The nurse is administering an H-2 receptor antagonist to a patient with multiple burn trauma to prevent
the development of stress ulcers based on the understanding that the drug:
Correct response:
provides protection of the stomach lining via acid blockage.
Explanation:
Histamine-2...
the nurse is administering an h 2 receptor antagonist to a patient with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug correct response
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CHAPTER 40
The nurse is administering an H-2 receptor antagonist to a patient with multiple burn trauma to prevent
the development of stress ulcers based on the understanding that the drug:
Correct response:
provides protection of the stomach lining via acid blockage.
Explanation:
Histamine-2 receptor antagonists are used for stress ulcer prophylaxis because the drugs block the
production of acid thereby protecting the stomach lining which is at risk because of decreased mucus
production. Decreasing the acid being regurgitated into the esophagus explains the reason for use of the
drug to treat erosive gastroesophageal reflux. Reducing the overall acid level explains the reason for use
of the drug as short-term treatment of active duodenal ulcer. Blocking the overproduction of
hydrochloric acid is the rationale for treatment of pathological hypersecretory conditions.
A patient is prescribed misoprostol. The nurse would expect to administer this drug by which route?
Correct response:
Oral
Explanation:
Misoprostol is administered orally.
The use of calcium carbonate is associated with the development of acid rebound.
Correct response:
True
Which drug treats heartburn by neutralizing the acidity of the stomach by combining with hydrochloric
acid (HCL) and increasing the pH of the stomach acid?
Correct response:
Magaldrate (Riopan)
Explanation:
Magaldrate (Riopan) is a combination product that contains magnesium and aluminate. Magaldrate
(Riopan) treats heartburn by neutralizing the acidity of the stomach by combining with hydrochloric acid
(HCL) and increasing the pH of the stomach acid.
The nurse should warn a patient taking aluminum and calcium-containing antacids about which adverse
effects?
Correct response:
Constipation
Explanation:
The nurse should warn a patient taking aluminum and calcium containing antacids about constipation
that can be associated with taking products containing either medication.
Which of the following herbal products have been used as a homeopathic remedy for GI problems,
including motion sickness, nausea, vomiting, and digestion? (Choose one)
Correct response:
Ginger
Explanation:
Ginger is an herbal product that has been used as a homeopathic remedy for GI problems, including
motion sickness, nausea, vomiting, and digestion.
,A nurse is assigned the responsibility to care for a patient with stomach hyperacidity. The physician has
prescribed aluminum carbonate gel to the patient. For which patient should the nurse administer the
aluminum carbonate gel with caution?
Correct response:
Patients with upper GI bleeding
Explanation:
The nurse should administer the aluminum carbonate gel with caution in patients with upper GI
bleeding. Calcium-containing antacids are used with caution in patients with renal impairment.
Dexpanthenol is contraindicated in patients with hemophilia or pheochromocytoma.
A patient has been prescribed chlorpromazine hydrochloride for nausea. What assessment should the
nurse perform before the drug is administered to the patient?
Correct response:
Assess signs of fluid and electrolyte imbalances
Explanation:
Before chlorpromazine hydrochloride is administered to the patient, the nurse should assess for signs of
fluid and electrolyte imbalances. When antacids are given, the nurse keeps a record of the patient's
bowel movements because these drugs may cause constipation or diarrhea. The nurse should monitor
continuous spitting of blood and measure oral fluid intake after chlorpromazine hydrochloride is
administered. While the patient is undergoing chlorpromazine hydrochloride therapy, the nurse needs to
provide the patient mouthwash or frequent oral rinses to remove the disagreeable taste that
accompanies vomiting.
A patient's GI discomfort is prescribed antacids. Nursing interventions associated with this prescription
should include:
Correct response:
Administer the antacid 1 hour before or 2 hours after other oral medications.
Explanation:
A patient taking antacids should be advised to take the antacid 1 hour before or 2 hours after other oral
medications. These tablets are often chewed to increase effectiveness. Limiting fluid intake can result in
rebound fluid retention.
The patient will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse
should inform the patient that common side effects related to this medication include:
Correct response:
headache.
Explanation:
Headache, dizziness, somnolence, and mental confusion may occur with H2 antagonists.
Ranitidine (Zantac) should be cautiously administered to individuals with evidence of which of the
following conditions?
