Todd initiating ferrous sulfate therapy

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Reference no: EM134033894

Question

1. Todd is a 52 year old male with a past medical history of gastroesophageal reflux disease (GERD) and hypertension who was recently diagnosed with iron-deficiency anemia. After discussion with his physician, he agrees to try adjusting his diet to include more iron. After several months, there is not improvement in Todd's condition. His primary care provider will prescribe which of the following?

Ferrous sulfate 90 mg daily

Ferrous sulfate 325 mg two times daily

Vitamin B12 25 mcg daily

Ferrous sulfate 60 mg daily

2. Which factors should be considered prior to Todd initiating ferrous sulfate therapy?

Todd's use of acetaminophen

Todd's consumption of meat

Todd's consumption of Vitamin B12

Todd's use of antacids

3. After 2 weeks of taking the prescribed medication Todd returns to the clinic complaining of stomach upset. What do you recommend?

Continue taking the medication, but add vitamin B6

Continue taking the medication , but take it with an antacid

Stop the medication

Continue taking the medication, but take it with a small snack or meal

4. When should labs be repeated?

Monitor B12 levels in 4 weeks

Monitor BUN/Creatinine in 4 weeks

Monitor hemoglobin and hematocrit and ferritin in 1 week

Monitor Hemoglobin and hematocrit and ferritin in 4 weeks

5. Lydia is a 25 year old female who sometimes has "mild burning" after eating spicy foods. She has no other complaints or symptoms and reports that the burning goes away after an hour. She would like to take something to help with the symptoms. Why is an antacid appropriate for Lydia?

Antacids are the only appropriate treatment for GERD

Antacids have a long duration of action

Antacids neutralize gastric acid

Antacids are absorbed systemically before being activated

6. Which side effect may occur when selecting an antacid?

Calcium carbonate containing antacids may cause belching and flatulence

Calcium carbonate containing antacids may cause dose related diarrhea

Magnesium containing antacids may cause dose related constipation

Aluminum containing antacids may cause dose related diarrhea

7. Lydia is taking levothyroxine. What information do you need to provide to Lydia?

Antacids may cause a reduced absorption of levothyroxine; separate administration by 4 hours

Antacids will not interfere with the absorption of levothyroxine and they can be taken together

The Levothyroxine should be discontinued

Antacids may cause increased absorption of levothyroxine; separate administration by 4 hours

8. Bethany is a 67 year old female with complaints of episodic epigastric pain for the past 6 weeks. The pain is non-radiating and is aggravated by ingestion of food. Bethany has been experiencing occasional nausea, bloating, and heartburn. She denies any changes in color or frequency of bowel movements. Prior to experiencing her pain, Bethany was prescribed ibuprofen 600 mg by mouth 3 times daily for osteoarthritis.

Which of the following treatment options would be an appropriate recommendation for Bethany?

Tell Bethany to take the ibuprofen with milk

Add omeprazole daily and reevaluate NSAID therapy for continued use

Change Ibuprofen to Naproxen

Add misoprostol to reduce mucosal irritation

9. What adverse effects are associated with use of acid suppression with PPIs?

hypocalcemia

Vitamin D deficiency

increased risk for fractures

hypomagnesemia

hypercalcemia

Vitamin B12 deficiency

hypermagnesemia

10. Angela is a 25-year-old Hispanic female who is 22 weeks pregnant with her first child. She is experiencing constipation. She describes straining with bowel movements, hard formed stool, and decreased frequency from her previous bowel pattern. She plans to breast feed after she delivers. The primary concern for use of laxatives during pregnancy is:

gastrointestinal stimulation can induce labor.

laxative dependency.

alteration in bowel flora.

alteration in electrolyte levels.

Reference no: EM134033894

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