Protonix 20 mg is ordered IV twice a day for a client. The Protonix is available in a 40 mg/5 mL concentration. How many milliliters would be given in 24 hours? (Round answer to whole number).

A. a lack of dyspepsia: While symptom relief is important, the primary therapeutic goal of the omeprazole and amoxicillin regimen is eradication of H. pylori. Dyspepsia can resolve temporarily with acid suppression alone and does not confirm that the underlying infection has been treated.

B. no gastroesophageal reflux: Omeprazole may help reduce reflux symptoms due to its acid-suppressing effects, but this is not a primary indicator of treatment success in peptic ulcer disease caused by H. pylori.

C. increased appetite and absence of nausea: Improved appetite and reduced nausea may occur as symptoms resolve, but they are nonspecific. These signs do not definitively confirm that H. pylori, the causative agent of many ulcers, has been successfully eradicated.

D. absence of Helicobacter pylori: The purpose of combining omeprazole (a proton pump inhibitor) with amoxicillin (an antibiotic) is to eliminate H. pylori. Confirming its absence through follow-up testing (e.g., urea breath test, stool antigen test) is the most reliable measure of therapeutic success.

A. "Reduce the fiber in your diet.": Bulk-forming laxatives, such as psyllium, work similarly to dietary fiber by absorbing water and increasing stool bulk. Reducing dietary fiber would counteract the intended therapeutic effect and is not advised during treatment.

B. "This medication will make you drowsy.": Bulk-forming laxatives do not have central nervous system effects and are not associated with sedation or drowsiness. This side effect is more relevant for medications like antihistamines or opioid analgesics.

C. "Drink plenty of fluid while taking this.": Adequate fluid intake is essential when using bulk-forming laxatives to prevent intestinal obstruction. Water helps the fiber expand and form a soft, bulky stool, which promotes effective and safe bowel movements.

D. "This laxative can be addictive.": Unlike stimulant laxatives, bulk-forming agents do not cause dependency or lead to laxative abuse. They are safe for long-term use when taken with sufficient water and proper diet.