Author Question: A patient is taking a low-dose PPI for long-term management of GERD and reports taking sodium ... (Read 75 times)

ts19998 · **on:** Jul 24, 2018

A patient is taking a low-dose PPI for long-term management of GERD and reports taking sodium bicarbonate (Alka-Seltzer) to help with occasional heartburn. The primary care NP should tell the patient to:

a. change to aluminum hydroxide (Amphojel).
b. use magnesium hydroxide (Milk of Magnesia) instead.
c. continue using sodium bicarbonate (Alka-Seltzer) as needed.
d. take calcium carbonate (Tums) instead of sodium bicarbonate (Alka-Seltzer).

Question 2

A patient who is newly diagnosed with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus. The primary care NP should consider initiating antipsychotic therapy with:

a. ziprasidone (Geodon).
b. olanzapine (Zyprexa).
c. risperidone (Risperdal).
d. chlorpromazine (Thorazine).

whitcassie · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

D
Sodium bicarbonate is not suitable for long-term use because of side effects. Calcium carbonate requires monitoring when used long-term but has the highest acid-neutralizing capacity. Antacids containing aluminum and magnesium can cause electrolyte imbalances.

Answer to Question 2

A
Many antipsychotics increase the risk of metabolic syndrome in patients. Ziprasidone does not have effects on weight. The other agents all increase the risk of weight gain and metabolic syndrome.