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. Alternate the use of each nostril when administering the nasal spray each day. B. Do not lie down within thirty minutes of use of the nasal spray. C. Use an nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur. D. Take an over-the-counter antihistamine with each dally dose of nasal spray.

Correct Answer is A

Explanation

A. Alternate the use of each nostril when administering the nasal spray each day: Alternating nostrils can help reduce local irritation and rhinitis associated with the use of nasal spray medications. This practice allows each nostril to recover and reduces the risk of continuous irritation from the spray.
B. Do not lie down within thirty minutes of use of the nasal spray: While this can help ensure the medication is absorbed properly, it is not specifically aimed at reducing rhinitis. It is more important to manage irritation by alternating nostrils.
C. Use a nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur: NSAIDs might not be suitable for everyone, and using them could mask symptoms or lead to additional side effects. They are not a primary strategy for managing rhinitis caused by nasal spray use.
D. Take an over-the-counter antihistamine with each daily dose of nasal spray: Antihistamines are not typically used to manage rhinitis caused by nasal sprays. Additionally, combining medications should be done cautiously and usually under medical advice.

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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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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A client is using the nasal spray hormone calcitonin to reduce bone loss from osteoporosis. To reduce rhinitis associated with administration of the nasal spray, the nurse should provide the client with which instruction?

Correct Answer is A

Explanation

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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?