An older adult patient with severe gastroesophageal reflux ...

[ashley]

An older adult patient with severe gastroesophageal reflux disease (GERD) has had only minimal relief using a histamine2-receptor antagonist (H2RA). The patient is to begin taking omeprazole (Prilosec). What will the nurse teach this patient?
 
  a. A complete cure is expected with this medication.
  b. Lifestyle changes can be as effective as medication therapy.
  c. Long-term therapy may be needed.
  d. The medication will be used until surgery can be performed.

Question 2

A patient stops taking a proton pump inhibitor (PPI) after 6 weeks of therapy for treatment of peptic ulcer disease. The patient reports symptoms of dyspepsia to the nurse. The nurse will tell this patient to:
 
  a. come to the clinic to be tested for Clostridium difficile.
  b. resume taking the PPI, because long-term therapy is necessary.
  c. resume taking the PPI until symptoms resolve completely.
  d. try an antacid to see whether it relieves these symptoms.

[ryansturges]

Answer to Question 1

ANS: C
Proton pump inhibitors, such as omeprazole, are much better than H2RAs for treating GERD. For patients with severe GERD, long-term maintenance therapy is recommended. These drugs do not cure GERD; relapse is common when the drugs are discontinued. Lifestyle changes can help but should not be considered a substitute for drugs. Surgery is reserved for young, healthy patients who cannot or will not stick to a drug regimen.

Answer to Question 2

ANS: D
When patients stop taking a PPI, a rebound hypersecretion of gastric acid can cause dyspepsia. This can be managed with an antacid. Although C. difficile infection is associated with dose-related increases in PPIs, the symptoms include diarrhea, not dyspepsia, so testing is not indicated for this patient. Resuming the PPI is not indicated, because these symptoms can be managed with antacids.

[ashley]

TY

[ryansturges]

You're welcome