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Chapter 31: Hyperacidity and Antiulcer Drugs

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Chapter 31: Hyperacidity and Antiulcer Drugs

12 problems · 0 figures

Case Study 31.2.1 §31.2 source ↗

Read the following clinical scenario to answer the questions that follow.

Logan Gomez is a 35-year-old parent of two presenting to the health care provider with reports of burning in the upper part of the abdomen. The pain develops after eating. Often the pain wakes them from sleeping. Logan schedules an appointment with the provider.

The client is diagnosed with peptic ulcer disease. Which medication does the nurse anticipate the provider will order for Logan?
  1. a.
    Sodium bicarbonate
  2. b.
    Amphojel
  3. c.
    Milk of Magnesia
  4. d.
    Famotidine
Table 31.5 in the book ↗
Vital Signs Physical Examination
Temperature: 98.4° F

• Head, eyes, ears, nose, throat (HEENT): Within normal limits

• Cardiovascular: Within normal limits

• Respiratory: Within normal limits

• GI: Abdomen soft, nontender, distended with hyperactive BS in all four quadrants

• GU: Reports normal urine output

• Neurological: Within normal limits

• Integumentary: No wounds noted; skin appropriate for age
Blood pressure: 118/66 mm Hg
Heart rate: 88 beats/min
Respiratory rate: 16 breaths/min
Oxygen saturation: 97% on room air
Height: 5'8"
Weight: 145 lb

Answer

D. Famotidine
Famotidine is a medication used to treat peptic ulcer disease.

Case Study 31.2.2 §31.2 source ↗

Read the following clinical scenario to answer the questions that follow.

Logan Gomez is a 35-year-old parent of two presenting to the health care provider with reports of burning in the upper part of the abdomen. The pain develops after eating. Often the pain wakes them from sleeping. Logan schedules an appointment with the provider.

The nurse is educating the client on the newly prescribed medication. Which of the following statements by the client indicates understanding?
  1. a.
    “I should stop taking the medication immediately when I feel better.”
  2. b.
    “While I am taking this medication I will avoid alcohol, spicy foods, and ibuprofen.”
  3. c.
    “It may help to take my antacid with the medication.”
  4. d.
    “This medication will give me extra energy.”
Table 31.5 in the book ↗
Vital Signs Physical Examination
Temperature: 98.4° F

• Head, eyes, ears, nose, throat (HEENT): Within normal limits

• Cardiovascular: Within normal limits

• Respiratory: Within normal limits

• GI: Abdomen soft, nontender, distended with hyperactive BS in all four quadrants

• GU: Reports normal urine output

• Neurological: Within normal limits

• Integumentary: No wounds noted; skin appropriate for age
Blood pressure: 118/66 mm Hg
Heart rate: 88 beats/min
Respiratory rate: 16 breaths/min
Oxygen saturation: 97% on room air
Height: 5'8"
Weight: 145 lb

Answer

B. “While I am taking this medication I will avoid alcohol, spicy foods, and ibuprofen.”
Famotidine is a histamine blocker that suppresses gastric acid by lowering the concentration of hydrogen ions. Alcohol, spicy foods, and NSAIDs increase gastric acid. Abruptly stopping a histamine blocker may cause rebound hyperacidity. Antacids should be taken 1–2 hours before or after other medications to avoid interfering with absorption. Histamine blockers often cause fatigue, not energy.

31-1 §31.RQ source ↗

A client in the clinic is prescribed aluminum hydroxide by the provider. The nurse should include which of the following in the client’s education?
  1. a.
    Take the medication 2 hours before or after other medications.
  2. b.
    This medication will put you at risk for respiratory infections like pneumonia.
  3. c.
    Stop taking this medication if constipation develops.
  4. d.
    You will need lab work to check your blood level of magnesium.

Answer

A. Take the medication 2 hours before or after other medications.
Aluminum hydroxide interferes with the absorption of many medications if taken at the same time.

31-2 §31.RQ source ↗

The nurse is administering IV cimetidine to a client admitted to the ICU with a GI bleed. Which of the following adverse effects is the client at increased risk for when receiving cimetidine parenterally?
  1. a.
    Gynecomastia
  2. b.
    Confusion
  3. c.
    Agranulocytosis
  4. d.
    Hypotension

Answer

D. Hypotension
Hypotension and cardiac arrhythmias are associated with the IV (parenteral) administration of cimetidine.

31-3 §31.RQ source ↗

The nurse is educating a client on a new prescription of omeprazole. What does the nurse include in teaching?
  1. a.
    The medication is best administered at bedtime.
  2. b.
    The medication decreases the production of gastric acids and pepsin.
  3. c.
    The medication is best taken 2 hours after a meal.
  4. d.
    The medication may cause hyperkalemia.

