Nokea
A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?
- A. Docusate sodium
- B. Lactulose
- C. Mineral oil
- D. Polyethylene glycol 3350
Correct Answer: D
Rationale: Polyethylene glycol is a very potent laxative that induces total cleansing of the bowel and is most commonly used before diagnostic or surgical bowel procedures. The other options are incorrect.
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A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication class to be ordered to treat this diarrhea?
- A. Lubricants
- B. Adsorbents
- C. Anticholinergics
- D. Probiotics
Correct Answer: D
Rationale: Probiotics work by replenishing bacteria that may have been destroyed by antibiotic therapy, thus restoring the balance of normal flora and suppressing the growth of diarrhea-causing bacteria.
The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
- A. Adsorbents
- B. Anticholinergics
- C. Probiotics
- D. Lubricants
Correct Answer: B
Rationale: Anticholinergic drugs work to slow peristalsis by reducing the rhythmic contractions and the smooth muscle tone of the gastrointestinal tract. The other options are incorrect.
The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? (Select all that apply.)
- A. Irritable bowel syndrome
- B. Undiagnosed abdominal pain
- C. Nausea and vomiting
- D. Fecal impaction
- E. Ingestion of toxic substances
- F. Acute surgical abdomen
Correct Answer: B,C,D,F
Rationale: Cautious use of laxatives is recommended in the presence of these: acute surgical abdomen; appendicitis symptoms, such as abdominal pain, nausea, and vomiting; intestinal obstruction; and undiagnosed abdominal pain. Oral laxatives must not be used with fecal impaction; mineral oil enemas are indicated for fecal impaction. The other options are indications for other laxative use.
A patient asks the nurse about the difference between diphenoxylate with atropine and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?
- A. Lomotil acts faster than Imodium.
- B. Imodium does not cause physical dependence.
- C. Lomotil is available in suppository form.
- D. Imodium is a natural antidiarrheal drug.
Correct Answer: B
Rationale: Although the drug exhibits many characteristics of the opiate class, physical dependence on loperamide has not been reported. All antidiarrheal drugs are orally administered. The other options are incorrect.
While recovering from surgery, an elderly woman started taking a stimulant laxative, senna, to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she likes how 'regular her bowel movements are now that she is taking the laxative.' Which teaching principle is appropriate for this patient?
- A. She needs to be sure to take this medication with plenty of fluids.
- B. It is important to have a daily bowel movement to promote bowel health.
- C. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
- D. She needs to switch to glycerin suppositories to continue having daily bowel movements.
Correct Answer: C
Rationale: Long-term use of laxatives may lead to dependency. Patients need to be taught that daily bowel movements are not necessary for bowel health.