PrepU Ch 40 Drug Therapy for Diarrhea
A caregiver of a 1-year-old asks the nurse if they can give the diphenoxylate that was prescribed for an older sibling to the child. Which is the nurse's best response? a. "Children younger than 1 year of age should not be given this medication." b. "There are over-the-counter medications that are better for the 1-year-old." c. "I will call the prescriber to find out if this is safe." d. "The medication needs to be adjusted for the 1-year-old's weight."
a
A client has been admitted to the hospital with dehydration and hypokalemia secondary to severe diarrhea. Why might the care team be reluctant to aggressively treat a client's diarrhea by slowing gastrointestinal (GI) peristalsis? a. The client's body may be ridding itself of toxins. b. Rebound bowel obstruction is likely to occur. c. A rapid cessation of diarrhea can exacerbate electrolyte imbalances. d. The client may become fluid overloaded.
a
A hospital client has been scheduled for a barium enema the following morning. The nurse should anticipate what prescription for the client's bowel preparation? a. polyethylene glycol-electrolyte solution b. polycarbophil c. magnesium sulfate d. senna
a
At your general medicine practice, your newest patient is a 2-year-old girl from Nigeria whose mother reports the child has excellent health, except for the diarrhea she has demonstrated. Diarrhea started within days of their arrival in the United States 3 weeks ago. History reveals nothing remarkable, but her mother comments on her love of (and continual consumption of) ice cream, something new to her since coming to this country. What would you expect her treatment to involve? a. Eliminate milk products from her diet b. Increase fluid intake, especially milk c. Increase cheese consumption, as cheese can have a constipating effect on many people d. Eliminate ice cream from her diet, as any new food causes diarrhea
a
Nonspecific therapy of diarrhea includes: a. Fluid and electrolyte replacement. b. Loperamide. c. Psyllium. d. Bulk laxatives.
a
The client states that prior to exams at school, the client has abdominal cramping and diarrhea. What does the nurse suspect is the trigger for these signs and symptoms? a. Functional diarrhea disorder b. Intestinal neoplasm c. Colitis d. Hyperthyroidism
a
The health care provider (HCP) has determined that a client diagnosed with bacterial gastroenteritis following an overseas trip is a candidate for antibacterial drug therapy. The nurse knows that the HCP will select the appropriate drug based on which factor? a. causative agent b. number of days with diarrhea c. the country from which the client returned d. symptomatology
a
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? a. Dizziness b. Polyuria c. Paleness of the face d. Bradycardia
a
When administering diphenoxylate to children, the nurse should observe for signs of what condition? a. Atropine overdose b. Fluid and electrolyte imbalance c. Opioid overdose d. Hypotensive crisis
a
Which is a common cause of diarrhea in older adults? a. Laxative overuse b. The normal aging process c. Glaucoma d. Poor muscle tone
a
The nurse is reviewing a new prescription for diphenoxylate with atropine for a client with moderate diarrhea. The nurse would contact the prescribing health care provider if the diarrhea is caused by what? Select all that apply. a. Salmonella infection b. Anxiety disorder c. Toxic materials d. Antibiotic-associated colitis e. Laxative abuse
a, b, c, d
What medical diagnoses would the nurse suspect if the client is experiencing diarrhea with mucus, proteins, and blood in the stool? Select all that apply. a. Crohn's disease b. Diverticulitis c. Gastroenteritis d. Irritable bowel disease e. Ulcerative colitis
a, b, c, e
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? a. inflammatory bowel disorder b. lactase deficiency c. Clostridium difficile d. irritable bowel syndrome
b
A health care provider has ordered paregoric for a client's diarrhea. The nurse recognizes this is a controlled drug because it contains: a. 10 mg/mL morphine b. 0.4 mg/mL morphine c. 2 mg/mL morphine d. 5 mg/mL morphine
b
A nurse is completing an admission assessment of a client who is having diarrhea. The client states that the diarrhea started after "abdominal surgery." The client cannot recall the type of surgery. Which does the nurse suspect as the cause of the diarrhea? a. Liver resection b. Excision of the small intestine c. Skin infection of the surgical site d. Surgical repair for colon polyps
b
The nurse should question an order for bismuth salts for a client with what condition? a. Hypertension b. Allergy to aspirin c. Viral gastroenteritis d. Rheumatoid arthritis
b
The parent of an adolescent client reports that the teen has chronic diarrhea and lacks an appetite. Assessment reveals that the client is significantly underweight, has dry hair, and exhibits erosion of tooth enamel. When asked, the client reports occasional laxative use for "constipation." What condition does the nurse consider most likely? a. sodium retention b. bulimia with laxative abuse c. anorexia nervosa d. dehydration and hyperkalemia
b
What is first-line therapy for infants and children 1 to 4 years of age with diarrhea? a. Bismuth salts (Pepto-Bismol) b. Electrolyte replacement c. Paregoric d. Difenoxin (Motofen)
b
A client diagnosed with irritable bowel syndrome has been prescribed alosetron. The nurse should ensure that the client has been made aware of what potentially severe adverse effect? a. anal fissures b. diverticulosis c. bowel obstruction d. blood dyscrasias
c
A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin? a. polycarbophil b. octreotide c. bismuth subsalicylate d. loperamide
c
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? a. photosensitivity b. hyperglycemia c. dark stool d. hypertension
c
A nurse is caring for a client prescribed an antidiarrheal drug. Based on the nurse's understanding of the drug, the nurse would administer the drug cautiously to the client with which condition? a. acute hepatitis b. renal impairment c. hepatic impairment d. fecal impaction
c
A nurse is caring for a client who 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? a. Hold the medication. b. Administer the medication as prescribed. c. Call the prescriber about the laboratory tests. d. Discuss the issues with another nurse on the unit.
