Nokea
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.
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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).
Antidiarrheals are contraindicated in clients whose diarrhea is associated with which of the following organisms that can harm the intestinal mucosa?
- A. Staphylococcus
- B. Shigella
- C. Salmonella
- D. Streptococcus
- E. Escherichia coli
Correct Answer: B,C,E
Rationale: Antidiarrheals are contraindicated in clients whose diarrhea is associated with Shigella, Salmonella, and Escherichia coli, which can harm the intestinal mucosa.
A client is prescribed an antidiarrheal drug. The nurse reviews the client's medical record for possible contraindications for use. Which of the following would alert the nurse to a possible contraindication?
- A. Pseudomembranous colitis
- B. Type 1 diabetes
- C. Abdominal pain of unknown origin
- D. Liver disease
- E. Obstructive jaundice
Correct Answer: A,C,E
Rationale: Clients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice should not take antidiarrheals.
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.