Correct response:
, Renal disease
Explanation:
All of the H2RAs are eliminated through the kidneys, and dosages need to be reduced in clients with
renal impairment. There is no caution necessary with Zantac and people with diabetes, pulmonary
disease, or migraine headaches.
A patient presents to the walk-in clinic reporting vomiting and burning in their mid-epigastria. The nurse
suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the physician is likely to
order a diagnostic test to detect the possible presence of:
Correct response:
infection with Helicobacter pylori.
Explanation:
Peptic ulcers may result from increased acid production, decrease in the protective mucous lining of the
stomach, infection with Helicobacter pylori bacteria, or a combination of these.
A female patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and
asks whether she can take an antacid. Which is an appropriate response by the nurse?
Correct response:
“Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”
Explanation:
If both ranitidine and antacids are prescribed, give them at least 2 hours apart to prevent decreased
absorption of ranitidine. The nurse should advise the patient to wait at least 2 hours between doses and
to take the antacid after the ranitidine. The other three statements are not true.
Ms. Kime is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux.
Which statement made by the patient indicates that she understood the teaching provided about taking
these medications?
Correct response:
"I should take ranitidine 2 hours before or after my antacid dosage."
Explanation:
If both ranitidine and antacids are prescribed, they should be taken at least 2 hours apart to prevent
decreased absorption of ranitidine.
Which of the following patients would be most likely to benefit from treatment with ondansetron
(Zofran)?
Correct response:
A woman who is receiving chemotherapy for the treatment of colon cancer
Explanation:
Ondansetron is used to prevent nausea and vomiting associated with cancer chemotherapy and
radiotherapy, and in postoperative states when expectation is high that nausea or vomiting will occur or
when nausea and vomiting must be avoided. It is less likely to be used in postsurgical care, though this
may be the case. Renal failure and skeletal fractures are not indications for the use of ondansetron.
The physician has prescribed ranitidine for a patient in your unit. Prior to administering the drug for the
first time, which adverse effects should the nurse mention to the patient?
Correct response:
Headache
Explanation:
, Adverse effects with H2RAs such as ranitidine are typically uncommon and mild with the usual doses and
duration of treatment. However, effects can include diarrhea or constipation, headache, dizziness,
muscle aches, and fatigue.
Ranitidine is a histamine2 receptor antagonist (H2RA) prescribed for treatment of peptic ulcer disease
and gastric reflux. Dosage of ranitidine must be reduced in patients with what condition?
Correct response:
Renal disease
Explanation:
H2RAs must be used with caution in patients with renal disease. Since these drugs are eliminated
through the kidneys, dosages are reduced to avoid adverse effects.
Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion
and ulceration. The drug is contraindicated in patients who:.
Correct response:
are pregnant.
Explanation:
Misoprostol is contraindicated during pregnancy because it may cause abortion, premature birth, or
birth defects. It is also contraindicated in women of childbearing potential who are not using effective
contraception.
The physician at your clinic has prescribed a chewable antacid to a patient with peptic ulcer disease.
Which of the following instructions should you offer the patient regarding use of the drug?
Correct response:
"Take the antacid two hours before or after other oral medications."
Explanation:
Antacids should not be taken with meals or other oral medications. Instead, the prescribed antacid
should be taken 1-3 hours after meals (as well as at bedtime) and about 2 hours before or after other
oral medications. Patients taking chewable antacids should follow the medication with a glass of water.
A nurse is teaching a 47-year-old client about omeprazole, which the physician has prescribed as part of
a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client
understands proper use of the drug?
Correct response:
"I need to swallow the drug whole."
Explanation:
Omeprazole, a proton pump inhibitor, must be swallowed whole; it should not be cut, crushed or
chewed. The drug should be taken approximately an hour before a meal, not after a meal. Concomitant
use of antacids is common, though the physician may instruct the patient to take the two medications at
different times during the day.
Your patient arrives at his sick call reporting chronic abdominal pain. Having a 40-pack year history, he
reports his smoking has decreased to approximately 20 packs/year. The physician, after thorough
assessment and evaluation and labs, prescribes a treatment regimen for a duodenal ulcer, caused by H.
pylori infection. What type of medications might be used to treat his ulcer?
Correct response:
Two antimicrobials and either a PPI or H2RA
Explanation:
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