PrepU Chapter 58
The nurse administers metoclopramide orally at 9:00 AM to a patient with GERD. The nurse would expect this drug to exert its maximum effectiveness at which time? 11:00 AM to 11:30 AM 12 noon to 12:30 PM 10:00 AM to 10:30 AM 1:00 PM to 2:00 PM
10:00 AM to 10:30 AM Metoclopramide, when administered orally, peaks in 60 to 90 minutes, which in this case would be between 10:00 AM to 10:30 AM.
The nurse administers metoclopramide orally at 9:00 AM to a patient with GERD. The nurse would expect this drug to exert its maximum effectiveness at which time? 1:00 PM to 2:00 PM 10:00 AM to 10:30 AM 12 noon to 12:30 PM 11:00 AM to 11:30 AM
10:00 AM to 10:30 AM Metoclopramide, when administered orally, peaks in 60 to 90 minutes, which in this case would be between 10:00 AM to 10:30 AM.
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? 2 days 1 day 12 hours 7 days
2 days 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 more than 2 days. Diarrhea lasting more than 2 days can indicate infection or a condition that will require more intense treatment with prescription medication. Dehydration can occur if untreated. Diarrhea of 12 hours to 1 day can be viral. Diarrhea for 7 days can be life threatening.
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 stimulant laxative Bismuth subsalicylate A bulk-forming (fiber) laxative A hyperosmotic laxative
A bulk-forming (fiber) laxative Bulk-forming (fiber) laxatives are considered the safest and most physiologic of the laxatives. As such, they are normally preferable to stimulant and hyperosmotic laxatives for occasional relief of constipation. Bismuth subsalicylate does not relieve constipation.
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 Lack of urge to defecate Frequent episodes of flatulence Lack of bowel movement for 5 days
Abdominal pain and fever Laxatives and cathartics are contraindicated in clients with abdominal pain. The presence of fever would also be a possible indication of infection.
The nurse cautions a client with what allergy to avoid the use of bismuth salts in the treatment of diarrhea? Penicillin Nuts Eggs Aspirin
Aspirin Clients who are allergic to aspirin should not use bismuth salts.
A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the client about which adverse effect(s)? Constipation Hyperthyroidism Breathlessness and hypotension Impaired cardiac function
Constipation The primary adverse effect of alosetron is constipation. Clients are also at risk for ischemic colitis, a rare but potentially fatal complication. This drug does not cause breathlessness, hypotension, impaired cardiac function, or hyperthyroidism.
A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the client about which adverse effect(s)?
Constipation The primary adverse effect of alosetron is constipation. Clients are also at risk for ischemic colitis, a rare but potentially fatal complication. This drug does not cause breathlessness, hypotension, impaired cardiac function, or hyperthyroidism.
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 When water is added, the laxative substance swells and becomes gel-like. The added bulk or size of the fecal mass stimulates peristalsis and defecation. The other options are not the mechanism of action of psyllium.
The nurse is teaching a client about loperamide, which the health care provider has prescribed for treatment of chronic diarrhea. Which adverse effects should the nurse be sure to mention? Nausea Tremors Flatulence Disorientation
Nausea Adverse effects of loperamide are few and generally mild, but they include nausea, abdominal pain, constipation, drowsiness, sedation, and vomiting.
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?
lactase deficiency Deficiency of lactase, which breaks down lactose to simple sugars (i.e., glucose and galactose) that can be absorbed by the gastrointestinal (GI) mucosa, inhibits digestion of milk and milk products. Lactase deficiency commonly occurs among people of African and Asian descent.
The nurse should know that lactulose achieves a therapeutic effect by which means? decreasing the viscosity of intestinal contents in the duodenum irritating the intestinal mucous membrane pulling water into the intestinal lumen by osmotic pressure relaxing the muscle tone of the ileocecal valve and anal sphincter
pulling water into the intestinal lumen by osmotic pressure Lactulose is a disaccharide that is not absorbed from the GI tract. It exerts laxative effects by pulling water into the intestinal lumen. It does not change muscle tone, change the viscosity of bowel contents, or irritate the intestinal epithelium.
What type of laxative would be the first choice for a client diagnosed with hemorrhoids experiencing intense pain when straining to pass stools? saline cathartic stimulant cathartic bulk-forming laxative stool softener
stool softener For clients in whom straining is potentially harmful or painful, stool softeners (e.g., docusate sodium) are the agents of choice.
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? "The medication needs to be adjusted for the 1-year-old's weight." "There are over-the-counter medications that are better for the 1-year-old." "I will call the prescriber to find out if this is safe." "Children younger than 1 year of age should not be given this medication."
"Children younger than 1 year of age should not be given this medication." Children younger than 2 years of age should not take this drug, and those from age 2 to less than 13 years should take the liquid preparation to enhance accuracy of the dosage. Calling the prescriber is not necessary. The nurse should not encourage over-the-counter medications for the child.
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 instructructions 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." Bulk-forming laxatives need to be taken with at least 8 oz of water or other liquid. The other options are incorrect statements and would indicate further need for teaching.
A client is being sent home with orders for a laxative PRN. The nurse is conducting client teaching on the use of a laxative. What will the nurse inform the client is one of the most common adverse effects of a laxative?
Abdominal cramping Common adverse effects of laxatives are diarrhea, abdominal cramping, and nausea. CNS effects such as dizziness, headache, and weakness can occur. However, these adverse effects usually relate to the loss of fluid and electrolyte imbalance associated with laxative use and are not the most common adverse effects.