Answer

B. The medication decreases the production of gastric acids and pepsin.
Omeprazole decreases pepsin, bile, and gastric acids.

31-4 §31.RQ source ↗

The nurse is educating the client on their newly prescribed medication misoprostol. Which of the following statements by the client indicates a priority need for additional follow-up?
  1. a.
    “I recently stopped taking my birth-control pills.”
  2. b.
    “I am taking a prescription-strength NSAID 3 times a day for my knee pain.”
  3. c.
    “I am worried taking this will cause gas and diarrhea.”
  4. d.
    “I need to remember to take this medication with food.”

Answer

A. “I recently stopped taking my birth-control pills.”
Misoprostol can cause spontaneous abortion, premature birth, or birth defects.

31-5 §31.RQ source ↗

A client being treated for GERD arrives at the clinic with complaints of constipation and flatulence. Which of the following medications is likely causing these symptoms?
  1. a.
    Magnesium hydroxide
  2. b.
    Calcium carbonate
  3. c.
    Simethicone
  4. d.
    Docusate sodium

Answer

B. Calcium carbonate
Calcium carbonate may cause constipation and flatulence.

31-6 §31.RQ source ↗

The nurse is discharging a client with instructions from the provider to take calcium carbonate to treat their indigestion. Which of the following statements by the client indicates the need for additional instruction?
  1. a.
    “I shouldn’t take this when I take my other medications.”
  2. b.
    “I should take this only when I have symptoms.”
  3. c.
    “I need to take this after meals and at bedtime.”
  4. d.
    “I need to take this every day for it to work.”

Answer

D. “I need to take this every day for it to work.”
Calcium carbonate should be taken as needed when symptoms occur, after meals and before bedtime; it does not need to be taken every day.

31-7 §31.RQ source ↗

The nurse is preparing to administer a dose of lansoprazole to a client with an ulcer. Which of the following statements by the client indicates the client needs additional instruction on this medication?
  1. a.
    “I know my pain will improve right after taking this.”
  2. b.
    “I need to take this every day before a meal.”
  3. c.
    “I understand it can take about 6 months to experience the full benefit of this medication.”
  4. d.
    “I hate the thought of having to take this for the rest of my life.”

Answer

A. “I know my pain will improve right after taking this.”
Lansoprazole begins to reduce acid after approximately 2 hours, with ulcer symptom relief after about a week of use. The medication should be taken on an empty stomach and is typically used short-term (less than 6 months) for an ulcer.

31-8 §31.RQ source ↗

The nurse is providing discharge instructions to a client with a gastric ulcer who is taking sucralfate. What information regarding administration is important to stress to the client?
  1. a.
    Take this medication 4 times a day; do not miss a dose.
  2. b.
    Limit dietary fiber and fluids.
  3. c.
    Take with an antacid as needed.
  4. d.
    It is safe to take before dialysis.

Answer

A. Take this medication 4 times a day; do not miss a dose.
Sucralfate adheres to the stomach lining for about 6 hours and will need to be repeated to ensure protection of the mucosal lining.

31-9 §31.RQ source ↗

The nurse is reviewing lab values for a client who has been taking over-the-counter antacid medications. Which of the following findings could be attributed to antacid use?
  1. a.
    Hypocalcemia
  2. b.
    Hyperphosphatemia
  3. c.
    Hyponatremia
  4. d.
    Hypermagnesemia

Answer

D. Hypermagnesemia
Antacids containing magnesium, such as magnesium hydroxide, can cause elevated magnesium levels.

31-10 §31.RQ source ↗

The nurse is educating a client who is taking pantoprazole. What information should be included in the education?
  1. a.
    Stop taking this medication if you have a headache.
  2. b.
    You will need this medication for the rest of your life.
  3. c.
    Swallow the medication whole, do not chew.
  4. d.
    Plan to take this medication only with meals.

Answer

C. Swallow the medication whole, do not chew.
The medication cannot be chewed and capsules cannot be opened, as the gastric acids will destroy the medication before it reaches the duodenum, where it is most effective.

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Problems and answers are adapted from Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris and Dorie Weaver, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/pharmacology/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.