A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?
Take the medication an hour after antacids.
Notify the healthcare provider of lethargy.
Decrease cigarette use to a pack per day.
Monitor for any signs of sexual dysfunction.
None
None
The Correct Answer is C
Choice A reason: Antacids can interfere with the absorption of cimetidine. It is generally recommended to avoid taking antacids within 1 hour before or after taking cimetidine to ensure optimal absorption. Therefore, taking cimetidine an hour after antacids is appropriate.
Choice B reason: Notifying the healthcare provider of lethargy is a correct statement, as it may indicate a serious side effect of cimetidine. Cimetidine can cause central nervous system effects, such as confusion, drowsiness, headache, and depression. Lethargy may also be a sign of anemia, which is another possible side effect of cimetidine. The nurse should instruct the client to report any unusual symptoms to the healthcare provider and monitor the client's blood count and liver function.
Choice C reason: Smoking has been shown to impair the effectiveness of cimetidine in treating ulcers and can delay healing. The goal should be complete smoking cessation rather than merely reducing cigarette use. Therefore, the statement about decreasing cigarette use to a pack per day indicates a misunderstanding and requires additional instruction by the nurse.
Choice D reason: Monitoring for any signs of sexual dysfunction is a correct statement, as it may indicate another side effect of cimetidine. Cimetidine can cause endocrine effects, such as gynecomastia, impotence, and decreased libido in men, and menstrual irregularities in women. The nurse should instruct the client to inform the healthcare provider if they experience any changes in their sexual function or reproductive health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Ginkgo biloba use should be limited and not taken during pregnancy is a true statement, but not the most important information for the nurse to include in the teaching plan. Ginkgo biloba may have adverse effects on the fetus, such as bleeding, seizures, or malformations. However, this information is only relevant if the client is pregnant or planning to become pregnant. The nurse should assess the client's reproductive status and advise her accordingly.
Choice B reason: Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo is the most important information for the nurse to include in the teaching plan. Ginkgo biloba has antiplatelet and anticoagulant properties, which means it can prevent blood clots from forming. However, this also increases the risk of bleeding, especially when combined with other drugs that affect blood clotting, such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs). The nurse should instruct the client to avoid taking these drugs with ginkgo biloba and inform the healthcare provider of all the medications and supplements she is using.
Choice C reason: Nausea and diarrhea can occur when using this supplement is a possible side effect of ginkgo biloba, but not the most important information for the nurse to include in the teaching plan. Nausea and diarrhea are usually mild and transient, and can be reduced by taking ginkgo biloba with food or water. The nurse should inform the client of this possibility and advise her to report any severe or persistent symptoms to the healthcare provider.
Choice D reason: Anxiety and headaches increase with the use of ginkgo biloba is a false statement, and not the information for the nurse to include in the teaching plan. Ginkgo biloba may actually have beneficial effects on anxiety and headaches, as it can improve blood circulation and oxygen delivery to the brain. The nurse should not discourage the client from using ginkgo biloba for these reasons, unless there is a contraindication or an interaction with other drugs.
Correct Answer is D
Explanation
Choice A reason: Lorazepam is a benzodiazepine that is used to treat anxiety, insomnia, and seizures. It is metabolized by the liver and does not have a significant effect on the kidneys. The nurse should monitor the client for signs of sedation, respiratory depression, and dependence.
Choice B reason: Digoxin is a cardiac glycoside that is used to treat heart failure and arrhythmias. It is eliminated by the kidneys and can cause toxicity if the renal function is impaired. The nurse should monitor the client's serum digoxin level, heart rate, and rhythm, and signs of toxicity, such as nausea, vomiting, visual disturbances, and confusion.
Choice C reason: Sucralfate is a mucosal protectant that is used to treat peptic ulcer disease. It forms a protective barrier over the ulcer and does not get absorbed into the bloodstream. It does not affect the kidneys and has few side effects. The nurse should monitor the client's symptoms and advise them to take the medication on an empty stomach.
Choice D reason: Vancomycin is an antibiotic that is used to treat serious infections caused by gram-positive bacteria. It is nephrotoxic and can cause AKI, especially in high doses or prolonged use. The nurse should monitor the client's serum vancomycin level, renal function tests, urine output, and signs of AKI, such as oliguria, edema, and electrolyte imbalances.
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