Which would the nurse identify as being affected by dexpanthenol? Dopamine Epinephrine Serotonin Acetylcholine
Acetylcholine Dexpanthenol works by increasing acetylcholine levels and stimulating parasympathetic system. Metoclopramide works by blocking dopamine receptors. Dexpanthenol does not affect serotonin. Dexpanthenol does not affect epinephrine.
A nurse is caring for a client with pseudomembranous colitis. The health care provider has prescribed loperamide HCl to the client. How does the nurse know that the drug has been effective?
Diarrhea is resolved. Loperamide HCl (Lomotil) is an antidiarrheal medication. The nurse will know that the medication is effective if the diarrhea is resolved in the client. The nurse should monitor the client for an elevation in body temperature, severe abdominal pain, abdominal rigidity, or distention because these are the indicators of intestinal perforation. The nurse should monitor for rectal bleeding when laxatives are administered.
A 59-year-old homeless man with a history of alcohol abuse, is admitted with dehydration and diarrhea. The admission interview indicates he collects his meals from dumpsters behind restaurants. What could be causing his diarrhea? (Select all that apply.) Salmonella Intestinal infection Campylobacter bacteria Dehydration
Intestinal infection Campylobacter bacteria Salmonella Food contaminated with pathogenic microbes can cause diarrhea.
After teaching a group of students about laxatives, the instructor determines that the teaching has been successful when the students identify which agent as an example of a bulk laxative? Polycarbophil Docusate Senna Bisacodyl
Polycarbophil Polycarbophil is an example of a bulk laxative. Bisacodyl and senna are examples of chemical stimulant laxatives. Docusate is an example of a lubricant laxative.
Before administering alosetron, the nurse should ensure that the client has been made aware of what potentially severe adverse effect? bowel obstruction diverticulosis blood dyscrasias anal fissures
bowel obstruction Severe constipation, with possible obstruction, perforation, and hemorrhage, is the most common problem resulting from alosetron. None of the other options are associated with this medication.
A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium? "This medication will only soften your stools over the next couple of days." "This drug will help you pass regular stools while you're in the hospital, but you should not take it for more than 5 days." "You'll usually have a bowel movement within 2 to 3 hours of taking this." "This medication will cause your bowels to contract more strongly than they normally do."
"This medication will only soften your stools over the next couple of days." Surfactant laxatives (e.g., docusate calcium or docusate sodium) decrease the surface tension of the fecal mass to allow water to penetrate into the stool. They also act as a detergent to facilitate admixing of fat and water in the stool. As a result, stools are softer and easier to expel. These agents have little, if any, laxative effect. Their main value is to prevent straining while expelling stool. They usually act within 1 to 3 days and should be taken daily.
The nurse should explain that metoclopramide (Reglan) decreases nausea and vomiting by which of the following actions? Decreasing gastric contractions Inhibiting stimulation of the vomiting center in the brain Decreasing gastric motility Increasing gastric emptying time
Inhibiting stimulation of the vomiting center in the brain Reglan inhibits stimulation of the vomiting center in the brain. This medication also increases the amplitude of gastric contractions and gastric motility while decreasing gastric emptying time.
A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium? It causes bloating and swells the colon. It reduces exchange of proteins and mucus in the stools. It binds and expels toxins into the stool. It absorbs toxins and water, decreasing fluidity of stools.
It absorbs toxins and water, decreasing fluidity of stools. Polycarophil and psyllium are most often used as bulk-forming laxatives as they absorb toxin and water, decreasing the fluidity of the stools. They do not cause bloating and swell the colon or reduce the exchange of proteins and mucus in the stools.
A client is admitted to the hospital for pneumonia. Since admission, the client has not had a bowel movement. The physician prescribes magnesium hydroxide. What should be an outcome of this therapy? The client will not sustain injury from drug therapy. The client will have a bowel movement after taking the drug. Within 2 to 3 hours of using the drug, the client will experience a decrease in abdominal pain and distention. Diarrhea will be controlled through the use of the drug.
The client will have a bowel movement after taking the drug. The desired outcome for magnesium hydroxide therapy would be for the client to have a bowel movement after taking the drug. Within 2 to 3 hours of using simethicone, the client will experience a decrease in abdominal pain and distention. Diarrhea will be controlled through the use of diphenoxylate HCl with atropine sulfate. The client will not sustain injury using diphenoxylate HCl with atropine sulfate.
A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin? octreotide polycarbophil bismuth subsalicylate loperamide
bismuth subsalicylate Bismuth subsalicylate is a commonly used OTC medication for diarrhea. It has a salicylate, which is in the family of aspirin. A nurse should teach the client that use of the medication with aspirin can cause an overdose. Octreotide acetate is a synthetic form of somatostatin and is used for diarrhea as it decreases GI secretion and motility. Polycarbophil is a bulk-forming laxative. Loperamide is a synthetic derivative of meperidine that decreases GI motility by its effect on intestinal muscles.
An older adult has regularly drunk mineral oil to treat occasional episodes of constipation. The nurse should encourage the client to explore other treatments because the use of oral mineral oil can result in which adverse effect? decreased absorption of drugs and vitamins paralytic ileus rebound constipation edema from changes in intestinal solute content
decreased absorption of drugs and vitamins Oral use of mineral oil may cause potentially serious adverse effects, including decreased absorption of fat-soluble vitamins and some drugs and lipid pneumonia if aspirated into the lungs. Thus, mineral oil is not an oral laxative of choice in any condition. It is not noted to cause rebound constipation, paralytic ileus, or edema.
