A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?
Provide a PRN dose of antacid along with the scheduled medications.
Instruct the client to take the dose of sucralfate PO while eating breakfast.
Hold the dose of IV pantoprazole until the client has finished eating breakfast.
Administer both of the medications before breakfast as scheduled.
The Correct Answer is D
Choice A Reason:
Providing a PRN dose of antacid along with the scheduled medications is not the best option. Antacids can interfere with the absorption of other medications, including sucralfate and pantoprazole. Sucralfate works by forming a protective barrier on the ulcer site, and pantoprazole is a proton pump inhibitor that reduces stomach acid production. Adding an antacid could alter the effectiveness of these medications.
Choice B Reason:
Instructing the client to take the dose of sucralfate PO while eating breakfast is incorrect. Sucralfate should be taken on an empty stomach, typically one hour before meals, to ensure it can effectively coat the ulcer site and provide protection. Taking it with food can reduce its efficacy.
Choice C Reason:
Holding the dose of IV pantoprazole until the client has finished eating breakfast is not advisable. Pantoprazole is most effective when taken before meals, as it helps to reduce stomach acid production in anticipation of food intake. Delaying the dose could result in less effective acid suppression and increased discomfort for the patient.
Choice D Reason:
Administering both of the medications before breakfast as scheduled is the correct action. Sucralfate should be taken on an empty stomach to form a protective barrier on the ulcer site, and pantoprazole should be administered before meals to reduce stomach acid production. This timing ensures both medications work optimally to manage the patient’s peptic ulcer disease and alleviate symptoms like heartburn.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.8"]
Explanation
Calculation Steps
Step 1: Identify the concentration of the medication in the syringe.
The syringe is labeled “Enoxaparin sodium injection, USP 60 mg/0.6 mL.”
Step 2: Calculate the amount of medication per mL.
60 mg ÷ 0.6 mL = 100 mg/mL
Result = 100 mg/mL
Step 3: Determine the prescribed dose.
The prescribed dose is 80 mg.
Step 4: Calculate the volume to administer.
80 mg ÷ 100 mg/mL = 0.8 mL
Result = 0.8 mL
Therefore, the nurse should administer 0.8 mL.
Correct Answer is A
Explanation
Choice A Reason:
Contact the healthcare provider: Given the client’s history of anaphylactic reaction to penicillin, there is a potential risk of cross-reactivity with cephalexin, a cephalosporin. Although the risk of cross-reactivity is relatively low, it is still significant enough to warrant caution. Studies indicate that 1-4% of people with a true penicillin allergy may also react to cephalosporins. Therefore, the nurse should contact the healthcare provider to discuss alternative antibiotics or additional precautions.
Choice B Reason:
Give with prescribed antihistamine: While antihistamines can help manage mild allergic reactions, they are not sufficient to prevent or treat anaphylaxis. Anaphylactic reactions require immediate medical intervention, including epinephrine administration. Therefore, relying solely on antihistamines is not an appropriate or safe action in this scenario.
Choice C Reason:
Administer the medication as prescribed: Administering cephalexin without consulting the healthcare provider could put the client at risk of a severe allergic reaction. Given the client’s history of anaphylaxis to penicillin, it is crucial to verify the safety of cephalexin with the healthcare provider before administration.
Choice D Reason:
Monitor the client for a rash or hives: While monitoring for allergic reactions is essential, it should not be the primary action in this case. The priority is to prevent a potential severe allergic reaction by consulting the healthcare provider before administering the medication. Monitoring alone does not address the underlying risk of cross-reactivity.
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