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A physician has prescribed bisacodyl to a client with constipation. The client complains of epigastric pain and a burning sensation after taking the drug. Which of the following instructions should the nurse provide to the client?
- A. Immediately stop taking the drug.
- B. Take antacids between meals.
- C. Take the drug in powdered form.
- D. Avoid milk before taking the drug.
Correct Answer: D
Rationale: The nurse should instruct the client to avoid milk, antacids, H2 antagonists, and proton pump inhibitors 1 to 2 hours before taking the bisacodyl tablets because the enteric coating may dissolve early before reaching the intestinal tract, resulting in gastric lining irritation or dyspepsia and decreasing the laxative effect of the drug. The nurse need not instruct the client to immediately stop taking the drug, take the drug in powdered form, or take antacids between meals as these interventions will not help in preventing gastric lining irritation.
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A nurse is caring for a client with irritable bowel syndrome. The physician has prescribed polycarbophil to the client. The nurse would administer this drug cautiously if the client's history revealed which of the following?
- A. Abdominal pain
- B. Pseudomembranous colitis
- C. Rectal bleeding
- D. Intestinal obstruction
Correct Answer: C
Rationale: The nurse should administer polycarbophil with caution in clients with rectal bleeding, in pregnant women, and during lactation. Antidiarrheals are contraindicated in clients with abdominal pain and pseudomembranous colitis. Aminosalicylates are contraindicated in clients with intestinal obstruction.
Antidiarrheals are contraindicated in clients whose diarrhea is associated with which of the following organisms that can harm the intestinal mucosa?
- A. Staphylococcus
- B. Shigella
- C. Salmonella
- D. Streptococcus
- E. Escherichia coli
Correct Answer: B,C,E
Rationale: Antidiarrheals are contraindicated in clients whose diarrhea is associated with Shigella, Salmonella, and Escherichia coli, which can harm the intestinal mucosa.
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.
A client is prescribed an antidiarrheal drug. The nurse reviews the client's medical record for possible contraindications for use. Which of the following would alert the nurse to a possible contraindication?
- A. Pseudomembranous colitis
- B. Type 1 diabetes
- C. Abdominal pain of unknown origin
- D. Liver disease
- E. Obstructive jaundice
Correct Answer: A,C,E
Rationale: Clients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice should not take antidiarrheals.
A nurse educating a client on balsalazide (Colazal) should advise the client about possible adverse reactions not involving the gastrointestinal tract. Which of the following would the nurse include in the teaching plan?
- A. Alopecia
- B. Headache
- C. Fever
- D. Tremors
- E. Bone pain
Correct Answer: B,C
Rationale: Balsalazide (Colazal) is an aminosalicylate. Nongastrointestinal adverse effects of aminosalicylates include headache, dizziness, fever, and weakness.