Chapter 50: Acid-Controlling Test, Famotidine, Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Acid-Controlling Test, Chapter 50, Famotidine, Nursing Diagnosis , Thrombocytopenia, Antacids, Patient, Chronic Renal Failure, Nurse, Pharmacology for Nurses: Practical Applications
What nursing diagnosis is appropriate for a patient receiving famotidine?
Risk for infection related to immunosuppression
Risk for injury related to thrombocytopenia
Impaired urinary elimination related to retention
Ineffective peripheral tissue perfusion related to hypertension
A serious side effect of famotidine is thrombocytopenia, which is manifested by a decrease in platelet count and an increased risk of bleeding. The patient receiving famotidine may experience hypotension as an adverse effect, not hypertension. Famotidine does not cause immunosuppression or urinary retention.
What patient statement demonstrates understanding of teaching by the nurse regarding the use of histamine2-receptor antagonists?
“I should increase bulk and fluids in my diet to prevent constipation.”
“I should take this medication 1 hour after each meal to maximally decrease gastric acidity.”
“Smoking decreases the effects of this medication, so I should look into cessation programs.”
“Because I am taking this medication, it is OK for me to eat spicy foods.”
Patients taking histamine2-receptor–blocking drugs should avoid spicy foods, extremes in temperatures, alcohol, and smoking. Diarrhea, not constipation, is a GI adverse effect. Whereas cimetidine should be taken with meals, famotidine can be taken without regard to meals.
PPIs have the ability to almost totally inhibit gastric acid secretion. Because of this possibility, the use of the medication can lead to what condition?
Gastric ulcer formation
Gastroesophageal reflux disease (GERD)
Diverticulosis
Achlorhydria
Because PPIs stop the final step of acid secretion, they can block up to 90% of acid secretion, leading to achlorhydria (without acid) in a patient.
For a patient with chronic renal failure, the nurse will question a prescription for what type of antacid?
Magnesium-containing antacids
Sodium-containing antacids
Aluminum-containing antacids
Calcium-containing antacids
Magnesium-containing antacids can cause hypermagnesemia in patients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in patients with chronic renal failure. Sodium- and aluminum-containing antacids are chemically more easily excreted in patients with renal compromise. Although calcium-containing antacids may accumulate in the bloodstream of patients with renal failure, they may also be appropriate because these patients may be hypocalcemic.
What condition will the nurse monitor for with a patient using sodium bicarbonate to treat gastric hyperacidity?
Hyperkalemia
Metabolic alkalosis
Metabolic acidosis
Hypercalcemia
Solutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum potassium and serum calcium would decrease, not increase, with alkalosis.