The client with a new burn injury asks the nurse why he is receiving intravenous cimetidine (Tagamet). What is the nurse’s best response?
A. "Tagamet will stimulate intestinal movement."
B. "Tagamet can help prevent hypovolemic shock."
C. "This will help prevent stomach ulcers."
D. "This drug will help prevent kidney damage."
Correct Answer: C. “This will help prevent stomach ulcers.”
Ulcerative gastrointestinal disease may develop within 24 hours after a severe burn as a result of increased hydrochloric acid production and decreased mucosal barrier. This process occurs because of the sympathetic nervous system stress response. Cimetidine inhibits the production and release of hydrochloric acid.
Option A: Gastrointestinal stimulants are drugs that increase motility of the gastrointestinal smooth muscle, without acting as a purgative. These drugs have different mechanisms of action but they all work to move the contents of the gastrointestinal tract faster.
Option B: Patients with burns of more than 20% – 25% of their body surface should be managed with aggressive IV fluid resuscitation to prevent “burn shock.” Four mL lactated ringers solution × percentage total body surface area (%TBSA) burned × patient’s weight in kilograms = total amount of fluid given in the first 24 hours.
Option D: Cimetidine does not prevent kidney damage. Acute renal failure is one of the major complications of burns and it is accompanied by a high mortality rate. Most renal failures occur either immediately after the injury or at a later period when sepsis develops.
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