Lower GI Drugs
A nurse is teaching a client about which foods she should include in her low-fiber diet. Which of the following statements indicates the client understands the teaching? -"A fresh pear would be a good snack option." -"I can prepare refried beans for supper." -"Bran cereal would be a good breakfast choice." -"I should choose white rice as a side dish."
-"A fresh pear would be a good snack option." (Fresh fruits contain higher amounts of fiber.) -"I can prepare refried beans for supper." (beans contain higher amounts of fiber.) -"Bran cereal would be a good breakfast choice." (Bran and other whole grains contain higher amounts of fiber.) -"I should choose white rice as a side dish." (White rice is a refined grain and has less fiber than whole or unrefined grains. The client can include white rice as part of a low-fiber diet.) !!!
A nurse is preparing to administer bisacodyl suppository to a client. Which of the following actions should the nurse take? (Select all that apply.) -Don sterile gloves. -Lubricate index finger. -Use a rectal applicator for insertion. -Position client supine with knees bent. -Insert suppository just beyond internal sphincter.
-Don sterile gloves. (The nurse should wear clean gloves when touching blood, body fluid, secretions, excretions, most mucous membranes, nonintact skin, and contaminated items or surfaces.) -Lubricate index finger. (The rounded end of the suppository is lubricated with a sterile water-soluble lubricating jelly) !!! -Use a rectal applicator for insertion. (The nurse should administer the suppository with the dominant index finger, which is lubricated. The nurse should not use an applicator to insert a suppository.) -Position client supine with knees bent. (To avoid the rupturing the rectum, the client is positioned on the left lateral side.) -Insert suppository just beyond internal sphincter. (The nurse should gently retract the buttocks with the nondominant hand. Insert the suppository gently through the anus, past the internal sphincter, and against the rectal wall. Following the administration of the medication, the nurse should apply gentle pressure to hold the buttocks together momentarily if needed to keep medication in place) !!!
A nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching? -"Do not take this medication before bedtime." -"Take the medication with a full glass of water." -"Expect abdominal pain with this medication." -"Take this medication on an empty stomach."
-"Do not take this medication before bedtime." (Morning or evening before bedtime is fine.) -"Take the medication with a full glass of water." (Unless contraindicated, but yes to reduce risk for constipation.) !!! -"Expect abdominal pain with this medication." (Notify provider if this occurs.) -"Take this medication on an empty stomach." (With or without food is fine.)
A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching? -"It might take up to 3 days for the medication to work." -"I will take the medication for diarrhea." -"I should drink 4 ounces of water when I take the medication." -"I can take this medication along with mineral oil."
-"It might take up to 3 days for the medication to work." (The client understands docusate sodium is a stool softener and the therapeutic effect might take up to 3 days to achieve.) !!! -"I will take the medication for diarrhea." (Docusate sodium is a stool softener and is not used to treat diarrhea.) -"I should drink 4 ounces of water when I take the medication." (Docusate sodium is a stool softener and the client should drink 8 ounces of water when taking the medication. The nurse should also instruct the client to increase fluid intake to prevent constipation.) -"I can take this medication along with mineral oil." (Docusate sodium may lead to toxicity if taken with mineral oil.)
A nurse is caring for a client who reports taking bisacodyl to promote a daily bowel movement. Which of the following assessment questions should be the nurse's priority? -"What do your bowel movements look like?" -"How long have you been taking the bisacodyl?" -"Do you take the bisacodyl with a glass of milk?" -"How often do you have a bowel movement?"
-"What do your bowel movements look like?" (This is to assess for adverse effects of the bisacodyl; however, another question is the priority.) -"How long have you been taking the bisacodyl?" (The greatest risk to this client is injury from dependency on laxatives, as bowel tone can be lost; therefore, this is the priority question.) !!! -"Do you take the bisacodyl with a glass of milk?" (Taking it with dairy products or antacids decreases the absorption of the medication; however, another questions is the priority.) -"How often do you have a bowel movement?" (To assess for regularity and the need for a laxative; however, another question is the priority).
A nurse is teaching an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching? -Bear down hard when defecating. -Drink four to five glasses of water daily. -Increase dietary intake of raw vegetables. -Limit activity.
-Bear down hard when defecating. (Avoid because can cause the client to develop hemorrhoids.) -Drink four to five glasses of water daily. (Should drink at least 6-8 glasses of fluids each day, which is recommended to keep the stool soft and prevent constipation.) -Increase dietary intake of raw vegetables. (To help provide fiber in the diet, which will increase stool bulk and move the stool through the colon to prevent constipation.) !!! -Limit activity. (Increasing activity actually is recommended to increase peristalsis and prevent constipation.)
A nurse is teaching a client who has constipation. Which of the following should the nurse discuss as causes of constipation? (Select all that apply.) -Excessive laxative use -Ignoring the urge to defecate -Inadequate fluid intake -Increased fiber in the diet -Increased activity
-Excessive laxative use (Chronic use of laxatives causes the large intestine to lose muscle tone and become less responsive to stimulation by laxatives.) !!! -Ignoring the urge to defecate (Anything that prevents the client from responding to the urge to defecate and disrupts regular habits can cause alteration in bowel habits, such as constipation.) !!! -Inadequate fluid intake (Reduced fluid intake slows the passage of food through the intestine and can result in hardening of stool.) !!! -Increased fiber in the diet (Increased fiber promotes more efficient bowel emptying.) -Increased activity (Increased activity promotes bowel emptying.)
A nurse is teaching a client who has constipation about a high-fiber diet. Which of the following foods should be included as sources of fiber? (Select all that apply.) -Kidney beans -Blackberries -Refined cereals -Whole wheat bread -Lean turkey
-Kidney beans !!! -Blackberries !!! -Refined cereals -Whole wheat bread !!! -Lean turkey (source of complete protein)
A nurse is caring for a client who is to start taking cyclosporine following a kidney transplant. The nurse should instruct the client that which of the following foods can have an adverse interaction with this medication? -Pepperoni -Orange juice -Grapefruit juice -Smoked salmon
-Pepperoni (Clients who are taking an MAOI should avoid foods high in tyramine, such as pepperoni. If a client eats food containing tyramine while taking an MAOI, there is a risk of hypertensive crisis and the client can experience severe headache, tachycardia, hypertension, and confusion with possible stroke and death.) -Orange juice -Grapefruit juice (Because it can increase the therapeutic effect leading to renal and hepatic toxicity.) !!! -Smoked salmon (Clients who are taking an MAOI should avoid foods high in tyramine, such as pepperoni. If a client eats food containing tyramine while taking an MAOI, there is a risk of hypertensive crisis and the client can experience severe headache, tachycardia, hypertension, and confusion with possible stroke and death.)