Chapter 58: Drugs Affecting Gastrointestinal Motility
A man with irritable bowel syndrome reports ongoing diarrhea and asks for a prescription for alosetron (Lotronex), which was helpful for his coworker who recently started taking the drug. What is the nurses best response? A) This drug is only approved for use in women. B) This drug is used as a laxative. C) This drug is contraindicated with irritable bowel syndrome. D) This drug is no longer on the market for prescription use.
A
The family brings a patient to the emergency department saying he has been hallucinating and falls so deeply asleep he stops breathing when not stimulated. The nurse learns the patient has been self-treating diarrhea and suspects the patient was taking what medication? A) Paregoric B) Bismuth subsalicylate C) Loperamide D) Colace
A
The hospice nurse is caring for a patient diagnosed with bone cancer who is receiving large doses of opioid medications to relieve pain. The patient has used other laxatives in the past to treat opioid-induced constipation but nothing is working now. What drug would the nurse request the family doctor to order for this patient? A) Methylnaltrexone (Relistor) B) Castor oil C) Paregoric D) Mineral oil
A
The nurse administers loperamide (Imodium) to decrease the number and liquidity of stool by what mechanism? A) Decreasing intestinal motility B) Absorbing toxins C) Binding with fecal material to increase bulk D) Blocking the chemoreceptor trigger zone (CTZ)
A
The nurse administers lubiprostone (Amitiza) to the patient with irritable bowel syndrome and anticipates what therapeutic action from the drug? A) Secretion of chloride-rich intestinal fluid leading to increased motility B) Adding bulk to the fecal matter to ease the process of stooling C) Irritation of the inner lining of the bowel to increase bowel motility D) Stimulate the bowel by increasing innervation
A
The nurse administers metoclopramide to the patient with what condition? A) Chronic diabetic gastroparesis B) Impaction C) Encopresis D) Patients requiring diagnostic procedures
A
The nurse collects a stool culture from a patient diagnosed with travelers diarrhea. What bacterium does the nurse expect the culture to grow? A) Escherichia coli B) Staphylococcus aureus C) Streptococcus type B D) Pseudomonas
A
The nurse teaches the patient that a common adverse effect of loperamide (Imodium) is what? A) Fatigue B) Flatulence C) Disorientation D) Tremors
A
The nurse, teaching a patient to be discharged with an order to use chemical stimulant laxatives PRN, instructs the patient that one of the most common adverse effects of this type of laxative is what? A) Abdominal cramping B) Rectal bleeding C) Confusion D) Iron deficiency anemia
A
The patient had surgery 2 days ago and bowel motility has not returned. What drug might the nurse administer to stimulate the gastrointestinal (GI) tract? A) Dexpanthenol B) Docusate C) Psyllium (Metamucil) D) Senna
A
What drug does the nurse recognize as being classified as a chemical stimulant? A) Bisacodyl (Dulcolax) B) Polycarbophil (FiberCon) C) Magnesium hydroxide (Milk of Magnesia) D) Docusate (Colace)
A
A clinic patient with a history of heart failure requires a laxative for treatment of chronic constipation. What medication would be most appropriate for this patient? A) Senna (Senokot) B) Lactulose (Chronulac) C) Magnesium sulfate (Milk of Magnesia) D) Castor oil (Neoloid)
B
A patient taking a chemical stimulant laxative and medications for heart failure and osteoarthritis calls the clinic and reports to the nurse that she is not feeling right. What is the priority question the nurse should ask this patient? A) Effectiveness of laxatives B) Timing of medication administration C) The amount of fiber in her diet D) Amount of fluid ingested
B
A patient who is taking metoclopramide (Reglan) has come to the clinic for a follow-up visit. The nurse will be most concerned about a drug-drug interaction when learning the patient is taking what other medication? A) Albuterol (Proventil) B) Digoxin (Lanoxin) C) Furosemide (Lasix) D) Acetylsalicylic acid (ASA)
B
The nurse develops a teaching plan for a 77-year-old patient who has been prescribed loperamide PRN. The nurses priority teaching point is what? A) May cause hallucinations or respiratory depression B) Take drug after each loose stool C) Drug remains in the bowel without being absorbed into the bloodstream D) Avoid pregnancy and breast-feeding while taking drug.
B
The nurse is caring for a patient who has had impacted stools twice in the past month. What is an appropriate laxative for this patient? A) Milk of Magnesia B) Agoral Plain C) Colace D) Dulcolax
B
The nurse provides drug teaching to the patient who will begin taking polycarbophil (FiberCon). What is the nurses priority teaching point? A) Do not eat or drink anything for 2 hours after taking the medication. B) Drink lots of water when taking the drug. C) Take at night before bedtime. D) The drug can be taken up to six times per day.
