Nokea
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.
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Which of the following drugs used to manage lower gastrointestinal disorders increase the risk of bleeding when administered to clients taking warfarin (Coumadin)?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Psyllium (Metamucil)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), can increase the risk of bleeding in clients taking warfarin (Coumadin).
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 educating a client on balsalazide (Colazal) should advise the client about possible adverse reactions not involving the gastrointestinal tract. Which of the following would the nurse include in the teaching plan?
- A. Alopecia
- B. Headache
- C. Fever
- D. Tremors
- E. Bone pain
Correct Answer: B,C
Rationale: Balsalazide (Colazal) is an aminosalicylate. Nongastrointestinal adverse effects of aminosalicylates include headache, dizziness, fever, and weakness.
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 nurse is caring for a client with pseudomembranous colitis. The physician has prescribed loperamide. Which of the following would the nurse identify as indicative of effectiveness?
- A. Elevation in temperature is noted.
- B. Rectal bleeding is noted.
- C. Diarrhea is resolved.
- D. Nausea and vomiting are resolved.
Correct Answer: C
Rationale: Loperamide is an antidiarrheal medication. The nurse will know that the medication is effective if the diarrhea is resolved in the client. The nurse should monitor the client for an elevation in body temperature, severe abdominal pain, abdominal rigidity, or distention because these are the indicators of intestinal perforation. The nurse should monitor for rectal bleeding when laxatives are administered.