Pharm Ch.58 PrepU

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."

A client develops Clostridium difficile after receiving antibiotic therapy. The client asks the nurse how this occurs. Which is the nurse's best response?

"By suppressing normal flora, antibiotics allow proliferation of the organism."

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

"Children younger than 2 years of age should not be given this medication."

A nurse is teaching a client about diarrhea. Which statement by the client regarding diarrhea would indicate a need for additional teaching?

"Diarrhea is a disease that has no cure."

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug?

Dizziness

What is first-line therapy for infants and children 1 to 4 years of age with diarrhea?

Electrolyte replacement

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants?

Increase the fluid in the intestinal contents

Which is a common cause of diarrhea in older adults?

Laxative overuse

The nurse is preparing to administer cascara to a client. The nurse anticipates administering this drug by which route?

Oral

After teaching a group of students about laxatives, the instructor determines that the teaching has been successful when the students identify which agent as an example of a bulk laxative?

Polycarbophil

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action?

Slows peristalsis by acting on the smooth muscles of the intestine

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 man with irritable bowel syndrome reports ongoing diarrhea and asks for a prescription for alosetron, which was helpful for his coworker who recently started taking the drug. What is the nurse's best response?

This drug is only approved for use in women.

An adult client asks the nurse how many stools per week is considered "normal." The nurse should indicate that there is no fixed number but that functional constipation is diagnosed at what frequency?

Three stools per week

A client diagnosed with hemorrhoids reports intense pain when straining to pass stools. What type of agent would the nurse expect to be the first choice for this client?

stool softener

A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium?

"This medication will only soften your stools over the next couple of days."

A nurse is preparing a presentation for a local woman's group about irritable bowel syndrome. Which of the following would the nurse include in the presentation? Select all that apply.

*An underlying anatomical cause has not been identified. *Stress may play a role in the cause of this disorder. *Abdominal distress and bouts of diarrhea or constipation are common.

A client is receiving metoclopramide intravenously prior to cancer chemotherapy. The nurse would expect this drug to begin acting within which time frame?

1-5 minutes

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

Aspirin

An older adult has regularly drunk mineral oil to treat occasional episodes of constipation. The nurse should encourage the client to explore other treatments because the use of oral mineral oil can result in which adverse effect?

Decreased absorption of drugs and vitamins

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

The nurse should explain that metoclopramide (Reglan) decreases nausea and vomiting by which of the following actions?

Inhibiting stimulation of the vomiting center in the brain

Why is loperamide generally associated with fewer adverse effects than diphenoxylate?

It does not affect the central nervous system.

A client is using psyllium hydrophilic mucilloid to promote evacuation of stool. What is the action of this medication?

It increases mass and water content of stool, promoting evacuation.

A client is scheduled for a colonoscopy in the morning. The nurse will provide information concerning which laxative?

Polyethylene glycol-electrolyte solution

Which would be most important to include when teaching a patient about using psyllium?

Taking the agent with a large amount of water

After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students identify which example of an irritant laxative? Select all that apply.

cascara sagrada bisacodyl

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

The nurse is teaching a client about loperamide, which the health care provider has prescribed for treatment of chronic diarrhea. Which adverse effects should the nurse be sure to mention?

Nausea

A 59-year-old homeless man with a history of alcohol abuse, is admitted with dehydration and diarrhea. The admission interview indicates he collects his meals from dumpsters behind restaurants. What could be causing his diarrhea? (Select all that apply.)

*Intestinal infection *Campylobacter bacteria *Salmonella

A client is prescribed alosetron. What information in the client's history would warrant the nurse calling the prescriber about the medication? Select all that apply.

*Male client *Elevated liver values *Daily dose of fluvoxamine

An adult resident of an assisted living facility has not responded appreciably to bulk-forming laxatives, so the primary care provider has prescribed bisacodyl. The nurse who oversees the care at the facility should know that this drug may be administered by what route? Select all that apply.

*Oral *Suppository

A client presents with fever, vomiting, and diarrhea. What should the nurse suspect are possible causes? Select all that apply.

*bacterial toxin *virus

The health care provider has recommended that an older adult client take a psyllium laxative. When providing client teaching, what potential effects should the nurse explain? Select all that apply.

*gas *bloating

An adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction? Select all that apply.

*rectal suppository *enema

The nurse administers metoclopramide orally at 9:00 AM to a patient with GERD. The nurse would expect this drug to exert its maximum effectiveness at which time?

10:00 AM to 10:30 AM

The nurse is teaching the client how to treat diarrhea and discussing general guidelines. The nurse reminds the client to stop taking the antidiarrheal medication and to call the clinic if fever and abdominal pain become severe, after how many days?

2

The nurse is seeing a 69-year-old client who is highly physically active and consumes a balanced diet that includes adequate fluid intake. Despite this, the client states experiencing occasional constipation in recent months. What remedy should be the nurse's first suggestion?

A bulk-forming (fiber) laxative

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

Which would the nurse identify as being affected by dexpanthenol?

Acetylcholine

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 the laboratory tests.

A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the client about which adverse effect(s)?

Constipation

A nurse is caring for a client with pseudomembranous colitis. The health care provider has prescribed loperamide HCl to the client. How does the nurse know that the drug has been effective?

Diarrhea is resolved.

When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?

E. coli

A nurse is completing an assessment on a client experiencing diarrhea. The client states having diarrhea for the past few days, but prior to the diarrhea experienced one week of constipation. Based on the description, what does the nurse suspect?

Irritable bowel syndrome

A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium?

It absorbs toxins and water, decreasing fluidity of stools.

What is the correct rationale for why the nurse would administer a laxative at a separate time from the client's other medications?

Laxatives may reduce absorption of other drugs present in the GI tract.

Ms. Case is prescribed diphenoxylate HCl with atropine sulfate for the treatment of acute diarrhea. Ms. Case has several allergies. Which allergy places her at greatest risk for an adverse reaction to this medication due to cross-sensitivity?

Meperidine

Defecation is normally stimulated by what physiologic trigger?

Movements and reflexes in the gastrointestinal tract

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)

The nurse should know that lactulose achieves a therapeutic effect by which means?

Pulling water into the intestinal lumen by osmotic pressure

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

After reviewing information about metoclopramide, the students demonstrate a need for additional teaching when they identify that the drug can be given by which route?

Rectal

A client is admitted to the hospital for pneumonia. Since admission, the client has not had a bowel movement. The physician prescribes magnesium hydroxide. What should be an outcome of this therapy?

The client will have a bowel movement after taking the drug.

A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin?

bismuth subsalicylate

A client reports the intention to use an over-the-counter bismuth product. The nurse should inform the client that there is a potential that the medication will cause what side effect?

dark stool

A 2-year-old child from Nigeria is reported to have excellent health, except for the diarrhea that started within days of the family's arrival in the United States 3 weeks ago. History reveals nothing remarkable, but the mother comments on her child's love of (and continual consumption of) ice cream, something not available in their native country. This history supports what possible cause of the child's diarrhea?

lactase deficiency

The health care provider has prescribed polycarbophil to a client for the treatment of diarrhea. The nurse should teach the client to expect what effect?

large stools of a gelatin-like consistency

A hospitalized client requests a magnesium citrate "bisacodyl pill" every night to "stay regular." The nurse should initially be most concerned about what potential health risk for this client?

laxative abuse

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