Nokea
A client's history reveals that the client is experiencing intestinal gas. Which of the following would the nurse expect the primary health care provider to prescribe?
- A. Charcoal (Flatulex)
- B. Omeprazole (Prilosec)
- C. Ranitidine (Zantac)
- D. Odansetron (Zofran)
- E. Simethicone (Mylicon)
Correct Answer: A,E
Rationale: Charcoal (Flatulex) and simethicone (Mylicon) are antiflatulents used to help relieve gas in the intestinal tract of a client. Omeprazole and ranitidine are used to treat hyperacidity disorders. Odansetron is used to treat nausea and vomiting.
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A physician has prescribed simethicone to a client with postoperative abdominal distention. After administering the drug, the nurse would assess the client for the possibility of which of the following?
- A. Heartburn
- B. Vomiting
- C. Fainting
- D. Nausea
Correct Answer: A
Rationale: The nurse should monitor for heartburn, bloating, constipation, and diarrhea in the client after administering simethicone. Vomiting, fainting, and nausea are adverse reactions to methylcellulose, which is administered for the relief of constipation.
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.
The nurse is preparing to administer a laxative that adds bulk and water to the contents of the intestines, thereby stimulating intestinal peristalsis. Which of the following would the nurse be likely to administer?
- A. Docusate (Colace)
- B. Methylcellulose (Citrucel)
- C. Polycarbophil (FiberCon)
- D. Bisacodyl (Docusate)
- E. Lactulose (Chronulac)
Correct Answer: B,C
Rationale: Bulk-producing laxatives, like methylcellulose (Citrucel) and polycarbophil (FiberCon), produce their laxative effect by adding bulk and water to the contents of the intestines, thereby stimulating intestinal peristalsis. Docusate is a stool softener. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmotic agent.
A nurse is caring for a client receiving bismuth subsalicylate for the relief of diarrhea. Which of the following interventions should the nurse perform to promote an optimal response to the prescribed drug therapy?
- A. Thoroughly mix and stir the drug before administering.
- B. Administer the drug after each loose bowel movement.
- C. Ensure the client receives adequate sunlight.
- D. Encourage the client to lightly exercise on a daily basis.
Correct Answer: B
Rationale: The nurse should administer the drug after each loose bowel movement to promote an optimal response to the prescribed drug therapy in the client with diarrhea. The nurse should inspect each bowel movement before making a decision to administer the drug. Laxatives that are in powder, flake, or granule form are mixed and stirred before being administered to the client with constipation. The nurse need not ensure that the client receives adequate sunlight or encourage the client to lightly exercise on a daily basis as these interventions will not help in promoting an optimal response to the prescribed drug therapy.
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.