Hesi RN Adult Health
Hesi RN Adult Health ( 57 Questions)
Which action should the nurse take?
A: Auscultating bowel sounds and measuring abdominal girth would not provide relevant information for assessing the effectiveness of lansoprazole therapy for erosive esophagitis. These assessments are typically used to evaluate gastrointestinal motility and distention, which are not primary concerns in this case. While bowel sounds can provide some information about gastrointestinal activity, they do not directly correlate with the degree of esophageal inflammation or healing. Similarly, abdominal girth measurements are more useful for monitoring conditions such as ascites or bowel obstruction, which are not related to erosive esophagitis. Rationale for
B: Confirming the timing of medication administration is important for adherence, but it would not be the most appropriate initial action in this scenario. Lansoprazole is typically taken 30-60 minutes before meals to optimize its acid-suppressing effects. However, even if the patient is taking the medication correctly, they may still require a dosage adjustment to achieve adequate symptom control. Rationale for
C: This is the most appropriate action because it directly addresses the possibility that the current dosage of lansoprazole is insufficient to manage the patient's symptoms effectively. The healthcare provider can evaluate the patient's response to therapy and determine if a dosage increase is necessary. In some cases, patients with erosive esophagitis may require twice-daily dosing of lansoprazole or a switch to a different proton pump inhibitor (PPI) to achieve optimal symptom relief and healing. Rationale for
D: While it is true that healing of erosive esophagitis typically takes several weeks, the patient's minimal symptom improvement after one week of treatment suggests that a more proactive approach is warranted. Simply advising the patient to wait for healing to occur could potentially delay necessary adjustments to the treatment regimen, prolonging the patient's discomfort and potentially increasing the risk of complications.
Rationale for Choice A:
Auscultating bowel sounds and measuring abdominal girth would not provide relevant information for assessing the effectiveness of lansoprazole therapy for erosive esophagitis. These assessments are typically used to evaluate gastrointestinal motility and distention, which are not primary concerns in this case.
While bowel sounds can provide some information about gastrointestinal activity, they do not directly correlate with the degree of esophageal inflammation or healing.
Similarly, abdominal girth measurements are more useful for monitoring conditions such as ascites or bowel obstruction, which are not related to erosive esophagitis.
Rationale for Choice B:
Confirming the timing of medication administration is important for adherence, but it would not be the most appropriate initial action in this scenario.
Lansoprazole is typically taken 30-60 minutes before meals to optimize its acid-suppressing effects.
However, even if the patient is taking the medication correctly, they may still require a dosage adjustment to achieve adequate symptom control.
Rationale for Choice C:
This is the most appropriate action because it directly addresses the possibility that the current dosage of lansoprazole is insufficient to manage the patient's symptoms effectively.
The healthcare provider can evaluate the patient's response to therapy and determine if a dosage increase is necessary.
In some cases, patients with erosive esophagitis may require twice-daily dosing of lansoprazole or a switch to a different proton pump inhibitor (PPI) to achieve optimal symptom relief and healing.
Rationale for Choice D:
While it is true that healing of erosive esophagitis typically takes several weeks, the patient's minimal symptom improvement after one week of treatment suggests that a more proactive approach is warranted.
Simply advising the patient to wait for healing to occur could potentially delay necessary adjustments to the treatment regimen, prolonging the patient's discomfort and potentially increasing the risk of complications.