Nokea
A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?
- A. Emollient laxatives
- B. Bulk-forming laxatives
- C. Hyperosmotic laxatives
- D. Stimulant laxatives
Correct Answer: B
Rationale: Bulk-forming laxatives are the only laxatives recommended for long-term use. Stimulant laxatives are the most likely of all the laxative classes to cause dependence. The other options are incorrect.
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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.
A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?
- A. Bulk-forming laxative, such as psyllium
- B. Stool softener, such as docusate salts
- C. Magnesium hydroxide
- D. Magnesium oxide tablets
Correct Answer: C
Rationale: Saline laxatives such as magnesium hydroxide produce a watery stool, usually within 3 to 6 hours of ingestion. Bulk-forming laxatives such as psyllium do not produce a bowel movement rapidly. Stool softeners such as docusate salts do not cause patients to defecate; they simply soften the stool to ease its passage. Magnesium oxide tablets are used as magnesium supplements, not as laxatives.
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.
A patient has been treated with alosetron for severe irritable bowel syndrome for 2 weeks. She calls the clinic and tells the nurse that she has been experiencing constipation for 3 days. The nurse will take which action?
- A. Advise the patient to increase intake of fluids and fiber.
- B. Advise the patient to hold the drug for 2 days.
- C. Instruct the patient to stop taking the drug and to come to the clinic right away to be evaluated.
- D. Instruct the patient to continue the alosetron and to take milk of magnesia for the constipation.
Correct Answer: C
Rationale: Alosetron must be discontinued immediately if constipation or signs of ischemic colitis occur. The other options are incorrect.