GI Drugs

Which is an important assessment for the nurse to make before administering a laxative?

Question the client regarding the type and intensity of symptoms to provide a baseline evaluation.

A client is diagnosed with traveler's diarrhea, and the health care provider prescribes rifaximin. The nurse describes this drug as:

antibiotic

contraindications for lactulose

appendicitis acute surgical abdomen impaction/obstruction Caution: diabetes (sugar)**

The nurse cautions a client with what allergy to avoid the use of bismuth salts in the treatment of diarrhea?

aspirin

In pharmacology class the students are learning about the mechanism of action of different laxatives. What would the students learn about the mechanism of action of psyllium hydrophilic mucilloid?

increasing mass and water content of stool

A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?

1 hour before eating

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?

1 to 2 weeks

Recovering from laxative abuse takes time and patience. After using laxatives to stimulate defecation, approximately how long will it take for the fecal column to re-establish with normal food intake?

2-3 days

How many stools per week would be considered constipation from a clinical standpoint?

3

A nurse instructs a client taking an antidiarrheal agent to stop the drug and call the health care provider if the client does not experience relief within which time frame?

48 hours

When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?

Alopecia

A nurse is teaching a client who is prescribed diphenoxylate with atropine. Which statement by the client indicates the teaching was effective?

As my stools decrease, I will discontinue this medication

Polycarbophil - what type of laxative?

Bulk stimulant (FiberCon)

A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency?

By aspirating stomach contents and measuring the pH

A nurse is caring for a client that has developed diarrhea after antibiotic administration. The client has a BUN of 35 and creatinine of 1.8. The provider has ordered diphenoxylate with atropine for the client. What action should the nurse implement?

Call the prescriber about lab tests

A community health nurse is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives?

Dependence

bisacodyl brand name and class

Dulcolax - chemical stimulant (laxative)

which class blocks dopamine receptors and makes GI cells more sensitive to acetylcholine, which leads to increased GI activity and rapid movement of food through upper GI tract

GI stimulants

A client diagnosed with HIV/AIDS has diarrhea that is not responding to antidiarrheal agents. Which medication will best assist in treating this client's diarrhea?

Octreotide acetate Octreotide acetate is a synthetic form of somatostatin that is effective in diarrhea related to HIV/AIDS

A client with constipation has been prescribed mineral oil. Which reason should the nurse provide for instructing the client to take the medication between meals or at bedtime?

It interferes with vitamin absorption

Which drug can cause spontaneous abortion of a fetus?

Misoprostol

Which adverse effects should the nurse teach a client to possibly expect when prescribed diphenoxylate with atropine? Select all that apply.

Nausea and vomiting Urinary retention Dizziness

Which drug category is less likely to cause adverse effects in the older adult population? H2RA's or PPI's?

PPI's

A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions? Select all that apply:

Rebound hyperacidity Headache Confusion

Metoclopramide (brand and class)

Reglan; GI stimulant

The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what?

Renal dysfunction

A client who is taking magnesium citrate experiences sweating, palpitations, and flushing. The nurse understands that this is most likely related to which of the following?

Sympathetic stress reaction due to intense GI tract neurostimulation

A male client has liver disease and is diagnosed with esophageal reflux. He asks the health care provider to prescribe PPIs. The nurse is aware that PPIs given in conjunction with liver disease may result in what issue for this client?

Transient elevations in liver function tests

A middle-aged client, frustrated by increasingly frequent episodes of constipation, is highly reluctant to take medications. What nonpharmacologic measure should the nurse recommend?

Use of a fiber supplement

Rifaximin has been prescribed for a client diagnosed with traveler's diarrhea. What information should the nurse include in the teaching plan about the medication?