B
The nurse teaches the patient to best maintain optimal GI function by including what in the daily routine? A) Exercise, adequate sleep, and avoiding caffeine B) Proper diet, fluid intake, and exercise C) Proper diet, avoiding alcohol, and cautious use of laxatives D) Avoiding prescription medications, increased fluid intake, and vigorous exercise
B
The nurse will question an order for bismuth salts (Pepto-Bismol) in a patient with what condition? A) Rheumatoid arthritis B) Allergy to aspirin C) Hypertension D) Viral gastroenteritis
B
The nurse, providing patient teaching, explains that difenoxin and diphenoxylate are chemically related to what medication? A) Morphine B) Demerol C) Diphenhydramine D) Diflucan
B
What drug does the nurse administer that inhibits intestinal peristalsis through direct effects on the longitudinal and circular muscles of the intestinal wall? A) Bismuth subsalicylate B) Loperamide C) Paregoric D) Magnesium citrate
B
What is the antidiarrheal of choice the nurse will administer to children older than 2 years of age with diarrhea? A) Bismuth salts (Pepto-Bismol) B) Loperamide (Imodium) C) Paregoric (generic) D) Difenoxin (Motofen)
B
What is the priority nursing diagnosis for an 89-year-old patient with frequent liquid stools? A) Imbalanced nutrition: less than body requirements B) Deficient fluid volume C) Deficient knowledge related to medications D) Pain related to abdominal cramping
B
A patient receiving loperamide (Imodium) should be alerted by the nurse to what possible adverse effect? A) Anxiety B) Bradycardia C) Fatigue D) Urinary retention
C
The home health nurse is caring for a 72-year-old man in his home. He complains about almost daily diarrhea. The nurse assesses for what common cause of diarrhea in older adults? A) Diabetes B) Hypertensive medications C) Laxative overuse D) Glaucoma
C
The home health nurse is caring for a patient with encopresis who was started on mineral oil therapy. The nurse teaches the patient and family that a common adverse effect is what? A) Nausea B) Vomiting C) Leakage D) Vitamin C deficiency
C
What should the nurse tell the patient who will begin taking rifaximin (Xifaxan) for travelers diarrhea? A) Do not start taking the drug until the diarrhea has persisted for at least 24 hours. B) Taking the antibiotic will allow you to enjoy the local water and food without concern. C) Do not take the drug if you have bloody diarrhea. D) Start the drug 3 days before leaving for your trip and continue until you return.
C
When would it be appropriate for the nurse to administer castor oil as a laxative? A) To ease the passage of stool in the patient who recently had a baby B) To remove ingested poisons from the lower gastrointestinal (GI) tract C) To evacuate the bowel for diagnostic procedures D) To treat chronic constipation
C
When would it be appropriate for the nurse to administer a cathartic laxative to the patient? (Select all that apply.) A) Partial small-bowel obstruction B) Appendicitis C) After having a baby D) After a myocardial infarction (MI) E) After anthelmintic therapy
C, D, E
A new mother required an episiotomy during the birth of her baby. Two days after delivery, the patient is in need of a laxative. What will be the most effective drug for the nurse to administer? A) Bisacodyl (Dulcolax) B) Castor oil (Neolid) C) Magnesium sulfate (epsom salts) D) Docusate (Colace)
D
For what action would the nurse administer magnesium citrate? A) Block absorption of fats B) Directly stimulate the nerve plexus in the intestinal wall C) Form a slippery coat on the contents of intestine D) Increase motility, increase fluid, and enlarge bulk of fecal matter
D
The nurse administers psyllium hydrophilic mucilloid (Metamucil) expecting it to have what action? A) Slows peristalsis B) Promotes reabsorption of water into bowel C) Has antibacterial properties D) Adds bulk to the stool
D
The nurse admits to the clinic a 7-month-old infant whose mother reports that the baby has not had a bowel movement in 6 days. What drug would be appropriate to treat this patient? A) Cascara (generic) B) Magnesium hydroxide (Milk of Magnesia) C) Polyethylene glycol-electrolyte solution (GoLYTELY) D) Glycerin (Sani-Supp)
D
The nurse teaches the patient who was prescribed a chemical stimulant laxative that this medication may have either a slow, steady effect or may cause severe cramping and rapid evacuation of the contents of the large intestine. What drug is the nurse teaching this patient about? A) Bismuth salts B) Bisacodyl C) Castor oil D) Cascara
D
What antidiarrheal would the nurse administer to reduce the volume of discharge from the patients ileostomy? A) Diphenoxylate (Lomotil) B) Octreotide (Sandostatin) C) Psyllium (Metamucil) D) Loperamide (Imodium)
D