The nurse is preparing to administer a stimulant cathartic to the client. The nurse should inform the client of the possible adverse effect of: rectal bleeding. vomiting. diarrhea. nausea.
diarrhea Diarrhea may result due to the action of strong, stimulant cathartics. A stimulant cathartic would not cause nausea, vomiting, or rectal bleeding.
A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium? "You'll usually have a bowel movement within 2 to 3 hours of taking this." "This medication will only soften your stools over the next couple of days." "This drug will help you pass regular stools while you're in the hospital, but you should not take it for more than 5 days." "This medication will cause your bowels to contract more strongly than they normally do."
"This medication will only soften your stools over the next couple of days." Surfactant laxatives (e.g., docusate calcium or docusate sodium) decrease the surface tension of the fecal mass to allow water to penetrate into the stool. They also act as a detergent to facilitate admixing of fat and water in the stool. As a result, stools are softer and easier to expel. These agents have little, if any, laxative effect. Their main value is to prevent straining while expelling stool. They usually act within 1 to 3 days and should be taken daily.
Which is a likely cause of diarrhea experienced by an older adult?
laxative abuse Laxative abuse is associated with diarrhea. This phenomenon is particularly common among older adults. Antihypertensive agents and anemia are not associated with diarrhea. Fluid volume deficit is a result, not cause, of diarrhea.
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 stimulant laxative Bismuth subsalicylate A hyperosmotic laxative A bulk-forming (fiber) laxative
A bulk-forming (fiber) laxative Bulk-forming (fiber) laxatives are considered the safest and most physiologic of the laxatives. As such, they are normally preferable to stimulant and hyperosmotic laxatives for occasional relief of constipation. Bismuth subsalicylate does not relieve constipation.
The patient has called the office to see if using bismuth subsalicylate will work to treat simple diarrhea. The nurse knows this will be a safe and effective treatment for diarrhea unless the patient has: Hypertension Allergy to aspirin Urinary retention Hypothyroidism
Allergy to aspirin People with an allergy to aspirin or aspirin products should not take bismuth subsalicylate.
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? Psyllium Fiber Ducosate Sorbitol
Ducosate A laxative such as a stool softener like ducosate sodium is recommended for clients who are straining or for whom defecation is painful. Sorbitol may be given with activated charcoal to remove toxic substances. Bulk-forming laxatives such as psyllium are used in clients who are debilitated, older, or unable or unwilling to eat an adequate diet. Fluids and fiber are indicated for all clients to encourage a healthy bowel regimen.
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 Reducing the surface tension of bowel contents Irritation of the intestinal mucosa Creating a barrier between the colon wall and feces
Increasing mass and water content of stool When water is added, the laxative substance swells and becomes gel-like. The added bulk or size of the fecal mass stimulates peristalsis and defecation. The other options are not the mechanism of action of psyllium.
What is the reason for administering a bulk-forming laxative like polycarbophil to a client experiencing liquid stools? Polycarbophil will increase bile and diminish bacterial flora in the intestines. Polycarbophil absorbs large amounts of water and decreases fluidity of stools. Polycarbophil will diminish the absorption of intestinal fiber and water. Polycarbophil will provide pain relief and decrease cramping and bloating.
Polycarbophil absorbs large amounts of water and decreases fluidity of stools. Polycarbophil is an adsorbent drug that works by absorbing large amounts of water and produces stools of gelatin-like consistency. Polycarbophil will not diminish the absorption of intestinal fiber and water. Polycarbophil will cause abdominal discomfort and bloating. Polycarbophil has no effect on bacterial flora in the intestines.
After reviewing information about metoclopramide, the students demonstrate a need for additional teaching when they identify that the drug can be given by which route? Intravenous Rectal Oral Intramuscular
Rectal Metoclopramide can be given orally, intramuscularly, or intravenously but not rectally.
A nurse is teaching a group of older adults about strategies for preventing constipation that do not involve the use of medications. The nurse should recommend what intervention? Select all that apply. consuming a high-fiber diet drinking 6 to 10 glasses of fluid each day reserving at least 8 hours nightly to assure adequate sleep introducing organic foods into the daily diet engaging in frequent physical exercise
consuming a high-fiber diet engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day Nonpharmacologic measures for preventing constipation include increased fiber intake, exercise, and adequate fluids. Organic foods do not have any particular benefit in the prevention of constipation. Adequate sleep has multiple benefits, but reduced constipation is not among these.
The nurse explains that there is no "normal" number of daily stools because of differences in what contributing factor? activity gender diet ethnicity
diet Due to variations in diet and other factors, there is no "normal" number of stools, but the traditional medical definition of constipation includes three or fewer bowel movements per week.
A caregiver of a 1-year-old asks the nurse if the caregiver can give the diphenoxylate that was prescribed for an older sibling to the child. Which is the nurse's best response? "The medication needs to be adjusted for the 1-year-old's weight." "I will call the prescriber to find out if this is safe." "There are over-the-counter medications that are better for the 1-year-old." "Children younger than 1 year of age should not be given this medication."
"Children younger than 1 year of age should not be given this medication." Children younger than 2 years of age should not take the drugs, and those from age 2 to less than 13 years should take the liquid preparation to enhance accuracy of the dosage. Calling the prescriber is not necessary. The nurse-should not encourage over-the-counter medications for the child.
Which is a common cause of diarrhea in older adults?
Laxative overuse Diarrhea in older adults may occur from laxative overuse.
The nurse is preparing to administer cascara to a client. The nurse anticipates administering this drug by which route? Intramuscular Oral Rectal, via suppository Rectal, via enema
Oral Cascara is administered orally. Senna may be administered orally or as a rectal suppository. Bisacodyl is given orally or rectally. No laxative is given intramuscularly.
