Nurs 125- Chapter 58: Drugs Affecting Gastrointestinal Motility

The nurse is about to administer a laxative to a client for the first time. What should be included in client education?

"It is not uncommon to experience some abdominal discomfort and flatulence."

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

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?

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

What is first-line therapy for infants and children 1 to 4 years of age with diarrhea?

Electrolyte replacement

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?

Excision of the small intestine

An older adult client has received a third dose of diphenoxylate. In addition to monitoring the number and consistency of the client's stools, the nurse should prioritize what assessment?

Fluid and electrolyte balance

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.

The nurse is preparing to administer cascara to a client. The nurse anticipates administering this drug by which route?

Oral

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, Suppository

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

After describing the drugs used to treat irritable bowel syndrome, the students demonstrate understanding of the information when they identify alosetron as which of the following?

Serotonin antagonist

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

The nurse is caring for a client who has developed severe diarrhea a few days after beginning an antibiotic prescribed for a severe respiratory infection. The nurse is prepared to initiate what initial treatment?

Stopping the causative drug

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?

Sympathetic stress reaction due to intense GI tract neurostimulation

An adult client asks the nurse how many stools per week is considered "normal." The nurse should indicate that there is no fixed number but that functional constipation is diagnosed at what frequency?

Three stools per week

A client is taking psyllium hydrophilic mucilloid daily. What information should be included in the discharge plan?

Up to 30 g of fluid with the medication can be divided over several divided doses daily.

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?

Used for E. coli infections.

In what client circumstance would the use of a bulk-forming laxative be contraindicated?

acute abdominal pain

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?

aspirin allergy

A client presents with fever, vomiting, and diarrhea. What should the nurse suspects are possible causes? Select all that apply.

bacterial toxin, viral infection

A client diagnosed with hemorrhoids reports intense pain when straining to pass stools. What type of agent would the nurse expect to be the first choice for this client?

stool softener

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."

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.

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?

10:00 AM to 10:30 AM

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?

2

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

A client was prescribed a cathartic laxative prior to scheduled sigmoidoscopy. The nurse should inform the client that it will take how long to experience another bowel movement?

2 to 3 days

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 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.

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

What recommendations should be included in client teaching as a means of avoiding constipation? (Select all that apply.)

Be active and exercise daily., Drink plenty of fluids., Eat foods high in bulk or roughage.

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?

Call the prescriber about the laboratory tests.

A client is prescribed loperamide for diarrhea. Loperamide can be used for which type of diarrhea?

Chronic diarrhea

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

Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action?

Decreasing intestinal motility

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?

Dependence

The nurse should educate the client prescribed a stimulant cathartic to be alert for which common adverse effect?

Diarrhea

A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching?

Drink at least 8 ounces of fluid with the medication.

When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?

E. coli

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

A nurse is completing an assessment on a client experiencing diarrhea. The client states having diarrhea for the past few days, but prior to the diarrhea experienced one week of constipation. Based on the description, what does the nurse suspect?

Irritable bowel syndrome

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)

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 is useful in critically ill patients who experience constipation.

The nurse should know that lactulose achieves a therapeutic effect by which means?

Pulling water into the intestinal lumen by osmotic pressure

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.

A group of students are reviewing information about the indications for laxatives. The students demonstrate understanding of the information when they identify which as an indication?

Remove ingested poisons from the lower GI tract.

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 have a bowel movement after taking the drug.

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?

bulimia with laxative abuse

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?

dark stool

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 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

The health care provider has recommended that an older adult client take a psyllium laxative. When providing client teaching, what potential effects should the nurse explain? Select all that apply.

gas, bloating

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

A hospitalized client requests a magnesium citrate "bisacodyl pill" every night to "stay regular."The nurse should initially be most concerned about what potential health risk for this client?

laxative abuse

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