A client has been diagnosed with an ulcer and will begin taking sucralfate. What information should the nurse include when providing education to the client?
This medication neutralizes gastric acid in the stomach by direct contact.*
"You should take this medication after meals to help limit gastric acid secretion!
"This medication decreases gastric acid production by blocking histamine 2 receptors.
"You should take this medication 30 minutes to 1 hour before meals and at bedtime"
The Correct Answer is D
A) This medication neutralizes gastric acid in the stomach by direct contact: Sucralfate does not neutralize gastric acid. Instead, it works by forming a protective barrier over the ulcer, which helps protect it from further damage by stomach acid and promotes healing. Sucralfate is a mucosal protectant, not an acid-neutralizing agent.
B) "You should take this medication after meals to help limit gastric acid secretion": Sucralfate should be taken on an empty stomach, typically 30 minutes to 1 hour before meals, to allow it to form an effective protective barrier over the ulcer. Taking it after meals would interfere with its action and effectiveness.
C) "This medication decreases gastric acid production by blocking histamine 2 receptors": Sucralfate does not work by blocking histamine 2 receptors. Histamine 2 receptor antagonists, such as ranitidine, work by reducing gastric acid secretion. Sucralfate works by coating and protecting the ulcer rather than by reducing acid production.
D) "You should take this medication 30 minutes to 1 hour before meals and at bedtime": Sucralfate should be taken on an empty stomach, typically 30 minutes to 1 hour before meals and at bedtime. This timing ensures that the medication can form an effective barrier over the ulcer before food intake and helps maximize its healing properties.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) The stomach acid has a lower pH level which results in increased absorption: While it is true that neonates have a lower gastric pH, which could affect the absorption of certain medications, this factor does not directly increase the risk for drug toxicity. Lower pH may increase absorption for some drugs, but it is not as critical in neonates as the immaturity of other organs, such as the liver and kidneys, which are responsible for drug metabolism and excretion.
B) The glomerular filtration rate (GFR) is increased causing rapid excretion: In neonates, the glomerular filtration rate (GFR) is actually decreased, not increased. This leads to slower excretion of medications, which can increase the risk for drug toxicity, especially for drugs that rely on renal elimination. This decreased renal function can result in accumulation of the drug in the bloodstream, potentially leading to toxicity.
C) The liver enzyme system responsible for drug metabolism is not fully developed: The liver enzyme system in neonates is immature, which significantly impacts the metabolism of drugs. Enzymatic activity is critical for breaking down medications to their active or inactive forms. Due to the underdeveloped liver function, drugs may not be metabolized properly, leading to a longer half-life and an increased risk for drug toxicity. This is a key factor in the increased risk of toxicity in neonatal clients.
D) The albumin levels are elevated due to rapid growth and protein binding is enhanced: Neonates typically have lower albumin levels, not elevated levels. Albumin is crucial for binding medications, and lower levels in neonates can result in more free (unbound) drug circulating in the bloodstream, which can increase the risk of drug toxicity. Elevated albumin would theoretically reduce this risk, but this is not typically the case in neonates.
Correct Answer is A
Explanation
To determine if the client's dose is safe and therapeutic, we need to calculate the appropriate dosing range based on the client's weight and compare it with the ordered dose.
Client's weight: 45 kg
Ordered dose: 500 mg every 8 hours, which equals 1500 mg/day (500 mg × 3 doses).
Calculate the therapeutic range:
The dosing range in the Davis Drug Guide is 20 to 40 mg/kg/day. So, for this client, based on their weight of 45 kg:
Minimum dose: 20 mg × 45 kg = 900 mg/day
Maximum dose: 40 mg × 45 kg = 1800 mg/day
The ordered dose of 1500 mg/day falls within this range (900 mg/day to 1800 mg/day), which means it is safe and therapeutic for the client.
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