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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.
B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.
C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.
D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.
Correct Answer is D
Explanation
- pH: Calcium acetate is not directly related to changes in blood pH. Therefore, monitoring pH levels would not indicate the effectiveness of the medication for CKD.
B) Calcium: Calcium levels may be affected by calcium acetate, but the primary goal of using calcium acetate in CKD is to reduce phosphate levels, not calcium levels. Therefore, monitoring calcium levels would not directly indicate the effectiveness of the medication.
C) Potassium: Calcium acetate is not typically used to affect potassium levels. Monitoring potassium levels would not indicate the effectiveness of calcium acetate for CKD.
D) Phosphate: This is the correct answer. Calcium acetate is a phosphate binder commonly used in CKD to help lower elevated phosphate levels. A decrease in phosphate levels in the blood would indicate that the medication is having the desired effect in controlling phosphate levels, which is important in managing CKD and preventing complications associated with hyperphosphatemia. Therefore, monitoring phosphate levels is essential to assess the effectiveness of calcium acetate therapy in CKD.
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