Nokea
During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter Prilosec OTC (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result?
- A. No serious consequences
- B. Prevention of more serious problems, such as an ulcer
- C. Chronic constipation
- D. Masked symptoms of serious underlying diseases
Correct Answer: D
Rationale: Long-term self-medication with antacids may mask symptoms of serious underlying diseases, such as bleeding ulcer or malignancy. Patients with ongoing symptoms need to undergo regular medical evaluations, because additional medications or other interventions may be needed.
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A patient will be taking a 2-week course of combination therapy with omeprazole and another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from which class to be ordered with the omeprazole?
- A. Antibiotic
- B. Nonsteroidal anti-inflammatory drug
- C. Antacid
- D. Antiemetic
Correct Answer: A
Rationale: The antibiotic clarithromycin is active against H. pylori and is used in combination with omeprazole to eradicate the bacteria. First-line therapy against H. pylori includes a 10- to 14-day course of a proton pump inhibitor such as omeprazole, plus the antibiotics clarithromycin and either amoxicillin or metronidazole, or a combination of a proton pump inhibitor, bismuth subsalicylate, and the antibiotics tetracycline and metronidazole.
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 is taking omeprazole for the treatment of gastroesophageal reflux disease (GERD). The nurse will include which statement in the teaching plan about this medication?
- A. Take this medication once a day after breakfast.
- B. You will be on this medication for only 2 weeks for treatment of the reflux disease.
- C. The medication may be dissolved in a liquid for better absorption.
- D. The entire capsule must be taken whole, not crushed, chewed, or opened.
Correct Answer: D
Rationale: Omeprazole needs to be taken before meals, and an entire capsule must be taken whole, not crushed, chewed, opened, or dissolved in liquid when treating GERD. This medication is used on a long-term basis to maintain healing.
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.