The nurse would monitor a patient using sodium bicarbonate to treat gastric hyperacidity for signs and symptoms of:
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Solution
Metabolic alkalosis
Solutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum K and serum calcium would decrease with alkalosis, not increase.
The nurse would question an order for which type of antacid in patients with chronic renal failure?
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Solution
Magnesium-containing antacids
Magnesium-containing antacids can cause hypermagnesemia in patients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in patients with chronic renal failure. Calcium-containing antacids are also appropriate because these patients may be hypocalcemic.
The nurse would monitor for which of the following adverse reactions to aluminum-containing antacids such as aluminum hydroxide (Amphojel)?
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Solution
Constipation
Aluminum- and calcium-containing antacids cause constipation, magnesium-containing antacids cause diarrhea and sodium-containing antacids cause sodium and fluid retention.
The nurse would teach patients that antacids are effective in treatment of hyperacidity because they:
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Solution
Neutralize gastric acid
Antacids work by neutralizing gastric acid, which would cause an increase in pH. They do not affect gastric motility.
One of your patients is receiving digitalis orally and is also to receive an antacid at the same time. Your most appropriate action, based on the pharmacokinetics of antacids, is to:
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Solution
Contact the physician regarding the drug interaction and request a change in the time of dosing of the drugs.
When used with hyperacidic disorders of the stomach, antacids are given to elevate the gastric pH to:
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Solution
2.0
Digoxin preparations and absorbents should not be given simultaneously. As a nurse, you are aware that if these agents are given simultaneously, which of the following will occur?
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Solution
Decreased absorption of digoxin
A client who has ulcerative colitis has persistent diarrhea. He is thin and has lost 12 pounds since the exacerbation of his ulcerative colitis. The nurse should anticipate that the physician will order which of the following treatment approaches to help the client meet his nutritional needs?
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Solution
Implement total parenteral nutrition
Food will be withheld from the client with severe symptoms of ulcerative colitis to rest the bowel. To maintain the client’s nutritional status, the client will be started on TPN. Enteral feedings or dividing the diet into 6 small meals does not allow the bowel to rest. A high-calorie, high-protein diet will worsen the client’s symptoms.
A client’s ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications?
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Solution
Hypokalemia
Excessive diarrhea causes significant depletion of the body’s stores of sodium and potassium as well as fluid. The client should be closely monitored for hypokalemia and hyponatremia. Ulcerative colitis does not place the client at risk for heart failure, DVT, or hypocalcemia.
Which goal of the client’s care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis?
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Solution
Managing diarrhea
Diarrhea is the primary symptom in an exacerbation of ulcerative colitis, and decreasing the frequency of stools is the first goal of treatment. The other goals are ongoing and will be best achieved by halting the exacerbation. The client may receive antidiarrheal medications, antispasmodic agents, bulk hydrophilic agents, or anti-inflammatory drugs.