Quiz 224 #3

jennraq2u's version from 2016-09-27 02:53


Question Answer
laxatives (CI) persistent abdominal pain, nausea, or vomiting /Fever
laxatives(Interactions) ↓ the absorption of other orally administered drugs by ↓ transit time.
laxatives (nsg Asst) Abd distention/ bowel sounds Assess color, consistency/ amount of stool produced. Elimination pattern
Laxatives (Nsg Imp) Give @bedtime; empty stomach w/ glass of H20/juice
Laxatives (Nsg Edu) ↑ fluid to a min 1500–2000 mL/day 2 prevent dehydration.
AntiulcerGERD/Peptic Ulcer Disease
Antiulcer (against H. pylori) a histamine H2-receptor antagonist, or a proton pump inhibitor, and 2 anti-infectives with or without bismuth subsalicylate for 10–14 days
Cimetidine inhibits the ability of the liver to metabolize several drugs, ↑ the risk of toxicity from warfarin, tricyclic antidepressants, theophylline, metoprolol, phenytoin, propranolol, and lidocaine. Omeprazole ↓ metabolism of phenytoin, diazepam, and warfarin. All agents that ↑ gastric pH will ↓ the absorption of ketoconazole and some of the protease inhibitors (e.g. atazanavir). Assessment Assess patient routinely for epigastric o
Omeprazole ↓ metabolism of phenytoin, diazepam, and warfarin.
AntiUlcer (Asst)Assess patient routinely for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate.
Antacids (Asst)Ck heartburn and indigestion as well as the location, duration, character, and precipitating factors of gastric pain.
Histamine H2 Antagonists (Asst)Assess elderly and severely ill patients for confusion routinely. Notify health care professional promptly should this occur.
Lab Test ConsiderationsMay cause false-negative results in skin tests using allergen extracts. These drugs should be discontinued 24 hr prior to the test. Potential Diagnoses
Antiucler (Nsg Imp) (ANtacids)Separate administration of antacids and other oral medications by at least 1 hr.
Antiulcer(Nsg Imp) (Proton Pump Inhibitors) b4 meals, preferably in the morn. Capsules s/b swallowed whole; no open, crush, or chew. May be administered concurrently with antacids.
HH2Proto: ranitidine (Zantec) — Others: cimetidine (Tagamet), nizatidine (Axid), famotidine (Pepcid) (P-A-T-Z)
HH2 Action• Selectively block H2 receptors in parietal cells to suppress gastric acid secretion
HH2 (Uses)• Gastric/peptic ulcers / GERD / hypersecretory conditions/Heartburn
HH2 gynecosmastia/ impotence, arrhtymias, aplastic anemia, agranulocytosis, CNS changes/hallucination
HH (C/I)Preggo/↑ risk of bacterial colonization=pneumonia
HH 2 (Drug/Drug)• Warfarin, phenytoin – metabolizing enzymes inhibited by cimetidine= ↑ levels/antacids↓absorption
HH2 (Edu) Stop drinking, stop smoking, eat smaller, more frequent meals *Ranitidine can be taken without regard to food
Question Answer
HH2 (Imp)1hr sep Antacds & cimitiden/rantaidine; PCP w/ Resp s/s D/O
PPIomeprazole (Prilosec)/pantoprazole (Protonix), lansoprazole (Prevacid), esomeprazole (Nexium)=P-O-L-E
PPI Action gastric acid secretion by irreversible inhibition of enzyme that produces it. Reduce basal and stimulated acid production
PPI (Use)• Gastric/peptic ulcers / GERD
PPI (s/e)C-Diff; B12 deficiency/Abd Pain/Impaction/Obstuction r/t not given w/ enough fluids
PPI (C/I) :HA, D, Pneumonia,Hypo-Mag/rebound acid hypersecretion, fractures
Question Answer
PPI (Drug/Drug)Delayed absorption of Ampicillin, digoxin, iron, ketoconazole if concurrent
PPI EduB4 Meals; Adequate Calcium/VitD intake/ return if s/s unresolved after 4-8wks
Sucralfatesucralfate to viscous gel that adheres to and protects ulcers.
SucralfateDuodenal ulcers/Gerd
Sucralfate ( s/e)constipation(fiber/fluids),dizziness, drowsiness
Sucralfate ( D/D)↓ absorption of phenytoin, fat-soluble vitamins/↓ effectiveness when used with antacid/Abx 2hrs apart
Sucralfate (Imp)empty stomach, 1 hr before meals and at bedtime/give antatcids 30min b4 or after
MOMBowel evacuant in preparation for surgical/radiographic procedures.Laxative
aluminimum hydroxidef peptic, duodenal, and gastric ulcers. Hyperacidity, indigestion, reflux esophagitis.
Al/Hydroxide (Drug)r/t Hi NaCl, cautiously w/ magnesium
Aluminum HydroxideImp=neuro impariment w/ mag toxicity; not w/ Cardia s/s
Antacids s/eal/ca=costipation/ Mg=diarrhea
Antacids c/iperforation/obstruction
zofranserotonin syndrome (mental status changes [agitation, hallucinations, delirium, coma/SJS/EPS/TEN
laxatives↑ fluid intake to a minimum of 1500–2000 mL/day during therapy to prevent dehydration. give @bedside mix
AntidiarrhealsC/I r/t preggo=Immodium/Lomotil
AntidarrhealsInstruct patient to notify health care professional if diarrhea persists; or if fever, abdominal pain, or palpitations occur.
AntidarrheaslDrowsiness/dizziness/abd discomfort
AntidarrhealImp=Asses hydration; bowel sounds; not with Fever/blood stools
Reglanc/i=seizures, parkinsons, bowel d/o
Reglans/e=drowsiness, extrapyramidal reactions, restlessness, NEUROLEPTIC MALIGNANT SYNDROME
ReglanDrug/Drug= Alcohol/CNS depressants do not use!
Reglan Imphyperthermia, muscle rigidity, altered consciousness, irregular pulse or BP, tachycardia, and diaphoresis).
Reglan Assess for signs of depression periodically throughout therapy.
Reglan Edu involuntary or repetitive movements of eyes, face, or limbs occur.
Reglan Nsg EduAdvise PCP if pregnancy or breastfeeding is planned
lacutoloses/e= belching, cramps, distention, flatulence
lactulose ; Enema should be retained for 30–60 min.
Question Answer
lactulosemonitor ammonia/electrolytes; increase fiber
Kalexate s/e ; INTESTINAL NECROSIS, constipation, fecal impaction
Question Answer
Kalexate (Imp)Do K+ post to c if its working; Encourage patient to retain enema as long as possible, at least 30–60 min.
KaxeyolateAssel bowel sounds r/t necrosis
metamucillarge amounts of fluid prevent impaction