Nokea
A client has been diagnosed with ulcerative colitis. The physician has prescribed sulfasalazine to the client. Based on the nurse's understanding of this condition, the nurse would monitor the client for which of the following?
- A. Mild symptoms of contact dermatitis
- B. Abdominal pain and distention
- C. Severe blood- and mucus-filled diarrhea
- D. Frequent loose or watery stools
Correct Answer: C
Rationale: The nurse should monitor for severe blood- and mucus-filled diarrhea in the client with ulcerative colitis. Pain and fatigue also accompany this disorder. Abdominal pain and distention are clinical manifestations of Crohn's disease. When clients are hypersensitive to ragweed, asters, and chrysanthemums are administered the chamomile herb, mild symptoms of contact dermatitis are observed. Frequent loose or watery stools are not associated with ulcerative colitis.
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A client is prescribed diphenoxylate. The nurse informs the client that he may experience which of the following effects?
- A. Euphoric effects
- B. Analgesic effects
- C. Anti-inflammatory effects
- D. Sedative effects
- E. Slowed GI effects
Correct Answer: A,D,E
Rationale: Because diphenoxylate (Lomotil) is opioid related, it may have sedative, slowed GI, and euphoric effects but no analgesic or anti-inflammatory activity.
Antidiarrheals are contraindicated in clients whose diarrhea is associated with which of the following organisms that can harm the intestinal mucosa?
- A. Staphylococcus
- B. Shigella
- C. Salmonella
- D. Streptococcus
- E. Escherichia coli
Correct Answer: B,C,E
Rationale: Antidiarrheals are contraindicated in clients whose diarrhea is associated with Shigella, Salmonella, and Escherichia coli, which can harm the intestinal mucosa.
The nurse is caring for a client who is prescribed mesalamine. The client is also taking warfarin. Which of the following interactions should the nurse monitor the client for when he is administered mesalamine with warfarin?
- A. Increased risk of immunosuppression
- B. Increased blood glucose level
- C. Increased risk of bleeding
- D. Increased risk of CNS depression
Correct Answer: C
Rationale: The client administered mesalamine and warfarin is at an increased risk of bleeding. Warfarin is an anticoagulant used as a blood thinner; mesalamine is an aminosalicylate, which is an aspirin-like compound with anti-inflammatory action. The combination of mesalamine and warfarin does not increase the risk of immunosuppression, increase the blood glucose level, or increase the risk of CNS depression. There is an increased risk of immunosuppression if an aminosalicylate interacts with methotrexate used in cancer and autoimmune conditions. There is an increased blood glucose level when oral hypoglycemic drugs interact with aminosalicylates. There is an increased risk of CNS depression when opioids are administered with aminosalicylates.
A nurse is caring for a client with irritable bowel syndrome. The physician has prescribed polycarbophil to the client. The nurse would administer this drug cautiously if the client's history revealed which of the following?
- A. Abdominal pain
- B. Pseudomembranous colitis
- C. Rectal bleeding
- D. Intestinal obstruction
Correct Answer: C
Rationale: The nurse should administer polycarbophil with caution in clients with rectal bleeding, in pregnant women, and during lactation. Antidiarrheals are contraindicated in clients with abdominal pain and pseudomembranous colitis. Aminosalicylates are contraindicated in clients with intestinal obstruction.
A nurse is caring for a client with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the client shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction?
- A. Administer the drug with adequate fluid intake
- B. Give mineral oil to the client after meals.
- C. Administer the drug after chilling it
- D. Provide foods high in bulk or roughage.
Correct Answer: A
Rationale: The nurse should administer the drug with adequate fluid intake to avoid obstruction of the esophagus, stomach, small intestine, and colon in a client with intestinal stenosis. Mineral oil is given to the client 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 client receiving laxatives. The nurse administers a laxative with an unpleasant or salty taste after chilling it to disguise its taste.