Pharmacology NCLEX GI drugs: GI agents and AntiUlcer

Pharmacology NCLEX GI drugs: GI agents and AntiUlcer

5.0 (1 review) Students also studied Terms in this set (29) Valdosta State UniversityNURS 3111 Save NCLEX style questions ( G.I. Drugs) 34 terms Grosas1Preview Psychiatric Medications NCLEX Prac...29 terms tiffany5484Preview Mental Health Medications NCLEX 58 terms Shirley_Hernandez Preview GI Phar 34 terms meg The client reporting "acid" when lying down at night asks the nurse if there is any medication that might help. Which statement is the nurse's best response?

• "There are no medications to treat this problem, but

losing weight will sometimes help the symptoms."

• "There are several over-the-counter and prescription

medications available to treat this. You should discuss this with your health-care provider."

• "Have you had any x-rays or other tests to determine if

you have cancer or some other serious illness?"

• "Acid reflux at night can lead to serious complications.

You need to have tests done to determine the cause."

ANSWER:

• PPIs, H2 blockers, and antacids all treat the symptoms of acid reflux. The nurse

should encourage the client to discuss which medication is best with the HCP.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• There are several classifications of medications used to treat acid reflux

problems. Sometimes losing weight will help relieve symptoms, but the client did not ask about lifestyle modifications.

• The symptoms do not indicate cancer. The nurse should not scare the client.
• Acid reflux can lead to complications, including adult-onset asthma, that should

be treated, but most HCPs will empirically treat the symptoms of acid reflux before ordering tests to determine the cause or possible complications.

The nurse on a medical unit has received the morning report. Which medication should the nurse administer first?

• Pantoprazole to a client on call to surgery.
• Calcium carbonate to a client reporting indigestion.
• Bismuth to a client diagnosed with an ulcer.
• Famotidine to a client diagnosed with

gastroesophageal reflux disease (GERD).

ANSWER:

• Pantoprazole (Protonix) is a PPI. A medication for a client on call to surgery is a

priority; the client's surgery could be delayed if the medication has not been administered when the call to surgery comes.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• Calcium carbonate (Tums) is an antacid. This would be the second medication

to administer, as this client has a report of discomfort.

• Bismuth (Pepto Bismol) is an antimicrobial. This medication is a routine

medication and could be administered at any time.

• Famotidine (Pepcid) is an H2 blocker. This medication is a routine medication

and could be administered at any time.Which statement is the scientific rationale for administering a proton-pump inhibitor (PPI) to a client diagnosed with GERD?

• PPI medications neutralize the gastric secretions.
• PPI medications block H2 receptors on the parietal

cells.

• PPI medications inhibit the enzyme that generates

gastric acid.

• PPI medications form a protective barrier against acid

and pepsin.

ANSWER:

• PPIs inhibit the enzyme that generates gastric acid.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• Antacids, not PPIs, neutralize gastric secretions.
• H2 blockers block receptors on the parietal cells.
• Mucosal barrier agents form a protective barrier against acid and pepsin.

Which statement is an advantage to administering a histamine2 (H2) blocker rather than an antacid to a client diagnosed with GERD?

• Antacids are more potent than H2 blockers in relieving

the symptoms of GERD.

• H2 blockers have more side effects than antacids.
• H2 blockers are less expensive than antacids.
• H2 blockers require less frequent dosing than antacids.

ANSWER:

• H2 blockers require less frequent administration than do antacids, which require

frequent administration, seven or more times a day, for therapeutic effects. The fewer times a client is expected to take a medication, the more likely the client is to comply with a medication regimen.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• H2 blockers actually block the production of gastric acid and have a longer

effect than an antacid.

• An increase in side effects would not be an advantage.
• Antacids are usually less expensive than H2 blockers.

Which side effects should the nurse explain to the male client who is prescribed cimetidine?

• The medication can cause indigestion and heartburn.
• The medication can cause impotence and

gynecomastia.

• The medication can cause insomnia and

hypervigilance.

• The medication can cause Zollinger-Ellison syndrome.

ANSWER:

• Cimetidine (Tagamet) is an H2 blocker. Over time, Tagamet can cause males to

become impotent, have decreased libido, and have breast development (gynecomastia)

RATIONALE WHY THESE AREN'T THE ANSWERS:

• Cimetidine (Tagamet), an H2 blocker, is used to treat indigestion and heartburn

(pyrosis).

• Tagamet can cause lethargy and somnolence, not insomnia and hypervigilance.
• Tagamet is used to treat Zollinger-Ellison syndrome, a syndrome characterized

by hypersecretion of gastric acid and the formation of peptic ulcers.The nurse is preparing to administer esomeprazole.Which intervention should the nurse implement? Select all that apply.

