Nokea
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.
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Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis?
- A. Sennosides (Senokot)
- B. Methylcellulose (Citrucel)
- C. Glycerin (Fleet Babylax)
- D. Bisacodyl (Dulcolax)
- E. Lactulose (Chronulac)
Correct Answer: A,D
Rationale: Irritant or stimulant laxatives, like sennosides (Senokot) and bisacodyl (Dulcolax), produce their laxative effect by direct action on the intestine to increase peristalsis. Methylcellulose is a bulk-forming laxative. Glycerin and lactulose are hyperosmolar drugs.
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.
During a routine clinic visit, a client tells the nurse that he is taking an over-the-counter antidiarrheal agent for treatment of diarrhea. The nurse reviews the drug information with the client. Afterward, the nurse determines that the teaching was successful when the client states that he will contact his primary health care provider if the diarrhea is not resolved within which time frame?
- A. 24 hours
- B. 48 hours
- C. 72 hours
- D. 96 hours
Correct Answer: B
Rationale: If diarrhea persists for more than 2 days when over-the-counter (OTC) antidiarrheal drugs are being used, the client should discontinue use and seek treatment from the primary health care provider.
A nurse is preparing to administer sulfasalazine (Azulfidine) to a client with inflammatory bowel disease. The nurse checks the clients medical record for a history of hypersensitivities, understanding that the drug should not be administered to a client with hypersensitivity to which of the following drugs?
- A. Enalapril (Vasotec)
- B. Doxycycline (Vibramycin)
- C. Azithromycin (Zithromax)
- D. Sulfamethoxazole/trimethoprim (Bactrim)
Correct Answer: D
Rationale: Sulfasalazine (Azulfidine) is an aminosalicylate. The use of aminosalicylates is contraindicated in clients with hypersensitivity to sulfonamides and sulfites, which includes sulfamethoxazole/trimethoprim (Bactrim).
When reviewing a client's history, a nurse determines that the use of laxatives would be contraindicated if the client has a history of which of the following?
- A. Chronic hepatitis
- B. Type 1 diabetes
- C. Acute appendicitis
- D. Intestinal obstruction
- E. Fecal impaction
Correct Answer: C,D,E
Rationale: Laxatives are contraindicated in clients with known hypersensitivity and those with persistent abdominal pain, nausea, vomiting, or pain of unknown cause or signs of acute appendicitis, fecal impaction, intestinal obstruction, or acute hepatitis.