Close-Outs Week 7 Flashcards
(26 cards)
if pt is experiencing mild, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?
lifestyle/dietary changes and-
antacid, low-dose H2RA, or combination of the two
use a PPI or see Dr
if pt is experiencing moderate, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?
lifestyle/dietary changes and-
antacid or high-dose H2RA
use a PPI or see Dr
if pt is experiencing heartburn 2 or more times a week, what is the recommendation?
lifestyle/dietary changes and-
PPI daily for 14 days or H2RA as needed
what are notable exclusions for self-treatment of heartburn?
- HB lasting more than 3 months
- Severe HB or dyspepsia
- HB at night
- Difficulty/pain swallowing solid foods
- unexplained weight loss
- wheezing, coughing, choking
- continuous nausea, vomiting, or diarrhea
- chest pain with sweating, shortness of breath
- adults over 45 with new-onset dyspepsia
patient should not exceed __ days of self-treatment with a PPI and should not use again for __ months
14, 4
patient should not exceed __ days of self-treatment with an antacid or H2RA w/o consulting PCP
14
do not recommend bismuth subsalicylate to patients allergic to?
aspirin/salicylates
do not give calcium carbonate to pregnant woman taking prenatals because?
prenatals usually have calcium
antacid recommendation for heartburn: sodium bicarbonate
directions for use:
side effects:
do not use longer than __ consecutive days
if symptoms worsen over the next 14 days, what should you counsel patient:
- dissolve 2 tablets in 4oz of water every 4 hours as needed
- Nausea, bloating, or gas
- 14
- if symptoms persist contact dr
antacid recommendation for heartburn: calcium carbonate
directions for use:
side effects:
do not use longer than __ consecutive days
if symptoms worsen over the next 14 days, what should you counsel patient:
- chew 2-4 tablets as needed
- Nausea, bloating, or gas
- 14
- if symptoms persist contact dr
H2RA recommendation for heartburn: famotidine
directions for use:
side effects:
don’t take longer than:
counsel patient on symptoms worsening or not going away after 14 days:
- 1 tablet with full glass of water, up to 2 tablets daily
- Headache, constipation, or diarrhea
- 14 days
- if symptoms persist or worsen over 14 days contact dr
PPI recommendation for heartburn: omeprazole
directions for use:
side effects:
do not use again for _ months:
counsel if experiencing heartburn while on this medication or before the 4 month period:
- 1 tab with a full glass of water 30 minutes before morning meal, take daily for 14 days
- Headache or abdominal pain
- 4 months
- contact Dr if still experiencing heartburn after 14 days or heartburn comes back before 4 months
when evaluating a patient with constipation, what are the steps involved?
- determine cause of constipation (food/drugs)
- if prescription drug induced, contact Dr
- if likely caused by food, recommend high fluid-fiber intake and inc exercise if needed
- if fluid/fiber isn’t working, recommend a bulk former or hyper-osmotic
- if OTC products don’t work, see Dr
exclusions for self-treatment of constipation:
- fever
- nausea/vomiting
- chronic medical condition
- laxative use
- changes in bowel habits and weight loss
- symptoms persisting over 2 weeks or recur within 3 months
- anorexia
- under 2 years old
when using bulk-forming laxatives, patients should be counseled to?
drink plenty of water with the laxative
how to insert an enema:
- if administered by someone else, lay on left-side with knees bent or go into the knee-to-chest position
- if you are administering, lay on back and bring knees to chest and raise your buttocks.
- make sure enema tip is lubricated and the anal area as well
- gently insert 2-3 inches into rectum
- allow solution to flow into rectum slowly and retain it inside rectum for 1-5 minutes
how to insert a suppository:
- make sure it is firm enough to insert and cool it down
- unwrap it and dip into lukewarm water for a few seconds
- lay on left side with knees bent or go into the knee-to-chest position
- relax buttocks before inserting and then insert
- continue to lie down for a few minutes while holding the buttocks together
- avoid a bowel movement for roughly an hour after insertion
recommended bulk-forming agent: psyllium directions for use: time for effect: do not use longer than: side effects: counsel point about fluids
- swallow 5 capsules with 8oz of liquid (1 capsule at a time) up to 4 times a day
- usually 12 to 72 hours
- 7 days
- Gas or stomach cramping
- drink plenty of fluids while using
recommended hyperosmotic agent: polyethylene glycol directions for use: time for effect? do not use longer than? side effects?
- 17g in 4-8oz of liquid once daily
- may take 2 to 4 days
- 14 days
- Nausea, cramping, or gas
recommended emollient agent: docusate sodium directions for use: time for effect: side effects: do not use longer than:
- 50-300mg qd
- may take 1 to 2 days
- Stomach pain, diarrhea, or cramping may occur
- 7 days
what is the best recommended otc product for constipation?
bulk-forming agents
best products for quick relief of constipation?
bulk-forming agents
best products for opioid caused constipation?
emollients
best products for use after surgery and prevent straining?
emollients
