A 75-year-old woman comes into the clinic and states she has had muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate?
- A. Constipation
- B. Metabolic acidosis
- C. Metabolic alkalosis
- D. Excessive gastric mucus
Correct Answer: C
Rationale: Excessive use of sodium bicarbonate may lead to systemic alkalosis.
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At 0900, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct?
- A. Give both the antacid and medications at 0900.
- B. Give the antacid at 0900, and then the medications at 0900.
- C. Give the medications at 0900, and then the antacid at 1900.
- D. Give the medications at 0900, and then the antacid at 0915.
Correct Answer: C
Rationale: Medications are not to be taken, unless prescribed, within 1 to 2 hours of taking an antacid because of the impact on the absorption of many medications in the stomach.
A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect?
- A. Prevent stress ulcers.
- B. Reduce bacteria levels in the stomach.
- C. Reduce gastric gas formation (flatulence).
- D. Promote gastric motility.
Correct Answer: A
Rationale: Stress-related mucosal damage is an important issue for critically ill patients. Stress ulcer prophylaxis (or therapy to prevent severe gastrointestinal [GI] damage) is undertaken in almost every critically ill patient in an intensive care unit and for many patients on general medical surgical units. Guidelines suggest that all such patients receive either a histamine receptor-blocking drug or a proton pump inhibitor.
The nurse is providing patient teaching about antacids. Which statements about antacids are accurate? (Select all that apply.)
- A. Antacids reduce the production of acid in the stomach.
- B. Antacids neutralize acid in the stomach.
- C. Rebound hyperacidity may occur with calcium-based antacids.
- D. Aluminum-based antacids cause diarrhea.
- E. Magnesium-based antacids cause diarrhea.
Correct Answer: B,C,E
Rationale: Antacids neutralize acid in the stomach. Magnesium-based antacids cause diarrhea, and aluminum-based antacids cause constipation. Calcium-based antacids often cause rebound hyperacidity.
A patient has excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?
- A. Famotidine
- B. Aluminum hydroxide and magnesium hydroxide
- C. Calcium carbonate
- D. Simethicone
Correct Answer: D
Rationale: Simethicone alters the elasticity of mucus-coated bubbles, causing them to break, and is an over-the-counter antiflatulent.
A patient will be receiving pantoprazole, 20 mg IV daily every morning. The medication, once reconstituted, has a strength of 40 mg/10 mL. Identify how many milliliters the nurse will draw up for this dose.
Correct Answer: 5 mL
Rationale: Calculate dose: 40 mg:10 mL::20 mg:x mL. (40 ?? x) = (10 ?? 20); 40x = 200; x = 5 mL.
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