Used for E. coli infections

The nurse is caring for an older client who has been prescribed bisacodyl for constipation. Which assessment finding will convince the nurse to contact the health care provider about administering the bisacodyl?

abdominal pain

The nurse is assessing a client who reports constipation. The use of a medication to treat this problem is contraindicated if the client reports what symptom?

abdominal pain and fever

An older adult client has been on long-term proton pump inhibitor (PPI) therapy. The nurse practitioner should focus on what assessment related to adverse effects?

bone density

A client diagnosed with irritable bowel syndrome has been prescribed alosetron. The nurse should ensure that the client has been made aware of what potentially severe adverse effect?

bowel obstruction

Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action?

decreasing intestinal motility

A client who has suffered a myocardial infarction is prescribed a laxative to help prevent straining during defecation. Which medication would the nurse expect to administer?

docusate (Colace)

A nurse is completing an admission assessment of a client who is having diarrhea. The client states that the diarrhea started after "abdominal surgery." The client cannot recall the type of surgery. Which does the nurse suspect as the cause of the diarrhea?

excision of the small intestine

A common side effect of Imodium is

fatigue

Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:

interfere with the metabolism of other drugs.

Which is a common cause of diarrhea in older adults?

laxative overuse

A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed?

loperamide

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:

metabolic alkalosis

which drug can be used to treat GERD short term who have not had success with first line drugs

metoclopramide

which drug can be used to treat gastroparesis

metoclopramide

which drug class draws more water into GI tract and stimulates GI activity

osmotic laxative

Pancrelipase is derived from _____?

pork

conditions that would cause caution with magnesium laxative

renal insuffieciency

conditions that would cause caution with polyethylene glycol (Miralax)

seizures (epilepsy)

The nurse is caring for a client who is prescribed esomeprazole. The client informs the nurse that he is also taking sucralfate. The nurse would anticipate which effect as a possibility when these two drugs are administered?

decreased absorption of the esomeprazole

The nurse is caring for a patient who has been prescribed a saliva substitute . The patient asks why this medication is necessary. What would be the most appropriate response?

"This medication helps people that have a condition that creates a lack of saliva."

When reviewing the medical record of a client who is to receive a chemical stimulant laxative, the nurse would monitor the client closely if he had which condition?

Coronary artery disease Could be affected by changes in electrolytes

Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?

Omeprazole

A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is:

Polyethylene glycol-electrolyte solution (NuLYTELY)

Adverse effects metoclopramide

agitation** restlessness drowsiness fatigue n/v/d decrease HR, BP

contraindications for chemical stimulants

allergy acute abdominal disorders (blockages, infarctions) Caution in CAD (avoid straining)

what to assess - chemical stimulants

allergy fecal impaction or obstruction elimination pattern n/v preg/lact neuro status activity level lab values

A client with ulcers has asked the nurse if it would be acceptable to take bismuth subsalicylate. Before recommending an over-the-counter (OTC) formulation of bismuth subsalicylate, the nurse should conduct which client assessment?

allergy status *allergy to aspirin counts too - both salicylates*

which class of drugs cause stretch on the GI tract, which stimulates local GI activityu

bulk stimulants

which class of drugs increase size of fecal matter and increase fluid in GI tract

bulk stimulants

which class of drugs increases GI motility by irritating the nerve plexus

chemical stimulants

A caregiver of a 1-year-old asks the nurse if they can give the diphenoxylate that was prescribed for an older sibling to the child. Which is the nurse's best response?

children under 1 shouldn't be given this medication

The nurse is conducting a pre-colonoscopy class and knows that polyethylene glycol- electrolyte solution will be contraindicated for the client with which condition?

colitis

A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply.

consuming a high-fiber diet engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day

A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:

serum phosphate level

The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long?

2 days

A female client is diagnosed with temporary acute diarrhea. Her other diagnoses include diabetes mellitus, arrhythmia, and hepatic impairment. The physician orders loperamide. Based on her diagnoses, which adverse effect would the nurse observe for in this client?

signs of CNS toxicity

The nurse is caring for a client who has developed severe diarrhea a few days after beginning an antibiotic prescribed for a severe respiratory infection. The nurse is prepared to initiate what initial treatment?

stopping of the causative drug