Laxatives

PO laxatives usually work overnight, when would you expect suppositories to take effect? - 4 hrs - 10 min - also overnight - 1 hr

1 hr

Patient assessment important for bowel motility drugs (Select all that apply): - Abdominal assessment - GI symptoms - Heart auscultation - Fluid/electrolyte status: labs, turgor, I/O - Stools

Abdominal assessment GI symptoms Fluid.electrolyte status: labs, turgor, I/O Stools

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? -Lack of urge to defecate -Abdominal pain and fever -Lack of bowel movement for 5 days -Frequent episodes of flatulence

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.)

A 29-year-old woman has been prescribed hyoscamine for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the client about which adverse effect(s)? -Constipation -Breathlessness and hypotension -Hyperthyroidism -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.)

The nurse is aware that critically ill clients are more at risk for constipation for what reasons? (Select all that apply.) -Decreased activity -Decrease in the amount of family interaction -ncreased access to a high-fiber diet -Use of opioid medications -Change in bowel routines

Decreased activity Use of opioid medications Change in bowel routines (Critically ill clients are more at risk for constipation because of decreased activity, decreased access to a high-fiber diet, the use of opioid medications, and changes in usual bowel routines.)

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? -Docusate (Colace) -Milk of magnesia -Bisacodyl (Dulcolax) -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 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.)

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 -Flatulence -Disorientation -Tremors

Nausea (Adverse effects of loperamide are few and generally mild, but they include nausea, abdominal pain, constipation, drowsiness, sedation, and vomiting.)

The nurse should advise clients taking laxatives of which of the following adverse effects? Select all that apply: -Nausea -Perianal irritation -Bloating -Constipation -Cramps

Nausea Perianal irritation Bloating Cramps (Laxatives may cause diarrhea, loss of water and electrolytes, abdominal pain or discomfort, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps and weakness. The nurse should advise clients taking laxatives of the possible adverse effects.)

A client is scheduled for a colonoscopy in the morning. What laxative would the nurse expect to be prescribed the evening before the procedure? -Psyllium -Polyethylene glycol-electrolyte solution -Castor oil -Lactulose

Polyethylene glycol-electrolyte solution (Saline or stimulant cathartics are acceptable as used for occasional bowel preparations for endoscopic or radiologic examinations.)

Which is an important assessment for the nurse to make before administering a laxative? -Once a medication is ordered by the health care provider, it is unnecessary to make any additional assessments before administering the medication. -An abdominal circumference measurement is an important assessment for the nurse to make in order to evaluate medication effectiveness. -It is imperative to ask clients whether they are expecting any visitors because the effects of the medication may hinder visitation. -Question the client regarding the type and intensity of symptoms to provide a baseline evaluation.

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.)

According to the slides the laxative okay for pregnancy & lactation is: - lactulose - senna - bisacodyl - polyethylene glycol

bisacodyl

Common s/e for laxatives (select all that apply): - cramping - diaphoresis - nausea - nephrotoxicity - diarrhea

cramping nausea diarrhea

The nurse is preparing to administer a stimulant cathartic to the client. The nurse should inform the client of the possible adverse effect of: -nausea. -vomiting. -diarrhea. -rectal bleeding.

diarrhea. (Diarrhea may result due to the action of strong, stimulant cathartics. A stimulant cathartic would not cause nausea, vomiting, or rectal bleeding.)

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 -psyllium -lubiprostone -lactulose

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.)

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.)

A client is scheduled for a colonoscopy in the morning. The nurse will provide information concerning which laxative? -psyllium -polyethylene glycol-electrolyte solution -castor oil -lactulose

polyethylene glycol-electrolyte solution (Polyethylene glycol-electrolyte solution is a nonabsorbable oral solution that induces diarrhea within 30 to 60 minutes and rapidly evacuates the bowel, usually within 4 hours for a colonoscopy. Psyllium is not strong enough for a colonoscopy preparation. Castor oil is not the most commonly prescribed preparation for a colonoscopy. Lactulose is used only when the serum ammonium level is elevated.)

These two laxatives are ok for the kiddos over 2 years of age (select all that apply): - senna - docusate - bisacodyl - polyethylene glycol

senna bisacodyl