The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug?

Choice A reason: NSAIDs, like ibuprofen, exacerbate peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) by inhibiting COX-1, reducing protective gastric mucus and increasing acid-related damage. They are contraindicated in these conditions, making this choice incorrect for treatment.

Choice B reason: Antacids neutralize gastric acid, providing rapid symptom relief in PUD and GERD by reducing acid irritation on the esophagus and stomach lining. They are a standard, non-prescription option for mild symptoms, making this a correct choice for managing these conditions.

Choice C reason: Laxatives treat constipation by promoting bowel movements but have no role in PUD or GERD, which involve acid-related damage to the stomach or esophagus. They don’t affect gastric acid or mucosal protection, making this choice incorrect for treatment.

Choice D reason: H2 antagonists, like ranitidine, reduce gastric acid secretion by blocking histamine receptors on parietal cells, promoting ulcer healing and relieving GERD symptoms. They are a mainstay treatment for both conditions, making this a correct choice for effective management.

Choice E reason: Proton pump inhibitors, like omeprazole, strongly inhibit gastric acid production by blocking the proton pump in parietal cells, allowing ulcer healing and reducing GERD symptoms. They are first-line therapy for PUD and GERD, making this a correct choice.

Choice A reason: A sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). While furosemide can cause hyponatremia, this value is not concerning. Hypokalemia is a greater risk with furosemide and digoxin, as it potentiates digoxin toxicity, making this choice less critical than potassium.

Choice B reason: Oxygen saturation of 95% is normal (95-100%). Crackles suggest pulmonary edema, but this saturation doesn’t indicate severe hypoxia requiring immediate action. Hypokalemia poses a greater risk with digoxin and furosemide, as it increases toxicity potential, making this choice less concerning.

Choice C reason: A potassium level of 3.0 mEq/L (normal: 3.5-5.0 mEq/L) indicates hypokalemia, exacerbated by furosemide’s diuretic effect. In digoxin use, low potassium increases cardiac toxicity risk, causing arrhythmias, especially with an irregular heart rate noted, making this the most concerning value requiring immediate attention.

Choice D reason: A blood glucose level of 100 mg/dL is normal (70-110 mg/dL fasting). It’s unrelated to digoxin or furosemide’s primary risks (e.g., electrolyte imbalances, arrhythmias). Hypokalemia is a more immediate concern due to its synergistic toxicity with digoxin, making this choice less critical.