A nurse is reviewing the medication history of a client. The nurse should identify that which of the following medications places the client at risk for hypokalemia?
Acyclovir 400 mg PO twice daily
Furosemide 80 mg PO daily
Cimetidine 300 mg PO four times per day
Meloxicam 5 mg PO once daily
The Correct Answer is B
Furosemide is a loop diuretic commonly prescribed for conditions such as hypertension and edema. One of the side effects of furosemide is the increased excretion of potassium in the urine, which can lead to low potassium levels in the body, known as hypokalemia. The other medications mentioned do not typically place the client at risk for hypokalemia: Acyclovir 400 mg PO twice daily: Acyclovir is an antiviral medication used to treat viral infections, such as herpes. It does not have a direct effect on potassium levels. Cimetidine 300 mg PO four times per day: Cimetidine is a histamine H2 receptor antagonist commonly used to reduce stomach acid production. It does not have a direct effect on potassium levels.
Meloxicam 5 mg PO once daily: Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief. It does not have a direct effect on potassium levels.
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Correct Answer is B
Explanation
Cimetidine is a medication known as a histamine H2 receptor antagonist, commonly used in the treatment of peptic ulcer disease. It works by reducing the production of stomach acid. When teaching a client about cimetidine, it is important to inform them about the timing of taking other medications, specifically antacids.
Antacids, which are used to neutralize stomach acid, can interfere with the absorption of cimetidine if taken simultaneously. Therefore, it is generally recommended to wait at least 1 hour after taking cimetidine before taking an antacid. This allows sufficient time for the cimetidine to be absorbed and start working effectively before neutralizing stomach acid with an antacid.
Correct Answer is A
Explanation
Elevating the head of the bed can help reduce the symptoms of GERD during sleep. By elevating the head, gravity can help prevent stomach acid from flowing back into the esophagus, reducing the occurrence of reflux.
The other statements do not demonstrate an understanding of the teaching: "I will sleep on my stomach with my head flat": Sleeping on the stomach can actually worsen the symptoms of GERD as it can increase the likelihood of stomach acid flowing back into the esophagus. It is generally recommended to sleep on the left side or back to minimize reflux.
"I will have a snack 1 hour before going to bed": Consuming a snack close to bedtime can increase the likelihood of reflux during sleep. It is generally recommended to avoid eating at least 2 to 3 hours before lying down to minimize reflux symptoms.
"I can have 6 ounces of alcohol before bed, to help me sleep": Alcohol can relax the lower esophageal sphincter (LES) and increase the risk of reflux. It is best to avoid alcohol before bedtime, especially for individuals with GERD.
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