
Q

What do you focus on with assessment?

A

Baseline hx and prognosis including allergies and medications
— FOCUS: GI and abdominal assessment related to disorder/AE

FOLLOW ADMIN PROTOCOL

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15
Q

Education:

A

— non-pharm interventions
— proper admin
— shortest duration to reduce risk of AE

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16
Q

What are examples of non-pharm interventions?

A

Eating small meals
Sitting up after admin of drug + meals

17
Q

What are common adverse affects with your GI secretion drugs?

A

— nausea
— vomiting
— diarrhea
— constipation
— abd discomfort
— rash

18
Q

When reviewing the health hx of a pt prescribed an antacid, the nurse knows that antacids containing magnesium need to be used cautiously in patients with which condition?

A. HTN
B. Renal failure
C. Peptic ulcer disease
D. HF

A

B. Renal failure

Both calcium and magnesium based antacids are more likely to accumulate to toxic levels in pts with renal disease. Pts with renal failure cannot regulate electrolytes

19
Q

A client has taken Omeprazole for many years; which test should the nurse anticipate the HCP will order to assess for a potential complication?

A. EGD
B. Creatinine
C. Bone density scan
D. H. Pylori test

A

C. Bone density scan

Long term use of PPIs have a potential to develop osteoporosis

20
Q

Nursing assessment with laxatives:

A

Baseline
Focused: bowel sounds, I&O, electrolytes

CONTRAINDICATED IN ACUTE BOWEL DISORDERS such as lieu’s, obstruction, ischemia, perforation
*laxatives will not help these issues

21
Q

What are some adverse effects with laxatives? What is the therapeutic effect?

A

— LOOSE STOOLS (diarrhea); hold medication if pt is having frequent BM
— nausea
— vomiting
— abd pain
— DEHYDRATION
— ELECTROLYTE IMBALANCE

Therapeutic effect:
Achievement of soft BM within 24hr of admin of laxative

22
Q

Implementation and teaching of laxatives:

A

Implementation:
— HOLD if loose stool
— encourage 3L water daily, high fiber diet, increase activity
— if multiple laxative orders: admin Docusate FIRST (most gentle); use Bisacodyl next then polyethylene

Teaching:
— do not take laxative if experiencing nausea, vomiting, abd pain
— contact provider if experiencing SEVERE abd pain, muscle weakness, cramps, dizziness
— do not use laxative for more than 7 days; can develop dependency

23
Q

What are contraindications for anti-diarrheals?

A

— diarrhea caused by poisoning or by bacterial toxins
— acute abd disorders including GI obstructions

24
Q

What is the therapeutic effect for anti-diarrheals?

A

Decrease number of BM

25
Q

Teaching for anti-diarrheal

A

— take as prescribed; overuse can lead to constipation
— notify HCP is symptoms persist after 2 days or experiencing signs of dehydration (may need fluids to replace from diarrhea)
— DO NOT USE FOR INFECTIOUS DIARRHEA can make it worse
— keep hydrated: 3L water/day

26
Q

The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications or cautions for the use of oral laxatives?

A. Nausea + vomiting
B. Ingestion of toxic substances
C. Undiagnosed abdominal pain
D. Fecal impaction
E. Acute surgical abdomen
F. Irritable bowel syndrome

A

A, C, D, E

Mineral oil enemas are used for fecal impaction

27
Q

Assessment with antiemetics:

A

Focus: GI, I&O, neuro/LOC
— s/s of dehydration, electrolyte imbalance from vomiting
— fall risk
— drug-drug: CNS DEPRESSANTS

28
Q

Implementation of antiemetic drugs:

A

Give PRN medication as appropriate (Ondansetron is first line tx)
— use least invasive
— VERIFY ROUTE
Preventative therapy: admin 30-60 min prior to chemo dose or end of surgery

29
Q

What are the different routes for antiemetic drugs? What route with you use if the pt is vomiting?

A

— oral
— oral disintegrating tablet
— transdermal patch
— suppository
— IM
— IV

Oral preffered; if pt is vomiting used alternative route
— suppository used in hospice

30
Q

Teaching and therapeutic effect:

A

Teach:
— timing of admin; take before other medications for antiemetic to have effect
— do not operate heavy machinery; sedation
FALL RISK

Therapeutic effect:
Absence of nausea/vomiting

AE: drowsiness, dizziness, CV
FALL RISK

31
Q

What is hepatic encephalopathy?

A

Liver cirrhosis, increase in ammonia levels
Tx: Lactulose
— excretes ammonia in stool
— loose stools are expected in therapeutic effect

Liver metabolizes ammonia to urea
— Ammonia stays in blood stream, going to the brain leading to toxicity; confusion

32
Q

The nurse is teaching a client who has been prescribed an antiemetic. What should the nurse include in the teaching?

A. Occasional problems with taste may be experienced
B. It is safe to take med with glass of wine
C. Avoid driving as medication can cause drowsiness
D. Periodic monitor BP

A

C

33
Q

The nurse is caring for a client prescribed Ondansetron and baclofen. The nurse should prioritize which assessment?

A. Bowel sounds
B. LOC
C. Intake and output
D. ROM

A

B. LOC

Combo of these drugs = drowsiness; fall risk. Bowel sounds and I&O are a priority with Ondansetron, but not with baclofen.

Pharm (16 decks)

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