Nokea
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.
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A client is receiving a bowel evacuant in preparation for a colonoscopy. The client tells the nurse that he has been 'going to the bathroom about every 30 to 45 minutes' since he started taking the drug and his stools are 'like water.' He reports that he is thirsty and his mouth feels dry. Which nursing diagnosis would the nurse most likely identify?
- A. Risk for Infection
- B. Risk for Injury
- C. Risk for Imbalanced Fluid Volume
- D. Deficient Knowledge
Correct Answer: C
Rationale: The client's report of frequent stools, which is a result of the drug therapy, along with complaints of feeling thirsty and dry mouth suggest the nursing diagnosis of Risk for Imbalanced Fluid Volume due to the large losses of fluid from the body from the drug. There is no evidence to support a risk for infection or deficient knowledge. Risk for Injury would be appropriate if the client was experiencing drowsiness or dizziness in conjunction with the fluid losses.
After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students identify which drug as producing the laxative effect by promoting water retention in the fecal mass and softening the stool?
- A. Docusate sodium (Colace)
- B. Methylcellulose (Citrucel)
- C. Bisacodyl (Dulcolax)
- D. Lactulose (Chronulac)
Correct Answer: A
Rationale: Stool softeners, like docusate sodium (Colace) and docusate calcium (Surfak), produce their laxative effect by promoting water retention in the fecal mass and softening the stool. Methylcellulose is a bulk-producing laxative. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmolar laxative.
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.
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.
A client is prescribed a laxative. Which of the following would the nurse include in the teaching plan for the client about possible adverse reactions?
- A. Nausea
- B. Perianal irritation
- C. Bloating
- D. Constipation
- E. Cramps
Correct Answer: A,B,C,E
Rationale: Laxatives may cause diarrhea, loss of water and electrolytes, abdominal pain or discomfort, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps, and weakness.