• Order an infusion pump for the client.
• Elevate the client's head of the bed.
• Check the client's ID with the medication administration

record (MAR).

• Check for allergies to cephalosporin.
• Ask the client his or her date of birth.

ANSWER:

• The head of the bed is elevated for the client to be able to swallow the

medication.

• The nurse must check the MAR with the client's ID band to ensure the correct

client is receiving the medication.

• The Joint Commission requires that two patient identifiers be used to determine

the "right patient." Most health-care facilities use the client's name and date of birth as these identifiers.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• Esomeprazole (Nexium), a PPI, is an oral medication. An IV pump is not needed.
• Esomeprazole (Nexium) is a PPI, not a cephalosporin. The cephalosporins are a

class of antibiotics.The home health-care nurse is caring for a male client diagnosed with a hiatal hernia and reflux. Which data indicates the medication therapy is effective?

• The client takes the antacid 1 hour before and 3 hours

after a meal.

• The client reports indigestion after eating a large meal.
• The client states that he did not wake up with heartburn

during the night.

• The client has lost 3 pounds in the past 2 weeks.

ANSWER:

• This indicates an improvement in symptoms and that the medication is effective.

MEDICATION MEMORY JOGGER: The nurse determines the effectiveness of a

medication by assessing for the symptoms, or lack thereof, for which the medication was prescribed.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• This indicates client compliance with the dosing regimen for antacids, not that

the medication is effective.

• The return of symptoms indicates the medication is not effective.
• Losing weight would not indicate that a medication for hiatal hernia is effective.

The nurse is discharging a client diagnosed with GERD.Which information should the nurse include in the teaching?

• "There are no complications of GERD as long as you

take the medications."

• "Notify the HCP if the medication does not resolve the

symptoms."

• "Immediately after a meal, lie down for at least 45

minutes."

• "If any discomfort is noted, take an NSAID for the pain."

ANSWER:

• The client should always be informed of what symptoms to report to the HCP.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• There may be several complications of GERD. Adult-onset asthma and Barrett's

esophagus leading to cancer of the esophagus are two complications of GERD.The chance of developing these problems is less if the GERD is adequately treated, but there are no guarantees.

• The client should be instructed to sit upright for at least 60 minutes following a

meal to prevent reflux from occurring.

• NSAIDs can increase gastric distress. Ulcers caused by NSAID use may be

asymptomatic, or the symptoms may be attributed to the GERD. The client should use the prescribed H2 receptor blocker, PPI, or an antacid to relieve the discomfort associated with GERD.The nurse is discharging a client 2 days postoperative hiatal hernia repair. Which discharge instructions should the nurse include? Select all that apply.

• "Take all of the prescribed antibiotic."
• "Eat six small meals per day."
• "Use the legs to bend down, not the back."
• "Take esomeprazole twice a day."
• "Use the pain medication when the pain is at 8-10."

ANSWER:

• Prophylactic antibiotics are frequently prescribed both presurgery and

postsurgery. The client should be instructed to take all the medication as directed.

• Hiatal hernia repair may not last and the client should continue the

recommended lifestyle modifications, such as eating small meals.

• Part of the lifestyle modifications for hiatal hernia is to limit pressure on the

abdominal cavity, especially after a meal. Using the leg muscles to bend down, rather than bending over, should be taught to the client.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• Esomeprazole (Nexium) is administered daily, not twice a day.
• For best relief, pain medication should be taken at the onset of the pain. The

client should not wait until the pain is an 8-10 before taking the pain medication.The adult client recently has been diagnosed with asthma. Which medication is recommended to treat this problem?

• Omeprazole daily.
• Amoxicillin twice daily.
• Loratadine daily.
• Prednisone daily.

ANSWER:

• Omeprazole (Prilosec) is a PPI. Up to 90% of adult-onset asthma is the result of

GERD. Treating the gastric reflux will treat the asthma.

RATIONALE WHY THESE AREN'T THE ANSWERS:

• Amoxicillin (Amoxil) is a penicillin-derived antibiotic. The client is diagnosed

with asthma, not an infection. There is no reason to administer an antibiotic.

• Loratadine (Claritin) is an antihistamine. Antihistamines such as Claritin are used

to treat allergic reactions to pollens, dust, or other irritating substances. They are not effective against asthma.

• Prednisone is a glucocorticoid. Glucocorticoids are prescribed daily for clients

with chronic lung diseases, such as emphysema or chronic bronchitis. A client with asthma would not be prescribed a daily steroid.