A client who has dysphagia after a cerebral vascular accident (CVA) receives a new prescription for lansoprazole capsules via nasogastric tube (NGT). Which action should the nurse implement prior to administering the medication?

Mix the capsule granules with water.

Request the pharmacist to provide tablets.

Open the capsule to crush the granules.

Sprinkle the granules in applesauce.

Answer and Explanation

The Correct Answer is A

A. Mix the capsule granules with water: Lansoprazole capsules contain granules that are typically not intended to be crushed or chewed. The appropriate method for administering these granules via an NGT is to mix them with water to ensure they are delivered properly. This approach aligns with the medication’s guidelines for administration through a tube.
B. Request the pharmacist to provide tablets: While tablets might be a suitable alternative, it is not the immediate action required if the client already has capsules. The focus should be on appropriately administering the prescribed form.
C. Open the capsule to crush the granules: Crushing or opening capsules is generally not recommended unless specifically instructed by the manufacturer or pharmacist. This can alter the drug’s effectiveness and release properties.
D. Sprinkle the granules in applesauce: Lansoprazole granules are not meant to be mixed with food like applesauce. They should be mixed with water to ensure proper dissolution and administration.

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Correct Answer is B

Explanation

A. Hematocrit 42% (0.42 volume fraction): This value is within the normal range for hematocrit (42% to 52%). Therefore, it does not indicate an immediate concern.
B. Positive guaiac of stool: A positive guaiac test for occult blood in the stool indicates gastrointestinal bleeding. Given the client's history of self-treating with ibuprofen (a nonsteroidal anti-inflammatory drug, NSAID) and his symptoms of fatigue and dizziness, this finding suggests possible gastrointestinal bleeding due to NSAID-induced ulcers or bleeding. This requires immediate reporting to the healthcare provider for further evaluation and intervention.
C. Gastric pH 2: While the gastric pH is on the acidic side, it is within the normal range for gastric acid (1.5 to 3.5). This finding does not necessarily indicate an acute problem by itself.
D. Hemoglobin 13 g/dL (8.07 mmol/L): Although this hemoglobin level is slightly below the normal range for males (14 to 18 g/dL), it is not as critical as a positive guaiac test for stool blood. It might be worth monitoring, but it is not as urgent as addressing potential gastrointestinal bleeding.

A. Assess the client for other indications of adverse effects of corticosteroid use. B. Advise the client that the medication should be stopped gradually rather than abruptly. C. Encourage the client to take the medication with food to decrease Gl distress. D. Review the client's dosing schedule to ensure he is taking the prescribed amount.

Correct Answer is B

Explanation

A. Assess the client for other indications of adverse effects of corticosteroid use: While important, this action does not address the immediate issue of stopping the medication safely.
B. Advise the client that the medication should be stopped gradually rather than abruptly: Corticosteroids should not be stopped suddenly due to the risk of adrenal insufficiency and withdrawal symptoms. Gradual tapering is necessary to safely discontinue the medication.
C. Encourage the client to take the medication with food to decrease GI distress: This can help manage GI symptoms but does not address the issue of safely discontinuing the medication.
D. Review the client's dosing schedule to ensure he is taking the prescribed amount: This is useful but does not resolve the problem of safely stopping the medication.

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A client who has dysphagia after a cerebral vascular accident (CVA) receives a new prescription for lansoprazole capsules via nasogastric tube (NGT). Which action should the nurse implement prior to administering the medication?

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Correct Answer is B

Explanation

A male client reports to the nurse that he is experiencing gastrointestinal (GI) distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement, which nursing action is most important for the nurse to Implement?

Correct Answer is B

Explanation

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