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. Use a stimulant laxative every day. Set a routine time and place for daily bowel movement. Consume food rich in fiber. Drink 64 to 80 ounces of fluids daily.
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. Stimulant laxatives such as bisacodyl (Dulcolax) should not be used frequently, because long-term use can impede normal bowel function and result in laxative dependence.
The nurse is caring for a client who is allergic to aspirin. Which over-the-counter medication should the nurse caution the client to avoid? Imodium Pepto-Bismol FiberCon The client should avoid all the above medications.
Pepto-Bismol Pepto-Bismol is a trade name for bismuth subsalicylate. Patients who are allergic to aspirin or other salicylates should not use the medication.
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? Slows peristalsis by acting on the smooth muscles of the intestine Decreases GI secretions Anti-inflammatory effects allowing absorption of fluids Antimicrobial effects
Slows peristalsis by acting on the smooth muscles of the intestine Diphenoxylate with atropine is chemically related to opioid drugs; therefore, they decrease intestinal peristalsis, which often is increased when the client has diarrhea.
The nurse should inform the client planning to use an over-the-counter bismuth product that there is a potential that the medication will cause what side effect? hyperglycemia and a metallic taste photosensitivity and visual "floaters" yellowing of the sclerae and skin a dark tongue or dark stool
a dark tongue or dark stool Bismuth subsalicylate causes a temporary and harmless darkening of the tongue or stool. It is not associated with any of the other options.
Defecation is normally stimulated by what physiologic trigger? synthesis and release of digestive enzymes movements and reflexes in the gastrointestinal tract changes in the osmolarity of bowel contents stimulation from the medulla oblongata
movements and reflexes in the gastrointestinal tract Defecation is normally stimulated by movements and reflexes in the gastrointestinal tract. It does not result from changes in osmolarity, central nervous system (CNS) stimulation of the medulla, or the release of digestive enzymes.
Defecation is normally stimulated by what physiologic trigger?
movements and reflexes in the gastrointestinal tract Defecation is normally stimulated by movements and reflexes in the gastrointestinal tract. It does not result from changes in osmolarity, central nervous system (CNS) stimulation of the medulla, or the release of digestive enzymes.
A client diagnosed with HIV/AIDS has diarrhea that is not responding to antidiarrheal agents. Which medication will best assist in treating this client's diarrhea? cholestyramine ciprofloxacin bismuth salts octreotide acetate
octreotide acetate Octreotide acetate is a synthetic form of somatostatin that is effective in diarrhea related to HIV/AIDS. Bismuth salts are not used for diarrhea that does not respond to other agents. Ciprofloxacin is an antibiotic and so would not be used to treat diarrhea. Cholestyramine is useful in treating diarrhea due to bile salt accumulation in conditions such as Crohn's disease or surgical excision of the ileum.
An adult resident of an assisted living facility has not responded appreciably to bulk-forming laxatives, so the primary care provider has prescribed bisacodyl. The nurse who oversees the care at the facility should know that this drug may be administered by what route? Select all that apply. oral intramuscular injection subcutaneous injection intravenous suppository
oral suppository Bisacodyl can be administered orally or by suppository. Parenteral administration is not possible.
How is constipation best defined? the passage of fewer than three stools in any 7-day period the passage of fewer than five stools in any 7-day period the infrequent and painful expulsion of hard, dry stools a subjective sensation of bowel fullness
the infrequent and painful expulsion of hard, dry stools Constipation is the infrequent and painful expulsion of hard, dry stools. It is not defined by a particular number of stools or in terms of an individual's subjective sensation.
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? 4 1 2 3
2 Clients should consult a health care provider if diarrhea is accompanied by severe abdominal pain or fever, lasts longer than 2 days, or if stools contain blood or mucus.
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? 72 hours 24 hours 48 hours 36 hours
48 hours If the client experiences no response within 48 hours, the client should notify her health care provider to determine a possible underlying medical cause for the diarrhea.
Which method is used to discourage the client from taking an excessive dosage of diphenoxylate HCl? The drug is not available over the counter. The taste of the drug is unpleasant. A small amount of atropine sulfate is combined with diphenoxylate HCl. The client is advised to strictly adhere to the prescriber's instructions.
A small amount of atropine sulfate is combined with diphenoxylate HCl. A small amount of atropine sulfate is combined with diphenoxylate HCl to discourage the client from taking an excessive dosage of diphenoxylate HCl. Atropine sulfate causes dry mouth and tachycardia, which are quite unpleasant. Advising the client to strictly adhere to the prescriber's instructions is not always an effective deterrent. The taste and limited availability of the drug do not act as deterrents.
A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin? Octreotide Bismuth subsalicylate Loperamide Polycarbophil
Bismuth subsalicylate Bismuth subsalicylate is a commonly used OTC used for diarrhea. It has a salicylate, which is in the family of aspirin. A nurse should teach the client that use of the medication with aspirin can cause an overdose. Octreotide acetate is a synthetic form of somatostatin and is used for diarrhea as it decreases GI secretion and motility. Polycarbophil is a bulk-forming laxative. Loperamide is a synthetic derivative of meperidine that decreases GI motility by its effect on intestinal muscles.
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? Discuss the issues with another nurse on the unit. Administer the medication as prescribed. Call the prescriber about the laboratory tests. Hold the medication.
Call the prescriber about the laboratory tests. The nurse knows that the use of diphenoxylate with atropine requires caution with clients that have renal or hepatic compromise. The nurse should call the provider and make sure the provider is aware of the laboratory values before administering the medication. Discussion with other nurses is not warranted. The medication does not need to be held at this time as diphenoxylate with atropine is not contraindicated with renal or hepatic compromise but can be administered with caution.
