The nurse is caring for a client who has begun vomiting after undergoing bariatric surgery. When including this complication in the plan of care, what would be an appropriate nursing conclusion related to the central nervous system (CNS) effects associated with an antiemetic?

A. apical heart rate: While changes in heart rate can occur as side effects of some antiemetic medications, dronabinol primarily affects the central nervous system. Cardiac monitoring is not the priority unless the client has a pre-existing heart condition.

B. blood pressure: Dronabinol may cause postural hypotension, especially in older adults, but this is generally mild and not the most urgent concern. Monitoring blood pressure is appropriate but not the top priority compared to neurologic effects.

C. skin integrity: Skin integrity is not directly impacted by dronabinol and is not a primary concern in the acute monitoring of this drug. There are no common dermatologic side effects associated with dronabinol use that would necessitate prioritizing skin assessment.

D. mental status: Dronabinol is a synthetic cannabinoid and may cause central nervous system effects such as dizziness, confusion, euphoria, or hallucinations. Assessing mental status is crucial, especially in older adults or those with a history of psychiatric illness, to identify adverse cognitive effects early.

A. PPIs cannot be crushed: Proton pump inhibitors are often enteric-coated to prevent degradation by stomach acid and ensure proper absorption in the small intestine. Crushing them disrupts this protective coating, reducing effectiveness and possibly leading to gastrointestinal irritation.

B. Famotidine is a common proton pump inhibitor: Famotidine is not a PPI but an H2-receptor antagonist. While both drug classes reduce gastric acid secretion, they work via different mechanisms and are not interchangeable in classification or pharmacological action.

C. Given to treat gastric ulcers: PPIs are commonly prescribed for gastric ulcers due to their potent acid suppression, which promotes mucosal healing. By inhibiting the H+/K+ ATPase enzyme in gastric parietal cells, they effectively reduce acid levels and facilitate ulcer recovery.

D. You can take PPIs daily indefinitely: Long-term daily use of PPIs is not recommended due to risks such as nutrient malabsorption, bone fractures, and increased susceptibility to infections like C. difficile. They should be used for the shortest effective duration, with regular reassessment.

E. PPIs have numerous adverse effects: Adverse effects associated with PPIs include headaches, diarrhea, vitamin B12 deficiency, hypomagnesemia, and increased risk of osteoporosis-related fractures.