c
A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium? a. It causes bloating and swells the colon. b. It binds and expels toxins into the stool. c. It absorbs toxins and water, decreasing fluidity of stools. d. It reduces exchange of proteins and mucus in the stools.
c
Rifaximin has been prescribed for a client diagnosed with traveler's diarrhea. What information should the nurse include in the teaching plan about the medication? a. Superinfections will not occur with this medication. b. The diarrhea is usually associated with fever and bloody stools. c. Used for E. coli infections. d. Adverse effects include migraine, joint pain, and nausea.
c
The nurse cautions a client with what allergy to avoid the use of bismuth salts in the treatment of diarrhea? a. Eggs b. Nuts c. Aspirin d. Penicillin
c
The nurse is teaching a client about diphenoxylate with atropine sulfate which has been prescribed for treatment of acute diarrhea. For which adverse effect should the nurse teach the client to anticipate? a. Diaphoresis b. Bradycardia c. Nausea d. Increased appetite
c
The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long? a. 12 hours b. 7 days c. 2 days d. 1 day
c
When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause? a. Staphylococcus aureus b. Pseudomonas c. E. coli d. C. difficile
c
Which of the following nursing diagnoses is a priority for a client who is 89 years old and has frequent liquid stools? a. Imbalanced Nutrition: Less than Body Requirements b. Pain related to abdominal cramping c. Deficient Fluid Volume related to excessive losses in liquid stools d. Deficient Knowledge related to medications
c
A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin? a. loperamide b. octreotide c. polycarbophil d. bismuth subsalicylate
d
A client with diarrhea has not had any improvement after taking loperamide for two days. Which action will the nurse take to help this client? a. Encourage the client to restrict the oral intake of fluids. b. Remind the client to drink milk with all meals. c. Recommend reducing the amount of bulk-forming foods in the diet. d. Notify the health care provider to have the medication discontinued.
d
A male client 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: a. bradycardia. b. muscle aches. c. increase in appetite. d. dizziness.
d
A nurse instructs a client taking an antidiarrheal agent to stop the drug and call the health care provider if the client does not experience relief within which time frame? a. 36 hours b. 72 hours c. 24 hours d. 48 hours
d
Determining the cause of diarrhea in a patient is important. It enables choosing the correct treatment. The nurse recognizes that a stool specimen is sometimes necessary to determine correct therapy. The nurse recognizes that a green, liquid stool may be from which of the following? a. Shigella b. Cholecystitis c. Inflammatory bowel disease d. Escherichia coli
d
Diarrhea can be caused by innumerable factors, including drugs. Which of the following medications can cause diarrhea? a. Misoprostol b. SSRIs c. Tacrolimus d. All of these
d
Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action? a. Binding with fecal material to increase bulk b. Absorbing toxins c. Inhibiting cellular division in causative bacteria d. Decreasing intestinal motility
d
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? a. Anti-inflammatory effects allowing absorption of fluids b. Antimicrobial effects c. Decreases GI secretions d. Slows peristalsis by acting on the smooth muscles of the intestine
d
The nurse administers loperamide to decrease the number and liquidity of stool by what mechanism? a. Binding with fecal material to increase bulk b. Blocking the chemoreceptor trigger zone (CTZ) c. Absorbing toxins d. Decreasing intestinal motility
d
The nurse is caring for a 68-year-old patient with diarrhea. The patient has been prescribed an antidiarrheal. The nurse is aware this patient is at risk for developing which of the following? a. Volume overload b. Pedal edema c. Anemia d. Constipation
d
The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours? a. 1 to 2 L of clear liquids b. 0.5 to 1 L of clear liquids c. 3 to 4 L of clear liquids d. 2 to 3 L of clear liquids
d
The nurse is preparing medications for a client with diarrhea. The nurse will withhold bismuth subsalicylate if the client's record indicates a history of what disorder? a. hypertension b. lactose intolerance c. type 2 diabetes d. aspirin allergy
d
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? a. 3 b. 4 c. 1 d. 2
d
Which of the following antidiarrheals may precipitate hepatic coma in clients with hepatorenal disease? a. Octreotide b. Psyllium c. Loperamide d. Diphenoxylate
d
