Bowel Disorder Drugs Flashcards
The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?
a. Fecal impaction
b. Electrolyte imbalances
c. Lipid pneumonia
d. Esophageal blockage
ANS: C
Lipid pneumonia may occur if the oral mineral oil is accidentally aspirated into the respiratory tract. The other options are incorrect.
When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?
a. The water acts to stimulate bowel movements.
b. The water will help to reduce the bulk of the intestinal contents.
c. These laxatives may cause esophageal obstruction if taken with insufficient water.
d. The water acts as a lubricant to produce bowel movements.
ANS: C
Bulk-forming drugs increase water absorption, which results in greater total volume (bulk) of the intestinal contents. Bulk-forming laxatives tend to produce normal, formed stools. Their action is limited to the gastrointestinal tract, so there are few, if any, systemic effects. However, they need to be taken with liberal amounts of water to prevent esophageal obstruction and/or fecal impaction.
A patient will be taking bismuth subsalicylate to control diarrhea. When reviewing the patient‘s other ordered medications, the nurse recognizes that which medication or medication class will interact significantly with this drug?
a. Hypoglycemic drugs
b. Antibiotics
c. Acetaminophen
d. Antidepressants
ANS: A
Taking hypoglycemic drugs with an adsorbent such as bismuth subsalicylate may result in decreased absorption of the hypoglycemic drugs. The other options are incorrect.
A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?
a. Docusate sodium
b. Lactulose
c. Mineral oil
d. Polyethylene glycol 3350
ANS: D
Polyethylene glycol is a very potent laxative that induces total cleansing of the bowel and is most commonly used before diagnostic or surgical bowel procedures. The other options are incorrect
While recovering from surgery, an elderly woman started taking a stimulant laxative, senna, to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she likes how ―regular‖ her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?
a. She needs to be sure to take this medication with plenty of fluids.
b. It is important to have a daily bowel movement to promote bowel health.
c. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
d. She needs to switch to glycerin suppositories to continue having daily bowel movements.
ANS: C
Long-term use of laxatives may lead to dependency. Patients need to be taught that daily bowel movements are not necessary for bowel health
A patient asks the nurse about the difference between diphenoxylate with atropine and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?
a. ―Lomotil acts faster than Imodium.‖
b. ―Imodium does not cause physical dependence.‖
c. ―Lomotil is available in suppository form.‖
d. ―Imodium is a natural antidiarrheal drug.‖
ANS: B
Although the drug exhibits many characteristics of the opiate class, physical dependence on loperamide has not been reported. All antidiarrheal drugs are orally administered. The other options are incorrect
A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?
a. Emollient laxatives
b. Bulk-forming laxatives
c. Hyperosmotic laxatives
d. Stimulant laxatives
ANS: B
Bulk-forming laxatives are the only laxatives recommended for a long-term use. Stimulant laxatives are the most likely of all the laxative classes to cause dependence. The other options are incorrect.
When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?
a. Fat-soluble vitamins
b. Water-soluble vitamins
c. Minerals
d. Electrolytes
ANS: A
Mineral oil can decrease the absorption of fat-soluble vitamins (A, D, E, and K). The other options are incorrect
The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
a. Adsorbents
b. Anticholinergics
c. Probiotics
d. Lubricants
ANS: B
Anticholinergic drugs work to slow peristalsis by reducing the rhythmic contractions and the smooth muscle tone of the gastrointestinal tract. The other options are incorrect.
The nurse is discussing the use of adsorbents such as bismuth subsalicylate with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?
a. Dark stools and blue gums
b. Urinary hesitancy
c. Drowsiness and dizziness
d. Blurred vision and headache
ANS: A
Dark stools and blue gums are two of the possible adverse effects of bismuth subsalicylate (see Table 51-2). The other adverse effects listed may occur with the use of other antidiarrheal drugs
A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication class to be ordered to treat this diarrhea?
a. Lubricants
b. Adsorbents
c. Anticholinergics
d. Probiotics
ANS: D
Probiotics work by replenishing bacteria that may have been destroyed by antibiotic therapy, thus restoring the balance of normal flora and suppressing the growth of diarrhea-causing bacteria
A patient will be taking bismuth subsalicylate to control diarrhea. When reviewing the patient‘s other ordered medications, the nurse recognizes that which medication will interact significantly with this drug?
a. Acetaminophen, an analgesic
b. Levothyroxine, a thyroid replacement drug
c. Warfarin, an anticoagulant
d. Fluoxetine, an antidepressan
ANS: C
The oral anticoagulant warfarin is more likely to cause increased bleeding times or bruising when co-administered with adsorbents. This is thought to be because the adsorbents bind to vitamin K, which is needed to make certain clotting factors. Vitamin K is synthesized by the normal bacterial flora in the bowel. The other options are incorrect.
A laxative has been ordered for a patient. The nurse checks the patient‘s medical history and would be concerned if which condition is present?
a. High ammonia levels due to liver failure
b. Diverticulosis
c. Abdominal pain of unknown origin
d. Chronic constipation
ANS: C
All categories of laxatives share the same general contraindications and precautions, includingavoidance in cases of drug allergy and the need for cautious use in the presence of these: acute surgical abdomen; appendicitis symptoms such as abdominal pain, nausea, and vomiting; fecal impaction (mineral oil enemas excepted); intestinal obstruction; and undiagnosed abdominal pain. The other options are possible indications for laxatives.
A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?
a. Bulk-forming laxative, such as psyllium
b. Stool softener, such as docusate salts
c. Magnesium hydroxide
d. Magnesium oxide tablets
ANS: C
Saline laxatives such as magnesium hydroxide produce a watery stool, usually within 3 to 6 hours of ingestion. Bulk-forming laxatives such as psyllium do not produce a bowel movement rapidly. Stool softeners such as docusate salts do not cause patients to defecate; they simply soften the stool to ease its passage. Magnesium oxide tablets are used as magnesium supplements, not as laxatives.
A patient is receiving lactulose three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?
a. High ammonia levels due to liver failure
b. Prevention of constipation
c. Chronic renal failure
d. Chronic diarrhea
ANS: A
Lactulose produces a laxative effect but also works to reduce blood ammonia levels by converting ammonia to ammonium. Ammonium is a water-soluble cation that is trapped in the intestines and cannot be reabsorbed into the systemic circulation. This effect has proved helpful in reducing elevated serum ammonia levels in patients with severe liver disease. The other options are incorrect.
