A patient is placed on a multidrug regimen that includes bismuth for treatment of peptic ulcer disease (PUD). The nurse should include which of the following points when providing patient education?

Question

a. One week of therapy should heal ulcers, relieve symptoms, and eradicate H. py-lori.
b. Resolution of pain indicates that the ulcer has healed.
c. The tongue and stool may turn black.
d. A single-antibiotic regimen is preferable to a multi-antibiotic regimen whenever possible.

Answer 1

C
Bismuth can impart a harmless black color to the tongue and stool. Patients should be forewarned of this effect.
One week of therapy does not heal ulcers. Eradication rates for H. pylori are consistently higher with a 2-week course of treatment.
Instructing the patient that when symptoms resolve, the ulcer will be healed is incorrect. The cessation of pain and disappearance of the ulcer rarely coincide.
Guidelines recommend that, to minimize the emergence of resistance, at least two antibiotics, and preferably three, should be used to eradicate H. pylori.