GI/Nutrition Concepts

Question 1

70. What are 4 possible treatments of GERD? (Medication classes, actions, and examples of the medications)

Answer 1

a. Antiacids: neutralize hydrochloric acid (stomach acid)
Examples: Calcium carbonate, aluminum hydroxide, etc.

b. Histamine 2 Blockers: block gastric histamine release and decrease gastric acid
Examples: “tidines” family, famotidine, cimetidine, etc.

c. Proton Pump Inhibitor: decrease HCl secretions by blocking the pump that produces acid
Examples: “prazole” family, pantoprazole, omeprazole, etc.
Special Note: *Blocks the absorption of B12 leading to deficiency in long term use

d. Mucosal Barriers: sucralfate acts like a “band aid” on the irritated or ulcerated areas.
Must have acid in the stomach to activate the drug.
misoprostol DO NOT GIVE IN PREGNANCY = Spontaneous abortion

Question 2

71. What is the rationale for using neomycin and lactulose in a client with end-stage liver disease?
    How would you know that the therapy was effective?

Answer 2

Neomycin helps to decrease the normal flora in the large intestine resulting in less ability to produce ammonia (NH3)

Lactulose is a laxative that helps to remove excess ammonia from the body
Therapeutic goal: ↓ serum ammonia levels to reduce hepatic encephalopathy

Question 3

72. What is the drug of choice for treating ascites in a client with end-stage liver disease?

Answer 3

spironolactone

Question 4

73. What important vitamin must a pregnant woman have and why? (know both names)

Answer 4

B9 or Folic Acid 1000 mcg to help reduce neural tube defects (NTDs) like spina bifida

Question 5

What important vitamin is given IM to clients with Pernicious Anemia and why?

Answer 5

b12 or cyanocobalamin must be given IM because the client with Pernicious Anemia lacks intrinsic factor and cannot absorb this vitamin through the stomach. B vitamins are vital in the
production of healthy red blood cells.

Question 6

74. What is TPN? What are the nursing considerations for a client receiving TPN?

Answer 6

Total parental nutrition is intravenous nutrient. The substance consists of hyperalimentation
(HAL) and lipid replacement. The solution is extremely hypertonic and contains amino acids,
proteins (like albumin), vitamins, minerals, and electrolytes.
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Nursing considerations for TPN: Strict aseptic technique when handling or changing the
solution. New tubing with every bag, no bag hangs more than 24 hours. Tubing is usually
vented. Because of the tonicity, must go through a central line or PICC line.
NEVER let it run dry, if the bag empties before the next one arrives must hang D10 until the
bag is available.