The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

Give sucralfate on an empty stomach.

Assess for secondary Candida infection.

Administer sucralfate once a day, preferably at bedtime.

Monitor for electrolyte imbalance.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct action to include in the client's plan of care, as sucralfate should be given on an empty stomach, at least one hour before meals and at bedtime. Sucralfate is a mucosal protectant that forms a protective barrier over the ulcer and prevents further damage from acid and pepsin. It requires an acidic environment to work, so it should not be taken with food or antacids.

Choice B reason: This is not a relevant action to include in the client's plan of care, as sucralfate does not cause or increase the risk of secondary Candida infection. Candida infection is a fungal infection that can affect the mouth, throat, esophagus, or vagina. It is more common in clients who use antibiotics, corticosteroids, or immunosuppressants, but not sucralfate.

Choice C reason: This is not an accurate action to include in the client's plan of care, as sucralfate should be administered four times a day, not once a day. Sucralfate has a short duration of action, so it needs to be taken frequently to maintain its protective effect on the ulcer.

Choice D reason: This is not a necessary action to include in the client's plan of care, as sucralfate does not cause or affect electrolyte imbalance. Electrolyte imbalance is an abnormality in the levels of sodium, potassium, calcium, magnesium, or other minerals in the blood. It can be caused by dehydration, vomiting, diarrhea, kidney disease, or other conditions, but not sucralfate.

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Correct Answer is A

Explanation

Choice A reason: Hematemesis is the vomiting of blood, which can indicate a serious gastrointestinal bleeding caused by ibuprofen. This is a life-threatening condition that requires immediate medical attention. Therefore, the nurse should report this finding to the healthcare provider as soon as possible.

Choice B reason: Insomnia is the difficulty in falling asleep or staying asleep. It can be a side effect of ibuprofen, but it is not as serious or urgent as hematemesis. The nurse can advise the client to take ibuprofen with food or milk, avoid caffeine and alcohol, and practice good sleep hygiene.

Choice C reason: Dizziness is the feeling of lightheadedness, faintness, or unsteadiness. It can also be a side effect of ibuprofen, but it is usually mild and transient. The nurse can instruct the client to rise slowly from a sitting or lying position, drink plenty of fluids, and avoid driving or operating machinery if dizzy.

Choice D reason: Nausea is the feeling of discomfort or unease in the stomach that may lead to vomiting. It can also be a side effect of ibuprofen, but it is usually manageable with simple measures. The nurse can suggest the client to take ibuprofen with food or milk, eat small and frequent meals, and avoid spicy or fatty foods.

A. Hold the calcitriol but administer the calcium carbonate as scheduled. B. Hold the calcium carbonate, but administer the calcitriol as scheduled. C. Hold both medications until contacting the healthcare provider. D. Administer both prescribed medications as scheduled.

Correct Answer is C

Explanation

Choice A reason: Holding the calcitriol but administering the calcium carbonate as scheduled is not appropriate, as both drugs can increase the serum calcium level and worsen the condition of hypercalcemia. Calcitriol is a synthetic form of vitamin D that enhances the absorption of calcium from the GI tract and promotes bone mineralization. Calcium carbonate is a supplement that provides additional calcium to the body.

Choice B reason: Holding the calcium carbonate, but administering the calcitriol as scheduled is not appropriate, as calcitriol alone can also raise the serum calcium level and cause hypercalcemia. Calcitriol is a synthetic form of vitamin D that enhances the absorption of calcium from the GI tract and promotes bone mineralization.

Choice C reason: Holding both medications until contacting the healthcare provider is the appropriate action to take, as the client's total calcium level is above the normal range of 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L and indicates hypercalcemia. Hypercalcemia can cause symptoms such as nausea, vomiting, constipation, confusion, lethargy, muscle weakness, cardiac arrhythmias, and kidney stones. The healthcare provider can adjust the dose or frequency of the medications or prescribe other treatments to lower the serum calcium level.

Choice D reason: Administering both prescribed medications as scheduled is not appropriate, as both drugs can increase the serum calcium level and worsen the condition of hypercalcemia. Calcitriol is a synthetic form of vitamin D that enhances the absorption of calcium from the GI tract and promotes bone mineralization. Calcium carbonate is a supplement that provides additional calcium to the body.

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The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?

Correct Answer is A

Explanation

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?

Correct Answer is C

Explanation

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