GI medications
A child is prescribed antidiarrheal medications. Which nursing actions indicate that the nurse is skilled in safe medication administration to pediatric clients? Select all that apply. A. The nurse calculates the medication dose according to the weight. B. The nurse recommends long-term use of the medication. C. The nurse promotes fluid and electrolyte balance. D. The nurse assesses the child for the presence of any eating disorders. E. The nurse assesses the severity of diarrhea by counting the number of stools every 48 hours.
A,C,D The nurse would calculate the dose according to the weight of the child to ensure accurate dosing. Diarrhea causes rapid loss of fluid volume and electrolytes through the stools; therefore the nurse would promote fluid and electrolyte balance by ensuring the appropriate intake of fluids. The nurse would assess the child for the presence of eating disorders such as bulimia and anorexia to check for the abuse of laxatives. The nurse would not recommend the long-term use of antidiarrheal medications because they cause toxic effects. The nurse would measure the amount of diarrhea by the number of stools every 24 hours and not for 48 hours.
A client with irritable bowel syndrome has instructions to take psyllium for constipation. Which statement is important for the nurse to include in the teaching plan? "Urine may be discolored." "Stop taking the laxative once a bowel movement occurs." "Each dose should be taken with a full glass of water or juice." "Daily use may inhibit the absorption of some fat-soluble vitamins."
Each dose should be taken with a full glass of water or juice." This bulk-forming laxative works by absorbing water into the intestine, which increases bulk and distends the bowel to initiate reflex bowel activity, thus promoting a bowel movement. A full glass of fluid taken at the same time will help minimize the risk of esophageal obstruction or fecal impaction. Senna, a stimulant laxative, may cause urine discoloration. Bulk-forming laxatives, such as psyllium, are the only laxatives that are recommended for long-term use, and in cases of irritable bowel syndrome; they are used to prevent constipation and should not be stopped once a bowel movement occurs. Prolonged use of lubricant laxatives, such as mineral oil, can inhibit the absorption of some fat-soluble vitamins.
A health care provider prescribes bed rest, loperamide, and esomeprazole for a client who just had major surgery. After several days of this regimen, the client complains of diarrhea. Which treatment strategy would the nurse conclude is the cause of the diarrhea? Loperamide Esomeprazole Bed rest Diet alteration
Esomeprazole Esomeprazole, a proton-pump inhibitor, may cause diarrhea. Loperamide, an antidiarrheal, may cause constipation, not diarrhea. Immobility causes constipation, not diarrhea. Although diet can affect elimination, no data are presented to support this conclusion.
The nurse provided teaching to a client prescribed a proton pump inhibitor (PPI). The nurse determines that teaching is effective when the client identifies that the medication is used to treat which condition? Diarrhea Vomiting Cardiac dysrhythmias Gastroesophageal reflux disease (GERD)
GERD PPIs are effective in decreasing the secretion of gastric acid, helping alleviate the symptoms of GERD. PPIs are not used for the treatment of diarrhea, vomiting, or cardiac dysrhythmias.
A client with gastroesophageal reflux disease (GERD) receives a prescription for an H 2 receptor antagonist. Which medications are within the classification of an H 2 receptor antagonist? Select all that apply. One, some, or all responses may be correct. A. Nizatidine B. Ranitidine C. Famotidine D. Lansoprazole E. Metoclopramide
A,B,C Nizatidine is an H 2 receptor antagonist that reduces gastric acid secretion and provides for symptomatic improvement in GERD. Ranitidine is an H 2 receptor antagonist that reduces gastric acid secretion and provides for symptomatic improvement in GERD. Famotidine is an H 2 receptor antagonist that reduces gastric acid secretion and provides for symptomatic improvement in GERD. Lansoprazole is a proton pump inhibitor that inhibits gastric secretion up to 90% with one dose daily and provides for symptomatic improvement in GERD. Metoclopramide is a prokinetic agent that increases the rate of gastric emptying; it has multiple side effects and is not appropriate for long-term treatment of GERD.
The nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which new prescription will the nurse question? Oral psyllium Oral potassium supplement Intravenous normal saline Magnesium citrate
Magnesium citrate Oral psyllium will absorb the watery diarrhea, giving more bulk to the stool. An oral potassium supplement is appropriate because diarrhea causes potassium loss. Intravenous normal saline is the intervention of choice to manage dehydration due to diarrhea. Magnesium citrate has a laxative effect and would worsen the client's dehydration.
A health care provider prescribes daily docusate sodium for a client. The nurse explains to the client that this medication has which action? Lubricates the feces Creates an osmotic effect Stimulates motor activity Softens the feces
Softens the feces The detergent action of docusate sodium promotes the drawing of fluid into the stool, which softens the feces. Lubricating the feces in the gastrointestinal (GI) tract is the action of lubricant laxatives such as mineral oil. Creating an osmotic effect in the GI tract is the action of saline laxatives, such as magnesium hydroxide, or other osmotics, such as lactulose. Stimulating motor activity of the GI tract is the action of peristaltic stimulants, such as cascara.
A client is admitted to the hospital with severe diarrhea, abdominal cramps, and vomiting for 5 days. Upon further assessment, the primary health care provider finds that the symptoms occurred after the client ate eggs, salad dressings, and sandwich fillings. Which food-borne disease would be suspected in this client? Listeriosis Shigellosis Salmonellosis Staphylococcus
Salmonellosis A client with salmonellosis will experience severe diarrhea, abdominal cramps, and vomiting; these symptoms last as long as 5 days after the intake of contaminated food. This disorder may be caused by Salmonella typhi or Salmonella paratyphi. The causative organism is usually present in such foods as eggs, salad dressings, and sandwich fillings. A client with listeriosis will experience severe diarrhea, fever, headache, pneumonia, meningitis, and endocarditis 3 to 21 days after infection. The symptoms of shigellosis range from cramps and diarrhea to a fatal dysentery that lasts for 3 to 14 days. Pain, vomiting, diarrhea, perspiration, headache, fever, and prostration lasting for 1 or 2 days are the symptoms of a Staphylococcus infection.
A health care provider prescribes bisacodyl for a client with constipation. The nurse explains to the client that this medication acts by which mechanism? Producing bulk Softening feces Lubricating feces Stimulating peristalsis
Stimulating peristalsis Bisacodyl stimulates nerve endings in the intestinal mucosa, precipitating a bowel movement. Bisacodyl is not a bulk cathartic. Bulk-forming laxatives, such as psyllium hydrophilic mucilloid, form soft, pliant bulk that promotes physiological peristalsis. Bisacodyl is not a stool softener. Stool softeners, such as docusate sodium, permit fat and water to penetrate feces, which softens and delays the drying of the feces. Bisacodyl is not an emollient. Emollient laxatives, such as mineral oil, lubricate the feces and decrease absorption of water from intestinal tract.