A client is prescribed loperamide for diarrhea. Loperamide can be used for which type of diarrhea? Diarrhea caused by ingestion of Salmonella organisms Diarrhea caused by pseudomembranous colitis Chronic diarrhea Diarrhea caused by gastroenteritis
Chronic diarrhea Unlike diphenoxylate, loperamide may be used for chronic as well as acute diarrhea. Loperamide is contraindicated for diarrhea related to infections and pseudomembranous colitis. Salmonellosis and gastroenteritis are both infectious diseases and should not be treated with loperamide.
The nurse is conducting a pre-colonoscopy class and knows that polyethylene glycol- electrolyte solution will be contraindicated for the client with which condition? Gastroesophageal reflux disease Chronic constipation Colitis Oral stomatitis
Colitis Polyethylene glycol-electrolyte solution is contraindicated in clients who have colitis.
The nurse is conducting a pre-colonoscopy class and knows that polyethylene glycol- electrolyte solution will be contraindicated for the client with which condition? Oral stomatitis Chronic constipation Colitis Gastroesophageal reflux disease
Colitis Polyethylene glycol-electrolyte solution is contraindicated in clients who have colitis.
Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action? Decreasing intestinal motility Inhibiting cellular division in causative bacteria Binding with fecal material to increase bulk Absorbing toxins
Decreasing intestinal motility Diphenoxylate with atropine sulfate resolves diarrhea by decreasing intestinal motility.
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? Castor oil Magnesium citrate Docusate Bisacodyl
Docusate A mild laxative may be used after delivery with care that it not enter breast milk and affect the newborn if the mother is nursing. Docusate would be the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate for this client.
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 Castor oil Bisacodyl Magnesium citrate
Docusate A mild laxative may be used after delivery with care that it not enter breast milk and affect the newborn if the mother is nursing. Docusate would be the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate for this client.
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? Selectively antagonize opioid binding Allow formation of a slippery coat on the intestinal contents Increase the fluid in the intestinal contents Directly stimulate the nerve plexus in the intestinal wall
Increase the fluid in the intestinal contents Bulk laxatives increase the fluid in the intestinal contents, which enlarges bulk and stimulates local stretch receptor and activates local activity. Chemical stimulant laxatives directly stimulate the nerve plexus in the intestinal wall. Mineral oil, a lubricant, forms a slippery coat on the contents of the intestinal tract. Methylnaltrexone acts as a selective antagonist to opioid binding at the mu receptor.
A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium? It absorbs toxins and water, decreasing fluidity of stools. It binds and expels toxins into the stool. It reduces exchange of proteins and mucus in the stools. It causes bloating and swells the colon.
It absorbs toxins and water, decreasing fluidity of stools. Polycarophil and psyllium are most often used as bulk-forming laxatives as they absorb toxin and water, decreasing the fluidity of the stools. They do not cause bloating and swell the colon or reduce the exchange of proteins and mucus in the stools.
What is the reason for administering a bulk-forming laxative like polycarbophil to a client experiencing liquid stools?
Polycarbophil absorbs large amounts of water and decreases fluidity of stools. Polycarbophil is an adsorbent drug that works by absorbing large amounts of water and produces stools of gelatin-like consistency. Polycarbophil will not diminish the absorption of intestinal fiber and water. Polycarbophil will cause abdominal discomfort and bloating. Polycarbophil has no effect on bacterial flora in the intestines.
Which would be most important to include when teaching a patient about using psyllium?
Taking the agent with a large amount of water A large amount of water is needed to prevent the laxative from swelling into a gelatin-like mass in the esophagus that could lead to obstruction. Psyllium can be taken any time, 1 to 3 times per day. Bulk laxatives, like psyllium, can increase the motility of the GI tract and interfere with the timing or process of absorption. Administration of other drugs with psyllium should be separated by at least 30 minutes. It would be important to encourage the patient to ingest high fiber foods to promote bowel evacuation and reduce the need for psyllium.
The nurse cautions a client with what allergy to avoid the use of bismuth salts in the treatment of diarrhea? Nuts Eggs Penicillin Aspirin
Aspirin Clients who are allergic to aspirin should not use bismuth salts.
A client was prescribed a cathartic laxative prior to scheduled sigmoidoscopy. The nurse should inform the client that it will take how long before he/she will experience a bowel movement? 12 to 24 hours 2 to 3 days 5 to 7 days up to 8 days
2 to 3 days After taking a strong laxative or cathartic, it takes 2 to 3 days of normal eating to produce enough feces in the bowel for a bowel movement.
Which would the nurse identify as being affected by dexpanthenol? Serotonin Acetylcholine Epinephrine Dopamine
Acetylcholine Dexpanthenol works by increasing acetylcholine levels and stimulating parasympathetic system. Metoclopramide works by blocking dopamine receptors. Dexpanthenol does not affect serotonin. Dexpanthenol does not affect epinephrine.
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? Give mineral oil to the patient after meals. Provide foods high in bulk or roughage. Administer the drug with adequate fluid intake. Administer the drug after chilling it.
Administer the drug with adequate fluid intake. The nurse should administer the drug with adequate fluid intake to avoid obstruction of the esophagus, stomach, small intestine, and colon in a patient with intestinal stenosis. Mineral oil is given to the patient as a laxative on an empty stomach in the evening. The nurse should provide foods high in bulk or roughage to avoid constipation in a patient receiving laxatives. The nurse administers a laxative with an unpleasant or salty taste after chilling it to disguise its taste.
