NU 308 Exam 5 | Questions with 100% Correct Answers

NU 308 Exam 5 | Questions with 100% Correct Answers Famotidine -take 30 minutes before you dine -cimetidine -used for duodenal ulcers, GERD, heartburn Famotidine pt teaching smoking decreases effectiveness & delays healing avoid alcohol spicy foods NSAIDs increase fiber & fluid Famotidine CI pregnancy older adults - reduced dose, higher risk for CNS effects kidney impairment- reduced dosage Cimetidine increases levels of warfarin, phenytoin, theophylline, and lidocaine Metoclopramide AE Prokinetic agent: - tardive dyskinesia - EPS - sedation - report major lip smacking - anticholinergic effects Metoclopramide admin: - monitor for CNS depression & EPS - if IV dose is 10 mg or less: IVP undiluted over 2 min, if IV dose > 10 mg: dilute & infuse over 15 min, dilute in 50 mL D5W, NS, or Lactated Ringer's Metoclopramide post op N/V & gastroparesis Meds for hyperemesis - ondansetron - promethazine - Dexamethasone + Aprepitant - Scopolamine ondansetron QT prolongation Serotonin syndrome Headache/ dizziness Diarrhea - do not mix with SSRI, SNRI promethazine EPS crosses BBB sedation not for Parkinson pt.) Dexamethasone + Aprepitant for N/V for chemo - report black tarry stools Can give IM 2 in 24 hours for moms having a baby Therapeutic effectiveness of nausea meds prevents emesis *may need more than 1 Antiemetic patient education - avoid sedatives opioids, & alcohol - sit or lie down if lightheadedness or dizziness occurs - combining 3 is more beneficial Antiemetic admin: if used to prevent give 1 hr to 30 min before treatment H Pylori infection treatment - burp smells like feces -combination of two or three antibiotics for 14 days to increase effectiveness & minimize development of medication resistance H Pylori Bismuth PPI + Metronidazole, Tetracycline, Bismuth subsalicylate H Pylori Non- Bismuth types PPI + Clarithromycin, Amoxicillin, Metronidazole H Pylori Non- Bismuth -more likely to develop an infection on a PPI because it decreases stomach acid & it can't destroy bacteria Antacid Administration can be seven times a day: 1 hr & 3 hr after meals & again at bedtime - do not mix meds with aluminum compounds (iron) - chew tablets with 8 oz of milk/ water - types aluminum hydroxide Laxative CI clients w/ fecal impaction bowel obstruction acute surgical abdomen client's w/ nausea, cramping, & abdominal pain ulcerative colitis & diverticulitis- all except for bulk-forming laxatives Lactulose - treat hepatic encephalopathy elevates ammonia level - confusion and massive diarrhea bulk forming laxative psyllium - soften fecal mass & increase bulk -identical to action of fiber surfactant laxative docusate sodium - lower surface tension of the stool to allow penetration of water osmotic agents laxative - magnesium hydroxide - causes water to be retained with the stool - increasing the number of bowel movements - softening the stool so it is easier to pass stimulants/cathartics laxative - bisacodyl result in stimulation of intestinal peristalsis (strongest) Esomeprazole patient teaching -increase vitamin D & calcium intake because of osteoporosis -take an antacid to manage the discomfort -active ulcers should be treated for 4 to 6 weeks -report cough, fever, chest pain because it can cause pneumonia Peptic Ulcer Disease medications -H2 antagonist -Proton Pump Inhibitors -Antacids -Mucosal Protectant Sucralfate H2 antagonist: Famotidine Proton Pump Inhibitors: omeprazole (ends in prazole) Antacids - aluminum hydroxide (AE constipation) - magnesium hydroxide (AE diarrhea) - calcium hydroxide Mucosal Protectant Sucralfate - administer on empty stomach 1-2 hr before eating - 4x daily, 1 before bed - 30 min before or after antacid IBS-D treatment -alosteron - "dries" the gut - client and physician agreement RAB Alosetron: - must watch for GI toxicity - only clients meeting specific criteria can take this med IBS-C Lubiprostone: linzess - take with food for a BM a day Proton pump inhibitors: - Increase vitamin D and Calcium intake - Use cautiously in pt. with COPD Diphenoxylate plus atropine Loperamide benefits: can treat diarrhea and/or decrease frequency & fluid content -antidiarrheal - BBW: abnormal heart rhythms - caffeine can exacerbate diarrhea atropine prevents abuse causes cholinergic crisis Dronabinol indications - to control CINV & to increase appetite in clients who have AIDS - for chemo pt with N/V Scopolamine use - motion sickness - car rides/cruises - transdermal patch behind ear - remember to take off after cruise/ cars Scopolamine AE: anticholinergic effects Dopamine antagonists' adverse effects -EPS symptoms like lip smacking, blinking, puffing cheeks, tongue protruding -hypotension -sedation -anticholinergic effects Sildenafil patient teaching and CI - notify provider if erection >4 hours - d/c if hearing is affected - take 1 hour before intercourse - grapefruit juice can inhibit metabolism - cannot take with nitroglycerin Contraceptives transdermal patches: reaction red peeling place it for 3 weeks & take off for menstruation oral contraceptives: - take every day estrogen: risk of blood clots - over 35 & smoker: higher clot risk - start Sunday after menstrual cycle BPH meds tamsulosin finasteride