A client is prescribed ranitidine (Zantac). The nurse checks the ...

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A client is prescribed ranitidine (Zantac). The nurse checks the client's BUN and serum creatinine levels prior to administering the drug for the first time. The rationale for checking these labs is:
 
  1. serum BUN and creatinine should be checked on all clients.
  2. that the drug is primarily biometabolized by the liver.
  3. to identify a hidden drug allergy.
  4. that the drug is primarily excreted by the kidneys.

Question 2

A client is diagnosed with a gastric ulcer secondary to NSAID overuse. The nurse would question which health care provider order?
 
  1. Clarithromycin
  2. Omeprazole
  3. Famotidine
  4. Ranitidine

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Answer to Question 1

Correct Answer: 4
Rationale 1: Serum creatinine and BUN do not need to be checked on all clients.
Rationale 2: Serum creatinine and BUN do not measure liver function.
Rationale 3: Serum creatinine and BUN will not identify hidden drug allergies.
Rationale 4: These drugs are mainly excreted by the kidneys, and clients with diminished kidney function require smaller doses.
Global Rationale: Ranitidine is excreted by the kidneys and used be used with caution in those with renal impairment. It is not routine to check serum creatinine and BUN on all clients, they do not measure liver function, and will not identify hidden drug allergies.

Answer to Question 2

Correct Answer: 1
Rationale 1: A combination of antibiotics is concurrently used to eradicate H. pylori and help decrease antibiotic resistance. Those with peptic ulcers who are not infected with H. pylori have been shown to have a worse outcome when receiving H. pylori treatment.
Rationale 2: Proton pump inhibitors are indicated for use in gastric ulcers.
Rationale 3: H2-receptor antagonists are indicated for use in gastric ulcers.
Rationale 4: H2-receptor antagonists are indicated for use in gastric ulcers.
Global Rationale: A combination of antibiotics is concurrently used to eradicate H. pylori and help decrease antibiotic resistance. Those with peptic ulcers who are not infected with H. pylori have been shown to have a worse outcome when receiving H. pylori treatment. The remaining drugs are logical for the treatment of NSAID induced gastric ulcers.

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Excellent

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Gracias!