A patient who has GERD has been taking a PPI for 2 months and reports a slight decrease in symptoms. The next response of the primary care NP is to:
a. add a histamine-2-receptor agonist.
b. increase the dose of the PPI.
c. change to long-term, low-dose PPI therapy.
d. refer the patient to an endocrinologist for endoscopy and further management.
A
If treatment with a PPI is inadequate by 2 months, histamine-2-receptor agonist therapy is indicated. Increasing the dose is not indicated. Long-term, lower dose therapy is used for recurrences of symptoms on a limited basis. When symptoms fail to resolve with pharmacologic treatments, patients should be referred to an endocrinologist.
You might also like to view...
The nurse is caring for a patient in the postoperative period following an abdominal hysterectomy
The patient states, "I don't want to use my pain meds because they'll make me dependent and I won't get better as fast." Which response is most important when explaining the use of pain medication? A) "You will need the pain medication for at least 1 week to help in your recovery. What do you mean you feel you won't get better faster?" B) "Pain medication will help to decrease your pain and increase your ability to breath. Dependency is a risk with pain medication, but you are young and won't have any problems." C) "Pain medication can be given by mouth to prevent the risk of dependency that you are worried about. The pain medication has not been shown to affect your risk of a slowed recovery." D) "You will move more easily and heal more quickly with decreased pain. Dependence only occurs when it is administered for an extended period of time."
A client is unable to care for her needs and requires assistance with activities of daily living
The son calls the clinic and informs the LPN that he wants his mother to be able to remain in her home but must work and is unable to care for her 24 hours per day. What options can the LPN suggest for the care of his mother? A) Employ private duty nurses to care for the parent. B) He must admit his mother to a nursing home. C) He will have to quit his job and stay home to care for her. D) Take her to an adult day care center.
A patient admitted with an infected wound is demonstrating signs of improvement. The nurse would attribute this improvement to which physiologic process?
1. Cortisol released from the adrenal glands 2. Hypothalamus activating white blood cells 3. Endothelial cells releasing mediators to contain the infection 4. Mediators that decrease permeability of vessel walls
Which safety measure does the nurse use for the adult client who has growth hormone deficien-cy?
a. Avoid intramuscular medications. b. Place the client in protective isolation. c. Use a lift sheet to reposition the client. d. Assist the client to change positions slowly.