A client with peptic ulcer disease (PUD) is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

Hold the dose of IV pantoprazole until the client has finished eating breakfast.

Provide a PRN dose of antacid along with the scheduled medications.

Instruct the client to take the dose of sucralfate PO while eating breakfast.

Administer both of the medications before breakfast as scheduled.

Answer and Explanation

The Correct Answer is D

A) Holding the dose of IV pantoprazole until the client has finished eating breakfast may delay the onset of action of the medication, as pantoprazole is typically administered before meals to maximize its effectiveness in reducing gastric acid secretion. Additionally, delaying the dose may not provide immediate relief for the client's he’rtburn symptoms.

B) Providing a PRN dose of antacid along with the scheduled medications may temporarily relieve the client's he’rtburn symptoms, but it does not address the underlying cause of peptic ulcer disease or prevent further gastric acid secretion, which is the primary goal of pantoprazole and sucralfate administration.

C) Instructing the client to take the dose of sucralfate PO while eating breakfast may interfere with the optimal absorption of the medication. Sucralfate forms a protective barrier over ulcers in the stomach and should be administered on an empty stomach to allow it to adhere to the gastric mucosa effectively.

D) Administering both of the medications before breakfast as scheduled is the most appropriate action. Pantoprazole is a proton pump inhibitor that reduces gastric acid production, and sucralfate forms a protective barrier over ulcers in the stomach. Administering these medications before breakfast allows them to work synergistically to reduce gastric acid secretion and protect the gastric mucosa, helping to alleviate the client's he’rtburn symptoms and promote ulcer healing.

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Correct Answer is A

Explanation

A) Recent oral intake: This information is important because pyridostigmine is typically administered orally and can interact with food, affecting its absorption. It is essential to ensure that the client has recently eaten or will eat soon to minimize gastrointestinal side effects and optimize medication absorption.

B) Trouble sleeping: While sleep disturbances can be a concern, particularly if they worsen with medication use, it may not be the most critical information to obtain before administering pyridostigmine. However, if the client experiences worsening sleep disturbances after starting the medication, it should be reported to the healthcare provider.

C) Unexplained weight loss: While weight loss can be a symptom of myasthenia gravis, it may not be directly related to the administration of pyridostigmine. However, if the client experiences significant weight loss or other unexplained symptoms, further assessment and evaluation may be necessary.

D) Difficulty with urination: Pyridostigmine can affect bladder function and may exacerbate urinary retention, especially in clients with myasthenia gravis. However, obtaining information about the client's recent oral intake is more crucial to ensure optimal medication absorption and minimize gastrointestinal side effects. Difficulty with urination should still be monitored, but it may not be the most immediate concern before administering the medication.

A. Measure the client’s vital signs. B. Obtain a fingerstick blood glucose. C. Perform a neurological exam. D. Administer glucagon intramuscularly (IM).

Correct Answer is B

Explanation

A) While measuring the client’s vital signs is a routine nursing intervention, the reported symptoms of confusion and blurred vision after receiving glipizide suggest the possibility of hypoglycemia. Vital signs may not provide immediate information about the client’s glucose levels or help confirm hypoglycemia. However, if the client’s symptoms persist or worsen, assessing vital signs becomes important to monitor for signs of shock or other complications.

B) Obtaining a fingerstick blood glucose is the priority action in this situation. Glipizide is an oral antidiabetic medication that stimulates insulin release from the pancreas, leading to lower blood glucose levels. Symptoms such as confusion and blurred vision are indicative of hypoglycemia, a potential adverse effect of glipizide. Checking the client’s blood glucose level will confirm hypoglycemia and guide further interventions.

C) While performing a neurological exam may be warranted if the client’s symptoms persist or if there are concerns about other neurological issues, confirming hypoglycemia with a fingerstick blood glucose test should be the immediate priority.

D) Administering glucagon intramuscularly (IM) is indicated for severe hypoglycemia when the client is unconscious or unable to swallow. However, in this scenario, the client is conscious and able to report symptoms. Before administering glucagon, it is essential to confirm hypoglycemia with a blood glucose measurement to avoid unnecessary interventions.

Therefore, the nurse should promptly obtain a fingerstick blood glucose to confirm hypoglycemia and initiate appropriate treatment for the client’s symptoms.

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A client with peptic ulcer disease (PUD) is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

Nursing Test Bank

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A client with myasthenia gravis receives a now prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

Correct Answer is A

Explanation

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Correct Answer is B

Explanation

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