A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?
Resume a diet that consists of milk, cream, and bland foods.
Call the clinic if diarrhea or headache occurs when taking esomeprazole.
Once pain subsides, NSAID therapy can be resumed.
Notify the healthcare provider of the passage of black stools.
The Correct Answer is D
Choice A reason:
Resuming a diet that consists of milk, cream, and bland foods is not the most critical instruction for a client taking esomeprazole. While bland foods can help reduce gastric irritation, they do not address the primary concern of monitoring for serious side effects. Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid, and dietary changes alone are not sufficient to manage potential complications.
Choice B reason:
Calling the clinic if diarrhea or headache occurs when taking esomeprazole is important, but it is not the most critical instruction. Diarrhea and headache are common side effects of esomeprazole, but they are usually not severe. The client should be aware of these potential side effects, but the primary concern is monitoring for signs of gastrointestinal bleeding.
Choice C reason:
Once pain subsides, NSAID therapy should not be resumed without consulting the healthcare provider. NSAIDs can cause significant gastrointestinal issues, including ulcers and bleeding. The client should be advised to avoid NSAIDs unless specifically directed by their healthcare provider.
Choice D reason:
Notifying the healthcare provider of the passage of black stools is the most critical instruction. Black stools can indicate gastrointestinal bleeding, which is a serious side effect of both NSAIDs and esomeprazole. Immediate medical attention is necessary if this occurs to prevent further complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Administering potassium is not the primary action for treating digoxin toxicity. While hypokalemia can exacerbate digoxin toxicity, the initial step is to assess and stabilize the patient’s overall condition, including acid-base and electrolyte balance. Potassium administration may be considered if hypokalemia is present, but it is not the first-line treatment.
Choice B reason: Cardioversion is not typically used to treat digoxin toxicity. Digoxin toxicity can cause various arrhythmias, but the treatment focuses on stabilizing the patient and addressing the toxicity itself2. Cardioversion may be considered in life-threatening arrhythmias, but it is not the primary intervention.
Choice C reason: Checking acid-base and electrolyte values is crucial in managing digoxin toxicity. Digoxin toxicity can lead to electrolyte imbalances, particularly hyperkalemia, which can be life-threatening. Assessing and correcting these imbalances is essential for stabilizing the patient and preventing further complications.
Choice D reason: Giving digoxin by another route to slow absorption is not an appropriate action. The primary treatment for digoxin toxicity involves stopping the medication and administering digoxin-specific antibody fragments (Fab) if necessary. These antibodies bind to digoxin, neutralizing its effects and allowing for its excretion.
Correct Answer is C
Explanation
Choice A reason: Potassium levels are not directly affected by calcium acetate. Calcium acetate is primarily used to manage hyperphosphatemia in patients with CKD by binding to dietary phosphate and preventing its absorption1. Therefore, a decrease in potassium levels would not indicate the effectiveness of calcium acetate.
Choice B reason: Calcium acetate can actually increase calcium levels in the blood, especially if taken in high doses or if the patient has other sources of calcium intake. Monitoring calcium levels is important to avoid hypercalcemia, but a decrease in calcium levels is not the desired effect of this medication.
Choice C reason: Calcium acetate is used to reduce serum phosphate levels in patients with CKD. It works by binding to dietary phosphate in the gastrointestinal tract, forming insoluble calcium phosphate, which is then excreted in the stool. A decrease in serum phosphate levels indicates that the medication is effectively reducing phosphate absorption and managing hyperphosphatemia.
Choice D reason: The pH level of the blood is not directly influenced by calcium acetate. While maintaining acid-base balance is important in CKD management, the primary goal of calcium acetate therapy is to control phosphate level. Therefore, changes in blood pH are not a measure of the medication’s effectiveness.
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