Author Question: The client has gastroesophageal reflux disease (GERD) and has been receiving medication treatment ... (Read 56 times)

iveyjurea · **on:** Jul 23, 2018

The client has gastroesophageal reflux disease (GERD) and has been receiving medication treatment for many years. What priority assessment findings associated with the medication must the nurse report to the physician?

1. Vomiting and mild upper mid-epigastric pain
2. Anemia, fatigue, and weakness
3. Hypotension and tachycardia
4. Diarrhea and soft stools

Question 2

An elderly client comes to the emergency department with his wife. He has a history of peptic ulcer disease (PUD), and is currently experiencing confusion and severe headaches. What does the best plan by the nurse include?

1. Ask the client if he has experienced any head injuries recently.
2. Obtain a complete blood count (CBC), chemistry profile, and urine drug screen.
3. Ask the client's wife for a list of medications that the client has taken.
4. Obtain a magnetic resonance imaging (MRI) exam to assess if the client has experienced a stroke.

mammy1697 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: Vomiting and mild upper mid-epigastric pain are not signs of pernicious anemia or vitamin B12 deficiency that may result from chronic suppression of stomach acid from medications.
Rationale 2: Anemia, fatigue, and weakness are common signs of pernicious anemia or vitamin B12 deficiency. With chronic suppression of stomach acid by medications used for gastroesophageal reflux disease (GERD), the stomach may not be able to absorb vitamin B12, and there is the possibility of pernicious anemia.
Rationale 3: Hypotension and tachycardia are not signs of pernicious anemia or vitamin B12 deficiency that may result from chronic suppression of stomach acid from medications.
Rationale 4: Diarrhea and soft stools are not signs of pernicious anemia or vitamin B12 deficiency that may result from chronic suppression of stomach acid from medications.

Answer to Question 2

Correct Answer: 3
Rationale 1: Since the client has PUD, it would be logical to ask about medication prior to asking about injury.
Rationale 2: A complete blood count (CBC), chemistry profile, and urine drug screen are worthwhile tests, but the first priority for a client with a history of peptic ulcer disease (PUD) should be to find out what medications he has been taking.
Rationale 3: There is a known correlation between H2-receptor antagonists and confusion and headaches in the elderly population; the nurse should ascertain what medications the client is taking.
Rationale 4: It is premature to obtain a magnetic resonance imaging (MRI) exam until other causes have been ruled out.