PN119 PrepU Chapter 41
A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching?
Drink at least 8 ounces of fluid with the medication.
A patient has been instructed to take polycarbophil (FiberCon). What should be an instruction on the use of this drug as a laxative?
Drink lots of water when taking the drug.
A home health nurse is caring for a 72-year-old male in his home. The client reports diarrhea on an almost-daily basis. What would the nurse explain to this client is a common cause of diarrhea in older adults?
Laxative overuse
Which of the following 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.
A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful?
An 80-year-old man who has diarrhea secondary to Clostridium difficile
Nonspecific therapy of diarrhea includes:
Adequate fluid and electrolyte replacement.
A patient is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is which of the following?
Polyethylene glycol-electrolyte solution (NuLYTELY)
Which statements by a patient leads the nurse to believe that the patient understands how to use bulk-forming laxatives?
"I will mix the medication with 4-8 ounces of liquid and follow it with an additional 4-8 ounces."
While discussing the use of laxatives a student, asks the nursing instructor what the best indication of normal bowel elimination is. What would be the best response by the instructor?
"A soft, formed stool."
The nurse has just finished client education with someone who is going home on bulk-forming laxatives. What statement by the client would lead the nurse to believe that the client has understood how to use the medication?
"I will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces."
A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements?
"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."
The nurse is about to administer diphenoxylate (Lomotil) to a client for the first time. Which of the following side effects should be included in the teaching about this medication?
"This medication may make you feel lightheaded or drowsy."
A patient is being sent home with orders for a laxative PRN. The nurse is conducting patient teaching on the use of a laxative. What will the nurse inform the patient is one of the most common adverse effects of a laxative?
Abdominal cramping
When administering a bulk laxative to a client, which action is important for the nurse to take?
Administer the laxative with a full glass of water or juice.
A patient calls the clinic and reports to the nurse that they are not feeling good. The patient goes on to say that they were recently prescribed a laxative. The nurse knows that the patient takes other medications for congestive heart failure and osteoarthritis. What should the nurse question the patient about?
Administration of the laxative in relation to taking her other medications
A woman is seen in the primary care provider's office with chronic severe diarrhea-predominant irritable bowel syndrome, which has not responded to conventional therapy. Which medication is the drug of choice?
Alosetron (Lotronex)
Older adults who are unable or unwilling to eat an adequate diet or who are debilitated may benefit from using bulk-forming laxatives. What is an important teaching regarding intake for anyone using bulk-forming laxatives?
Assure adequate fluid intake
A 36-year-old pregnant woman is visiting the OB office for her monthly prenatal visit. She is at 36 weeks' gestation. She reports continual constipation, which is causing major discomfort with her hemorrhoids. Which substance would the nurse expect the obstetrician to recommend to relieve her constipation?
Bulk-forming laxative plus increased water intake
Which of the following nursing diagnoses is a priority for a client who is 89 years old and has frequent liquid stools?
Deficient Fluid Volume related to excessive losses in liquid stools
Mr. Jones is prescribed loperamide for diarrhea. Loperamide can be used for which type of diarrhea?
Chronic diarrhea
A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)?
Constipation
Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action?
Decreasing intestinal motility
The nurse is caring for an 89-year-old client with frequent liquid stools. When preparing a plan of care for this patient, what nursing diagnosis is a priority?
Deficient fluid volume
A new mother had to have an episiotomy during the birth of her baby. Two days after delivery, the patient is in need of a laxative. What will the nurse administer?
Docusate (Colace)
The nurse may advise a patient to take what after a myocardial infarction to prevent straining during defecation?
Docusate (Colace)
Which should be included in client teaching as a means of avoiding constipation? (Select all that apply.)
Drink plenty of fluids. Be active and exercise daily. Eat foods high in bulk or roughage.
Mineral oil can be used as a laxative. The nurse knows that which statement regarding mineral oil is correct?
If aspirated, mineral oil can cause pneumonia.
A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy?
Increased abdominal pain and vomiting
A nurse is caring for a patient with rheumatoid arthritis who is prescribed sulfasalazine. The patient informs the nurse that he is also taking methotrexate for the treatment of cancer. What condition should the nurse monitor for in this patient as a result of the interaction of the two drugs?
Increased risk of immuno-suppression
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, promoting evacuation
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
A patient is using psyllium hydrophilic mucilloid (Metamucil) to promote evacuation of stool. What is the action of this bulk-forming laxative?
It increases mass and water content of stool, promoting evacuation.
Which of these is NOT an advantage of Kaopectate?
Kaopectate is centrally acting.
A patient with hepatic encephalopathy may have high levels of ammonia in their blood, which of the following can be used to lower the level ammonia in a patient's blood? (Choose one)
Lactulose (Cephulac)
An older patient is experiencing diarrhea. Which is a likely cause of diarrhea?
Laxative abuse
What is an antidiarrheal that treats diarrhea by acting directly on the muscle wall of the bowel to slow motility?
Loperamide (Imodium)
A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis?
Mesalamine
Which of the following drugs must the nurse question when it is given with an anti-diarrheal medication, because it can lead to a hypertensive crisis?
Monoamine oxidase inhibitor (MAOI) antidepressants
You are teaching your client about diphenoxylate with atropine sulfate, which the physician has prescribed for treatment of acute diarrhea. Which of the following adverse effects should you be sure to mention?
Nausea
A patient is administered difenoxin HCl with atropine (Motofen) for the treatment of acute diarrhea. What should the nurse include in the teaching plan of the patient?
Observe caution when performing hazardous tasks
The nurse knows that many drugs can decrease gastrointestinal activity and promote constipation. Among these are which of the following? Select all that apply.
Opioid analgesics Calcium-channel blockers Cholestyramine (Questran) Iron
A cancer patient has intractable diarrhea that is not of an infectious nature. Which of the following medications will be prescribed?
Opioids
Constipation is a common problem. The nurse knows that there are many ways to decrease the risk of constipation. These include which of the following? Select all that apply.
Partake in daily physical exercise. Consume food rich in fiber. Drink 64 to 80 ounces of fluids daily. Set a routine time and place for daily bowel movement.
A patient who has been experiencing liquid stools is prescribed polycarbophil (FiberCon). What is the reason for administering a bulk-forming laxative?
Polycarbophil absorbs large amounts of water and decreases fluidity of stools.
A patient needing to evacuate the colon for endoscopy would likely take:
Polyethylene glycol electrolyte solution (NuLYTELY)
A client is scheduled for a colonoscopy in the morning. What laxative would the nurse expect to be prescribed the evening before the procedure?
Polyethylene glycol-electrolyte solution
A patient is scheduled for a colonoscopy in the morning. Which laxative is most likely prescribed the evening before the colonoscopy?
Polyethylene glycol-electrolyte solution (NuLYTELY)
Which of the following 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.
Which statement is true about the pharmacokinetics of simethicone?
The drug is inert and not absorbed from the GI tract.
Mr. Hall, age 65, is admitted to the hospital for pneumonia. Since admission he has not had a bowel movement. The physician prescribes magnesium hydroxide. What would be a realistic outcome of this therapy?
The patient will have a bowel movement after taking the drug.
A patient develops diarrhea secondary to antibiotic therapy. He is to receive two tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for each loose stool. The nurse should inform him that he may experience
dizziness
The nurse is interviewing the latest admission to the GI floor. The female patient requests a magnesium citrate "cocktail" every night to "keep her regular." Her request is evidence of potential:
laxative abuse.