When administering a bulk laxative to a client, which action is important for the nurse to take? Other than standard safety measures, no additional actions are needed. Immediately place the client on a bedpan or commode. Administer the laxative with a full glass of water or juice. Administer an anti-diarrheal medication simultaneously.
Administer the laxative with a full glass of water or juice. Give bulk-producing or stool-softening laxatives with a full glass of water or juice. The administration of a bulk-producing laxative is followed by an additional full glass of water. Administration of an anti-diarrheal is contraindicated because it would reduce the effect of the laxative. The onset of action of the laxative does not necessitate placement on a commode or bed pan at the time of medication administration.
The patient has called the office to see if using bismuth subsalicylate will work to treat simple diarrhea. The nurse knows this will be a safe and effective treatment for diarrhea unless the patient has: Allergy to aspirin Urinary retention Hypertension Hypothyroidism
Allergy to aspirin People with an allergy to aspirin or aspirin products should not take bismuth subsalicylate.
A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin?
Bismuth subsalicylate Bismuth subsalicylate is a commonly used OTC used for diarrhea. It has a salicylate, which is in the family of aspirin. A nurse should teach the client that use of the medication with aspirin can cause an overdose. Octreotide acetate is a synthetic form of somatostatin and is used for diarrhea as it decreases GI secretion and motility. Polycarbophil is a bulk-forming laxative. Loperamide is a synthetic derivative of meperidine that decreases GI motility by its effect on intestinal muscles.
A nurse is caring for a client that 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? Hold the medication. Call the prescriber about the laboratory tests. Administer the medication as prescribed. Discuss the issues with another nurse on the unit.
Call the prescriber about the laboratory tests. The nurse knows that the use of diphenoxylate with atropine requires caution with clients that have renal or hepatic compromise. The nurse should call the provider and make sure the provider is aware of the laboratory values before administering the medication. Discussing the situation with other nurses is not warranted. The medication does not need to be held at this time as diphenoxylate with atropine is not contraindicated with renal or hepatic compromise but can be administered with caution.
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? Bradycardia Polyuria Dizziness Paleness of the face
Dizziness Adverse effect of diphenoxylate include tachycardia, urinary retention, flushing, headache, and dizziness as well as nausea and vomiting.
A patient who experiences frequent constipation asks the nurse for advice regarding which agent would be best for long-term daily use? The nurse will respond that the best for daily use is which of the following? Bisacodyl (Dulcolax) Milk of magnesia Docusate (Colace) Mineral oil
Docusate (Colace) Docusate, a surfactant that enhances entry of water into fecal material, is safest for daily use. Milk of magnesia, a saline cathartic, should not be used frequently, because it can lead to electrolyte imbalance. Bisacodyl, a stimulant laxative, also can cause electrolyte imbalance. Mineral oil, a lubricant, can interfere with intestinal absorption of fat-soluble vitamins and some orally administered drugs.
What recommendations 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. Measures to prevent constipation include: drink plenty of fluids, get exercise, and eat foods high in bulk or roughage. Opioid medications can cause constipation and are therefore not a means of prevention. Avoiding the need to defecate when the urge occurs can lead to constipation.
The home health nurse is visiting with a client who has been prescribed diphenoxylate with atropine (Lomotil) for chronic diarrhea. Which of the following adverse effects should the nurse be aware of when assessing the client's present condition? Select all that apply. Tachypnea Bradycardia Hypertension Lightheadedness Dry mouth
Dry mouth Lightheadedness Adverse effects include dry skin and mucous membranes, nausea, constipation and lightheadedness.
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? Psyllium Ducosate Fiber Sorbitol
Ducosate A laxative such as a stool softener like ducosate sodium is recommended for clients who are straining or for whom defecation is painful. Sorbitol may be given with activated charcoal to remove toxic substances. Bulk-forming laxatives such as psyllium are used in clients who are debilitated, older, or unable or unwilling to eat an adequate diet. Fluids and fiber are indicated for all clients to encourage a healthy bowel regimen.
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? Functional diarrhea disorder Hyperthyroidism Colitis Intestinal neoplasm
Functional diarrhea disorder The client is describing functional diarrhea disorder where the diarrhea occurs as a result of stress or anxiety. The client does not have hyperthyroid, intestinal neoplasm, or colitis. While all of these conditions can lead to diarrhea, the client's description does not support any of these diagnoses.
The nurse is preparing to administer dexpanthenol to a client based on the understanding that this drug acts in which manner? Acting directly on the muscles of the GI tract Exerting an osmotic pull on fluids Increasing acetylcholine levels Blocking dopamine receptors
Increasing acetylcholine levels Dexpanthenol works by increasing acetylcholine levels and stimulating the parasympathetic system. Metoclopramide works by blocking dopamine receptors and making the GI cells more sensitive to acetylcholine. Bulk laxatives exert an osmotic pull on fluids. Loperamide acts directly on the muscles of the GI tract to slow activity.
A client is using psyllium hydrophilic mucilloid to promote evacuation of stool. What is the action of this medication?
It increases mass and water content of stool, promoting evacuation. Bulk-forming laxatives increase mass and water content of the stool, promoting evacuation. Bulk-forming laxatives do not reduce surface tension of bowel contents. Bulk-forming laxatives do not irritate the intestinal mucosa to increase intestinal motility. Bulk-forming laxatives do not create a barrier between the colon wall and feces.
