Nokea
A nurse is caring for a client with constipation. The physician prescribes cascara sagrada to the client. Which of the following effects should the nurse monitor for in the client after administration of the drug?
- A. Sudden increase in weight
- B. Brownish discoloration of urine
- C. Reduced sperm count
- D. Abdominal pain and cramping
Correct Answer: B
Rationale: The nurse should monitor for pink-red, red-violet, red-brown, yellow-brown, or black discoloration of urine after administration of cascara sagrada to the client. Reduced sperm count is the adverse effect of sulfasalazine. Abdominal pain and cramping are the adverse effects of olsalazine. Cascara sagrada does not cause a sudden increase in the weight of the client.
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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.
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 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 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.
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.