Nokea
A client is prescribed a laxative. Which of the following would the nurse include in the teaching plan for the client about possible adverse reactions?
- A. Nausea
- B. Perianal irritation
- C. Bloating
- D. Constipation
- E. Cramps
Correct Answer: A,B,C,E
Rationale: Laxatives may cause diarrhea, loss of water and electrolytes, abdominal pain or discomfort, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps, and weakness.
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A nurse would most likely expect a primary health care provider to prescribe psyllium (Metamucil) to a client who is experiencing constipation related to which drug?
- A. Spironolactone (Aldactone)
- B. Clonidine (Catapres)
- C. Enalapril (Vasotec)
- D. Fexofenadine (Allegra)
- E. Amitriptyline (Elavil)
Correct Answer: A,B,D,E
Rationale: The following drugs may cause constipation in clients and require the use of a laxative to relieve constipation: anticholinergics, antihistamines (fexofenadine), phenothiazines, tricyclic antidepressants (amitriptyline), opioids, non-potassium-sparing diuretics (spironolactone), iron preparations, barium, clonidine, and calcium- or aluminum-containing antacids.
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.
When describing the drugs used as treatment for clients with ulcerative colitis to a group of nursing students, the instructor discusses aspirin-like compounds with anti-inflammatory properties. Which of the following would the instructor most likely include?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Magnesium oxide (Mag-Ox)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), are aspirin-like compounds with anti-inflammatory properties used in the treatment of clients with ulcerative colitis.
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.
A physician has prescribed difenoxin with atropine to a client with acute diarrhea. The client informs the nurse that he is also taking MAOI antidepressants. The nurse would assess the client for which of the following that might result from the interaction of the two drugs?
- A. Decreased effect of difenoxin
- B. Increased risk of hypertensive crisis
- C. Increased cholinergic blocking adverse reactions
- D. Increased risk of CNS depression
Correct Answer: B
Rationale: The nurse should monitor the client for an increased risk of hypertensive crisis as an effect of the interaction between difenoxin with atropine and MAOI antidepressants. When the client is administered antihistamines, opioids, sedatives, or hypnotics with antidiarrheal drugs, there will be increased risk of CNS depression. When the client is administered antihistamines and general antidepressants with antidiarrheal drugs, there will be increased cholinergic blocking adverse reactions. There will not be a decreased effect of difenoxin when there is an interaction between difenoxin and MAOI antidepressants.