pharm prep u ch 39

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.

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 caring for a new mother who had to have an episiotomy during the birth of her baby. Two days after delivery the client is in need of a laxative. What will the nurse administer?

docusate

The nurse is providing care to a client with hepatic encephalopathy. Which would the nurse anticipate administering to assist in lowering the client's blood ammonia level?

lactulose

While discussing the use of laxatives a student asks the nursing instructor what indicates normal bowel elimination. What would be the best response by the instructor?

"A soft, formed stool."

The nurse recognizes that a client needs additional instruction if the client makes which comment about treatment for occasional constipation?

"I will make sure that I have a bowel movement every day."

A 73-year-old woman is experiencing recurrent constipation. The woman reports to the nurse 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 client's statements?

"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."

The nurse receives a call from a client who is taking lactulose. The client reports having two to three soft stools every day and the client is afraid of developing diarrhea. What is the nurse's best response to this client?

"That is exactly what the medication is supposed to do."

The nurse has just finished client education with a client who is being discharged home on bulk-forming laxatives. The nurse knows the client understands discharge instructions regarding these medications when which statement is made?

"i will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces."

A health care provider may advise the nurse to administer psyllium (Metamucil) to clients taking which drug that can cause constipation? Select all that apply:

Amitriptyline (Elavil), Fexofenadine (Allegra), Spironolactone (Aldactone), Clonidine (Catapres)

A hospitalized client's request for a magnesium citrate "bisacodyl pill" every night to "keep regular" should alert the nurse to what potential health risk for the client?

laxative abuse

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

A client is being sent home with orders for a laxative PRN. What should the nurse inform the client is one of the most common adverse effects of a laxative?

abdominal cramping

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

A nurse is caring for a patient with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the patient shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction?

administer the drug with adequate fluid intake

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 female client calls the clinic and reports not feeling good to the nurse. The client tells the nurse that the client was recently prescribed a laxative. The nurse knows that the client takes other medications for congestive heart failure and osteoarthritis. What should the nurse question the client about?

administration of the laxative in relation to taking the other medications

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 student asks the physiology instructor what failure to respond to the defecation reflex will cause. What would the instructor answer?

decreased sensory stimulation of reflex

The nurse explains that there is no "normal" number of daily stools because of differences in what contributing factor?

diet

A new mother had to have an episiotomy during the birth of her baby. Two days after delivery, the client is in need of a laxative. What will the nurse administer?

docusate (Colace)

A client 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 client reports to the nurse about needing to strain to defecate. The client adds that defecating is very painful. What laxative will the nurse suggest to the prescriber based on the painful defecation?

ducosate

You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect?

hypernatremia

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

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

The nurse is caring for a client who is diagnosed with hepatic encephalopathy. The nurse knows that which medication will be used to treat the constipation that accompanies this condition?

lactulose

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

What are the pharmacokinetics of magnesium citrate?

not absorbed systemically

You are caring for four clients. Which client would you know is at highest risk for constipation?

paraplegic

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 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)

A client is advised to use a bulk-forming laxative to alleviate constipation. The nurse will recommend:

psyllium (metamucil)

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 evalutation

The nurse is giving instructions to a client who will be having a colonoscopy in the morning. The client will be taking polyethylene glycol-electrolyte solution for bowel cleaning. What information will help increase the palatability of this medication?

refrigerate the solution until it is cold

What type of laxative would be the first choice for a client diagnosed with hemorrhoids experiencing intense pain when straining to pass stools?

stool softener

A client with a history of constipation has been taking over-the-counter laxatives with good success. The client tells the nurse that he is relieved to have found a solution to his constipation. When providing health education, the nurse should prioritize what topic?

strategies for preventing dependence on laxatives

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

taking the agent with a large amount of water

The nurse is aware that critically ill clients are more at risk for constipation for what reasons? (Select all that apply.)

use of opioid medications, decreased activity, change in bowel routines

What physiological result occurs when an individual regularly fails to take needed bathroom breaks?

weakened defecation reflex