NURS 615 Exam 4 Questions With Correct Answers

PPI long term consequences -ANSWER osteoporosis, B 12 and iron deficiency How would you treat peptic ulcer disease and H-pylori (H-pylori being the leading cause of peptic ulcer with NSAIDS and aspirin being second leading causes) -ANSWER Triple therapy: PPI twice a day Amoxicillin 1gm BID or metronidazole Clarithromycin 500mg daily for 7-14 days (10 days to 2 weeks recommended) Then continue with PPI for 8-12 weeks Step down with GERD -ANSWER Standard dose PPI x 8 weeks. If not resolved, double PPI dose for 4-8 weeks. After 4 weeks a lower dose of PPI is tried, if no relief after 8 weeks daily PPI then refer to GI. Step down to lowest PPI dose or transition to H2RA blocker if symptoms are not relieved. If first line GERD therapy fails (triple therapy), what is second line therapy? -ANSWER quadruple therapy. PPI bid, metronidazole, tetracycline, bismuth subsalicylate x 14 days Step up therapy for GERD? -ANSWER Lifestyle changes antacids H2RA PPI