A client with constipation has been prescribed mineral oil. Which reason should the nurse provide for instructing the client to take the medication between meals or at bedtime? It causes nausea and vomiting It enhances absorption of the drug It causes sedation It interferes with vitamin absorption
It interferes with vitamin absorption When mineral oil is taken orally, it interferes with absorption of the fat-soluble vitamins, namely A, D, E, and K. Therefore, it should be given in between meals or at bedtime to avoid interfering with food absorption. Mineral oil does not have a sedative effect. Administering it between meals does not enhance its absorption. Mineral oil is not absorbed; rather, it forms a coating on the feces, acts as a lubricant, softens feces, and prevents straining on bowel movements. It does not cause nausea and vomiting.
What is a true statement regarding diphenoxylate with atropine? Select all that apply. It is a controlled substance Causes an increase in blood pressure and heart rate Works by suppressing the vomiting center Requires a prescription Used to treat mild to moderate diarrhea
It is a controlled substance Requires a prescription Diphenoxylate with atropine is an oral opioid used to treat moderate to severe diarrhea. It is a schedule V controlled substance requiring a prescription. It works by slowing peristalsis by acting on the smooth muscle of the intestine and not the vomiting center. There are side effects of this medication, which include respiratory depression and constipation and not an increase in blood pressure and heart rate.
What is a true statement regarding diphenoxylate with atropine? Select all that apply. Works by suppressing the vomiting center Requires a prescription Can cause an increase in blood pressure and heart rate It is a controlled substance Used to treat mild to moderate diarrhea
It is a controlled substance Requires a prescription Diphenoxylate with atropine is an oral opioid used to treat moderate to severe diarrhea. It is a schedule V controlled substance requiring a prescription. It works by slowing peristalsis by acting on the smooth muscle of the intestine and not the vomiting center. There are side effects of this medication, which include respiratory depression and constipation and not an increase in blood pressure and heart rate.
What is the correct rationale for why the nurse would administer a laxative at a separate time from the client's other medications? They often taste bad and clients are less likely to take other medications. Laxatives may reduce absorption of other drugs present in the GI tract. Often laxatives make the client nauseated, which interferes with the ability to take medications. Because a laxative may stimulate a bowel movement, it can interfere with medication administration.
Laxatives may reduce absorption of other drugs present in the GI tract. Laxatives may reduce absorption of other drugs present in the GI tract by combining with them chemically, or hastening their passage through the intestinal tract. Nausea, taste, and onset of action have no bearing on administration of laxatives.
A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is: Polyethylene glycol solution (MiraLAX) Bisacodyl (Dulcolax) Psyllium (Metamucil) Polyethylene glycol-electrolyte solution (NuLYTELY)
Polyethylene glycol-electrolyte solution (NuLYTELY) Polyethylene glycol-electrolyte solution taken orally will rapidly provoke extensive diarrhea with complete emptying of the lower intestine. Polyethylene glycol solution, bisacodyl, and psyllium work much more slowly and are useful in managing constipation.
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) Polyethylene glycol-electrolyte solution taken orally will rapidly provoke extensive diarrhea with complete emptying of the lower intestine. Polyethylene glycol solution, bisacodyl, and psyllium work much more slowly and are useful in managing constipation.
Psyllium (Metamucil) is a bulk-forming laxative available over-the-counter and frequently used. The nurse knows that which of these statements regarding use of psyllium is correct? Psyllium can be used freely in children. Home care nurses should not become involved in their patients' bowel management. Laxatives are the preferred method for bowel management in older adults. Psyllium is useful in critically ill patients who experience constipation.
Psyllium is useful in critically ill patients who experience constipation. Psyllium should be administered to children only under health care provider supervision. In older adults, dietary fiber, adequate fluid consumption, and exercise are the preferred method for bowel management. Critically ill patients often experience constipation from decreased physical activity and, at times, administration of opioid analgesics. Home care nurses should determine patients' risk for constipation and assist in bowel management.
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 evaluation. It is important to assess the client before giving any medication. Important assessments include a review of the client's chart for the course of treatment, and discovering the reason for administration of the prescribed drug. Question the client regarding the type and intensity of symptoms (e.g., pain, discomfort, diarrhea, or constipation) to provide a baseline for evaluation of the effectiveness of drug therapy. Listen first to bowel sounds and then palpate the abdomen, monitoring the client for signs of guarding or discomfort. An abdominal circumference measurement and the presence of visitors are not critical assessments prior to administration of the medication.
A client who is taking magnesium citrate experiences sweating, palpitations, and flushing. The nurse understands that this is most likely related to which of the following? Direct stimulation of the nerve plexus in the abdominal wall Detergent action on the surface of the intestinal bolus Formation of a slippery coat on the contents of the intestinal tract Sympathetic stress reaction due to intense GI tract neurostimulation
Sympathetic stress reaction due to intense GI tract neurostimulation The client's symptoms are most likely related to a sympathetic stress reaction due to intense neurostimulation of the GI tract or to the loss of fluid and electrolyte imbalance. Direct stimulation refers to the action of chemical stimulant laxatives. Detergent action is related to the use of docusate. Formation of a slippery coat relates to the use of mineral oil.
A client who is taking magnesium citrate experiences sweating, palpitations, and flushing. The nurse understands that this is most likely related to which of the following? Direct stimulation of the nerve plexus in the abdominal wall Formation of a slippery coat on the contents of the intestinal tract Detergent action on the surface of the intestinal bolus Sympathetic stress reaction due to intense GI tract neurostimulation
Sympathetic stress reaction due to intense GI tract neurostimulation The client's symptoms are most likely related to a sympathetic stress reaction due to intense neurostimulation of the GI tract or to the loss of fluid and electrolyte imbalance. Direct stimulation refers to the action of chemical stimulant laxatives. Detergent action is related to the use of docusate. Formation of a slippery coat relates to the use of mineral oil.
