A client who is newly diagnosed with erosive esophagitis secondary to gastroesophageal reflux disease (GERD) reports to the nurse that they did not notice any reduction in symptoms after taking lansoprazole PO for one full week. Which action should the nurse take?
Notify the healthcare provider that the client may need a change in dosage.
Auscultate the client’s bowel sounds and measure the abdominal girth.
Advise the client that healing typically takes several weeks to occur.
Confirm that the client is taking the medication one hour after meals.
The Correct Answer is C
Choice A rationale
Lansoprazole, a proton pump inhibitor (PPI), typically requires several weeks to achieve its full therapeutic effect. Notifying the healthcare provider for a dosage change after only one week is premature and not supported by clinical guidelines.
Choice B rationale
Auscultating bowel sounds and measuring abdominal girth are not directly related to the effectiveness of lansoprazole in treating GERD. These actions are more relevant for assessing gastrointestinal motility and potential complications like bowel obstruction.
Choice C rationale
Healing of erosive esophagitis with PPIs like lansoprazole usually takes several weeks. Advising the client that healing typically takes several weeks to occur is appropriate and aligns with the expected therapeutic timeline.
Choice D rationale
Lansoprazole should be taken before meals, not after, to maximize its effectiveness. Confirming that the client is taking the medication one hour after meals would not address the issue of symptom persistence.
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View Related questions
Correct Answer is A
Explanation
Choice A rationale
pH 7.49, PCO₂ 45 mm Hg, HCO₃ 32 mEq/L (32 mmol/L), PO₂ 90 mm Hg indicates metabolic alkalosis. The elevated pH and HCO₃ levels are consistent with this condition.
Choice B rationale
pH 7.30, PCO₂ 20 mm Hg, HCO₃ 22 mEq/L (22 mmol/L), PO₂ 85 mm Hg indicates metabolic acidosis with respiratory compensation, not metabolic alkalosis.
Choice C rationale
pH 7.46, PCO₂ 55 mm Hg, HCO₃ 36 mEq/L (36 mmol/L), PO₂ 95 mm Hg indicates metabolic alkalosis with respiratory compensation. However, the pH is slightly lower than in Choice A, making Choice A more indicative of metabolic alkalosis.
Choice D rationale
pH 7.29, PCO₂ 35 mm Hg, HCO₃ 25 mEq/L (25 mmol/L), PO₂ 99 mm Hg indicates metabolic acidosis, not metabolic alkalosis.
Correct Answer is A
Explanation
Choice A rationale
Isoniazid is an antitubercular drug used to treat active tuberculosis. The effectiveness of this medication is evaluated by observing a decrease in symptoms such as cough and sputum production. This indicates that the infection is being controlled and the bacteria are being eradicated.
Choice B rationale
A positive sputum smear and culture would indicate the presence of active tuberculosis bacteria, suggesting that the treatment is not effective. Therefore, this is not an expected outcome of effective treatment.
Choice C rationale
Decreased appetite and weight loss are not indicators of the effectiveness of tuberculosis treatment. In fact, these symptoms could indicate a worsening of the condition or side effects of the medication.
Choice D rationale
Vertigo and tinnitus are not related to the effectiveness of tuberculosis treatment. These symptoms could be side effects of the medication but do not indicate the success of the treatment.