A male client who has been taking a high-dose of a nonsteroidal anti-inflammatory drug (NSAID) comes to the clinic reporting 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 te’ching plan?

Notify the healthcare provider of the passage of black stools.

Call the clinic if diarrhea or headache occur when taking esomeprazole.

Once pain subsides, NSAID therapy can be resumed.

Resume a diet that consists of milk, cream, and bland foods.

Answer and Explanation

The Correct Answer is A

A) Notify the healthcare provider of the passage of black stools: This is the correct response. Black stools can indicate gastrointestinal bleeding, which is a serious adverse effect of NSAID use. It's im’ortant for the client to report this symptom promptly to the healthcare provider for further evaluation and management.

B) Call the clinic if diarrhea or headache occur when taking esomeprazole: While it's im’ortant to report any adverse effects of medication to the healthcare provider, diarrhea and headache are not specific to esomeprazole and may not warrant immediate attention unless severe or persistent.

C) Once pain subsides, NSAID therapy can be resumed: This statement is incorrect. The client should avoid NSAIDs in the future, as they are likely the cause of the gastric pain and gastrointestinal bleeding. Resuming NSAID therapy would increase the risk of recurrent bleeding.

D) Resume a diet that consists of milk, cream, and bland foods: This statement is incorrect. While bland foods may be easier to tolerate during acute gastric pain, they do not address the underlying issue of gastrointestinal bleeding. Additionally, dairy products like milk and cream may exacerbate symptoms in some individuals.

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Correct Answer is B

Explanation

A) Cheese, milk, and yogurt: These foods are high in calcium and may not be the best choice for a client taking furosemide, as they can contribute to calcium levels and potentially exacerbate hypercalcemia, which is a risk with loop diuretic use.

B) Bananas, oranges, and peaches: This is the correct response. These fruits are rich in potassium, which is often depleted in clients taking loop diuretics like furosemide. Encouraging foods high in potassium can help replenish electrolytes and prevent hypokalemia.

C) Pasta, cereal, and bread: While these foods are generally well-tolerated and can provide carbohydrates for energy, they do not specifically address the electrolyte imbalances associated with loop diuretic use.

D) Liver, beef, and chicken: These foods are good sources of protein but do not directly address the electrolyte imbalances associated with loop diuretic use.

Therefore, encouraging the client to consume foods rich in potassium, such as bananas, oranges, and peaches, can help offset the potassium loss caused by furosemide and mitigate the risk of hypokalemia.

A. Bronchitis. B. Diabetes mellitus. C. Hypertension. D. Hypercholesterolemia.

Correct Answer is C

Explanation

A) Bronchitis: Methylphenidate, a central nervous system stimulant, is not contraindicated in clients with bronchitis. While caution may be warranted in individuals with respiratory conditions due to potential stimulant effects, bronchitis alone does not necessitate specific precautions or contraindications for methylphenidate use.

B) Diabetes mellitus: Methylphenidate use does not typically pose significant risks for individuals with diabetes mellitus. While stimulant medications may affect appetite and blood glucose levels, they are not contraindicated in clients with diabetes. Monitoring blood glucose levels may be prudent, but it is not the primary concern when reviewing the medical record before administering methylphenidate.

C) Hypertension: Reviewing the medical record for hypertension is essential before administering methylphenidate. Stimulant medications like methylphenidate can increase heart rate and blood pressure, potentially exacerbating hypertension or cardiovascular conditions. Clients with uncontrolled hypertension may require dose adjustments or alternative treatments to mitigate cardiovascular risks associated with methylphenidate use.

D) Hypercholesterolemia: Methylphenidate is not contraindicated in clients with hypercholesterolemia. While stimulant medications may have minor effects on lipid profiles, they are not typically considered significant enough to warrant specific precautions or contraindications in individuals with hypercholesterolemia.

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