What assessment is most important to make before administering bismuth subsalicylate? assess for allergy to opioids assess for pain assess electrolytes assess for allergy to aspirin
assess for allergy to aspirin Bismuth salts have antibacterial and antiviral activity. Bismuth subsalicylate contains salicylate, and the client should be assessed for an aspirin allergy before administration. It is important to assess for pain and electrolyte balance, but is not the primary assessment to be made. The nurse would not need to assess for allergy to opioids because bismuth does not contain opioids.
A client presents with fever, vomiting, and diarrhea. What should the nurse suspect are possible causes? Select all that apply. irritable bowel syndrome bacterial toxin chronic pain laxative abuse virus
bacterial toxin virus Fever, vomiting, and diarrhea are frequently found in illnesses caused by ingestion of bacterial toxins or viruses. Chronic pain, laxative abuse, and irritable bowel syndrome do not have symptoms of fever or vomiting.
A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin? octreotide bismuth subsalicylate polycarbophil loperamide
bismuth subsalicylate Bismuth subsalicylate is a commonly used OTC medication for diarrhea. It has a salicylate, which is in the family of aspirin. A nurse should teach the client that use of the medication with aspirin can cause an overdose. Octreotide acetate is a synthetic form of somatostatin and is used for diarrhea as it decreases GI secretion and motility. Polycarbophil is a bulk-forming laxative. Loperamide is a synthetic derivative of meperidine that decreases GI motility by its effect on intestinal muscles.
Before administering alosetron, the nurse should ensure that the client has been made aware of what potentially severe adverse effect? diverticulosis bowel obstruction blood dyscrasias anal fissures
bowel obstruction Severe constipation, with possible obstruction, perforation, and hemorrhage, is the most common problem resulting from alosetron. None of the other options are associated with this medication.
A community health nurse is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives? fecal incontinence dependence impaired absorption of water-soluble vitamins abdominal pain
dependence Overuse of laxatives results in dependence. This is a significant problem among older adults and is more common than fecal incontinence, impaired vitamin absorption, or abdominal pain.
The nurse should educate the client prescribed a stimulant cathartic to be alert for which common adverse effect? nausea rectal bleeding diarrhea vomiting
diarrhea The stimulant cathartics are the strongest and most abused laxative products. These drugs act by irritating the GI mucosa and pulling water into the bowel lumen. As a result, feces are moved through the bowel too rapidly to allow colonic absorption of fecal water, so a watery stool is eliminated. Nausea, vomiting, and rectal bleeding should not routinely occur.
The nurse should educate the client prescribed a stimulant cathartic to be alert for which common adverse effect? vomiting nausea rectal bleeding diarrhea
diarrhea The stimulant cathartics are the strongest and most abused laxative products. These drugs act by irritating the GI mucosa and pulling water into the bowel lumen. As a result, feces are moved through the bowel too rapidly to allow colonic absorption of fecal water, so a watery stool is eliminated. Nausea, vomiting, and rectal bleeding should not routinely occur.
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 Docusate a stool softener, may be prescribed after a myocardial infarction to prevent straining during defecation. Psyllium is a bulk-forming laxative and may require straining to eliminate. Lubiprostone and lactulose are hyperosmotic agents that are used to relieve constipation and the reduction of blood ammonia levels in hepatic encephalopathy which may require straining.
The nurse should prioritize what assessment when providing care for a client who has taken over-the-counter (OTC) bisacodyl daily for several months?
electrolyte levels People should not use bisacodyl frequently or for longer than 1 week because it may produce serum electrolyte and acid-base imbalances (e.g., hypocalcemia, hypokalemia, metabolic acidosis, or alkalosis). Assessment of electrolytes would thus be warranted in the care of this client. Reflexes, heart rate, and coagulation factors may be affected, but these would be consequent to alterations in electrolyte levels.
To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the client to take the medication:
four times a day. To maximize the therapeutic effect, diphenoxylate HCl with atropine sulfate is usually administered four times daily, which serves to help maintain a therapeutic drug level.
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? intestinal neoplasm colitis hyperthyroidism functional diarrhea disorder
functional diarrhea disorder The client is describing functional diarrhea disorder where the diarrhea occurs as a result of stress or anxiety. The client does not have hyperthyroid, intestinal neoplasm, or colitis. While all of these conditions can lead to diarrhea, the client's description does not support any of these diagnoses.
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? intestinal neoplasm hyperthyroidism functional diarrhea disorder colitis
functional diarrhea disorder The client is describing functional diarrhea disorder where the diarrhea occurs as a result of stress or anxiety. The client does not have hyperthyroid, intestinal neoplasm, or colitis. While all of these conditions can lead to diarrhea, the client's description does not support any of these diagnoses.
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 Stimulant laxatives such as bisacodyl are generally useful and safe for short-term treatment of constipation, cleansing the bowel prior to endoscopic examinations, and treating fecal impaction. However, they are not safe for frequent or prolonged usage but are often used or overused in older adults.
A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed? loperamide diphenoxylate sodium bicarbonate omeprazole
loperamide Loperamide is not chemically related to opioid drugs and treats diarrhea by acting directly on the muscle wall of the bowel to slow motility. Diphenoxylate is chemically related to opioid drugs and treats diarrhea by decreasing intestinal peristalsis. Sodium bicarbonate is used to reduce stomach acid levels and should be used only temporarily. Omeprazole is a proton pump inhibitor that relives symptoms of GERD and other stomach conditions.