A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?
A.
Take the medication an hour after antacids.
B.
Notify the healthcare provider of lethargy.
C.
Decrease cigarette use to a pack per day.
D.
Monitor for any signs of sexual dysfunction.
The Correct answer and Explanation is:
The statement that requires additional instruction by the nurse is:
C. Decrease cigarette use to a pack per day.
Explanation:
Cimetidine is an H2 receptor antagonist commonly used to treat peptic ulcer disease by reducing stomach acid production. Effective management of peptic ulcer disease not only involves medication but also lifestyle modifications. Among these modifications, smoking cessation plays a critical role. Here’s a breakdown of why statement C requires further instruction:
- Impact of Smoking on Ulcers: Smoking has been shown to exacerbate peptic ulcer disease. It increases stomach acid production, impairs mucosal defenses, and delays ulcer healing. Continuing to smoke, even at reduced levels, can hinder the effectiveness of treatments and contribute to persistent ulcer symptoms.
- Cimetidine’s Role: Cimetidine helps manage ulcer symptoms by reducing acid secretion in the stomach. However, if the underlying factors contributing to the ulcer, such as smoking, are not addressed, the medication may not be as effective. Smoking reduction alone, as suggested by statement C, is insufficient for optimal ulcer management.
- Recommended Smoking Cessation: The best practice for clients with peptic ulcer disease is to quit smoking entirely. Reduction to a lower number of cigarettes may still be detrimental to ulcer healing and symptom relief. Full cessation should be the goal, and the client should be encouraged to seek support for quitting smoking, such as counseling or smoking cessation programs.
- Other Statements:
- Statement A: Taking cimetidine an hour after antacids is correct. Antacids can interfere with the absorption of cimetidine, so spacing them appropriately helps ensure effective medication levels.
- Statement B: Notifying the healthcare provider of lethargy is important as it could indicate potential side effects or interactions.
- Statement D: Monitoring for signs of sexual dysfunction is relevant because cimetidine can cause such side effects, and any issues should be reported to the healthcare provider.
In summary, reducing cigarette use to a pack per day does not align with the best practices for managing peptic ulcer disease. The client should be instructed to quit smoking entirely to improve treatment outcomes and overall health.