Pharmacology and the Nursing Process
Pharmacology and the Nursing Process
7th Edition
ISBN: 9780323087896
Author: Linda Lane Lilley
Publisher: Elsevier Health Sciences
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Chapter 50, Problem 7NERQ
Summary Introduction

To define:

Administration of cimetidine is 300 mg in 100 mL normal saline IVPB tid. The infusion should be completed over 30 minutes. If the infusion pump is programmed to deliver to the drug over 30 minutes, find the amount of mL/hour of cimetidine for each IVPB dose that is programmed by the nurse.

Concept introduction:

H2 receptor antagonists such as cimetidine, famotidine, ranitidine, and nizatidine are used to treat gastroesophageal reflux disease (GERO), peptic ulcer, and erosive esophagitis. Also, they are used as adjunct therapy for gastrointestinal tract bleeding. Cimetidine is the first prototypical H2 receptor antagonist released on the market. Cimetidine or other H2 receptor antagonists block the effect of histamine receptors, which are found in the parietal cells. These cells secrete hydrochloric acid (HCl) in the stomach. However, oversecretion of HCl may cause various gastrointestinal problems. The inhibition of histamine receptors by H2 receptor antagonists results in a reduced response of parietal cells to stimuli. This, in turn, leads to a decreased acid secretion. About 90% of acid secretion can be suppressed by H2 receptor antagonists.

Cimetidine has more risk in the case of drug interactions than other H2 receptor antagonists. Cimetidine can bind to enzymes of the liver cytochrome P-450, which is mainly involved in the metabolisms of several drugs (for example, phenytoin).

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DaVita Dietitian Reference Manual Module 7- Adequacy of Hemodialysis CASE STUDIES Case 1 David was diagnosed with chronic kidney disease a year ago, and now needs hemodialysis. At his first treatment, the nurse hooks up the bloodlines to an access in David's chest. He tells her that he had surgery on his arm three months ago so it can be used for dialysis eventually. 1. What type of access does David have for the initial treatment? 2. Is David's arm access most likely a graft or fistula? 3. What possible reasons prevent use of a fistula or graft for the first dialysis treatment? Case 2 Ramon, a hemodialysis patient for six years, has lost 1.5 kg over the past six weeks. He denies nausea or vomiting, but does admit to eating less at meals and skipping dinner some days. Current dialysis prescription is: 3 1/2 hours (210 minutes), 3 times a week, ASAHI 1050S, APS dialyzer, dialysis flow rate 800 ml/min, blood flow rate 400 ml/min. Monthly bloodwork is as follows: Date K PO4 Pre-BUN…
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