Nokea
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.
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Which of the following drugs used to manage lower gastrointestinal disorders increase the risk of bleeding when administered to clients taking warfarin (Coumadin)?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Psyllium (Metamucil)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), can increase the risk of bleeding in clients taking warfarin (Coumadin).
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 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.
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.
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.