Nokea
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.
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A patient will be taking bismuth subsalicylate to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication or medication class will interact significantly with this drug?
- A. Hypoglycemic drugs
- B. Antibiotics
- C. Acetaminophen
- D. Antidepressants
Correct Answer: A
Rationale: Taking hypoglycemic drugs with an adsorbent such as bismuth subsalicylate may result in decreased absorption of the hypoglycemic drugs. The other options are incorrect.
A patient will be taking bismuth subsalicylate to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with this drug?
- A. Acetaminophen, an analgesic
- B. Levothyroxine, a thyroid replacement drug
- C. Warfarin, an anticoagulant
- D. Fluoxetine, an antidepressant
Correct Answer: C
Rationale: The oral anticoagulant warfarin is more likely to cause increased bleeding times or bruising when co-administered with adsorbents. This is thought to be because the adsorbents bind to vitamin K, which is needed to make certain clotting factors. Vitamin K is synthesized by the normal bacterial flora in the bowel. The other options are incorrect.
The nurse is discussing the use of adsorbents such as bismuth subsalicylate with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?
- A. Dark stools and blue gums
- B. Urinary hesitancy
- C. Drowsiness and dizziness
- D. Blurred vision and headache
Correct Answer: A
Rationale: Dark stools and blue gums are two of the possible adverse effects of bismuth subsalicylate. The other adverse effects listed may occur with the use of other antidiarrheal drugs.
A patient is taking linaclotide to treat irritable bowel syndrome (IBS). The nurse will monitor this patient for which adverse effect?
- A. Chest pain
- B. Chronic constipation
- C. Abdominal pain
- D. Elevated blood glucose levels
Correct Answer: C
Rationale: Common adverse effects of linaclotide (Linzess) are diarrhea, abdominal pain, and flatulence. Elevated blood glucose levels, chest pain, and chronic constipation are not adverse effects of linaclotide.
When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?
- A. The water acts to stimulate bowel movements.
- B. The water will help to reduce the bulk of the intestinal contents.
- C. These laxatives may cause esophageal obstruction if taken with insufficient water.
- D. The water acts as a lubricant to produce bowel movements.
Correct Answer: C
Rationale: Bulk-forming drugs increase water absorption, which results in greater total volume (bulk) of the intestinal contents. Bulk-forming laxatives tend to produce normal, formed stools. Their action is limited to the gastrointestinal tract, so there are few, if any, systemic effects. However, they need to be taken with liberal amounts of water to prevent esophageal obstruction and/or fecal impaction.