Nokea
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).
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A client is prescribed a laxative. Which of the following would the nurse include in the teaching plan for the client about possible adverse reactions?
- A. Nausea
- B. Perianal irritation
- C. Bloating
- D. Constipation
- E. Cramps
Correct Answer: A,B,C,E
Rationale: Laxatives may cause diarrhea, loss of water and electrolytes, abdominal pain or discomfort, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps, and weakness.
The nurse is caring for a client who is prescribed mesalamine. The client is also taking warfarin. Which of the following interactions should the nurse monitor the client for when he is administered mesalamine with warfarin?
- A. Increased risk of immunosuppression
- B. Increased blood glucose level
- C. Increased risk of bleeding
- D. Increased risk of CNS depression
Correct Answer: C
Rationale: The client administered mesalamine and warfarin is at an increased risk of bleeding. Warfarin is an anticoagulant used as a blood thinner; mesalamine is an aminosalicylate, which is an aspirin-like compound with anti-inflammatory action. The combination of mesalamine and warfarin does not increase the risk of immunosuppression, increase the blood glucose level, or increase the risk of CNS depression. There is an increased risk of immunosuppression if an aminosalicylate interacts with methotrexate used in cancer and autoimmune conditions. There is an increased blood glucose level when oral hypoglycemic drugs interact with aminosalicylates. There is an increased risk of CNS depression when opioids are administered with aminosalicylates.
After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students identify which drug as producing the laxative effect by promoting water retention in the fecal mass and softening the stool?
- A. Docusate sodium (Colace)
- B. Methylcellulose (Citrucel)
- C. Bisacodyl (Dulcolax)
- D. Lactulose (Chronulac)
Correct Answer: A
Rationale: Stool softeners, like docusate sodium (Colace) and docusate calcium (Surfak), produce their laxative effect by promoting water retention in the fecal mass and softening the stool. Methylcellulose is a bulk-producing laxative. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmolar laxative.
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.
The nurse is reviewing a client's history and finds that the client uses a laxative that produces its effects by dehydrating local tissues, which causes irritation and increased peristalsis, with consequent evacuation of the fecal mass. Which of the following would this be?
- A. Docusate sodium (Colace)
- B. Methylcellulose (Citrucel)
- C. Glycerin (Fleet Babylax)
- D. Bisacodyl (Dulcolax)
- E. Lactulose (Chronulac)
Correct Answer: C,E
Rationale: Hyperosmotic agents, like glycerin (Fleet Babylax) and lactulose (Chronulac), produce their laxative effect by dehydrating local tissues, which causes irritation and increased peristalsis, with consequent evacuation of the fecal mass. Docusate is a stool softener. Methylcellulose is a bulk-forming laxative. Bisacodyl is an irritant laxative.