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The nurse is caring for a client who is prescribed mesalamine. The client is also taking warfarin. Which of the following interactions should the nurse monitor the client for when he is administered mesalamine with warfarin?
- A. Increased risk of immunosuppression
- B. Increased blood glucose level
- C. Increased risk of bleeding
- D. Increased risk of CNS depression
Correct Answer: C
Rationale: The client administered mesalamine and warfarin is at an increased risk of bleeding. Warfarin is an anticoagulant used as a blood thinner; mesalamine is an aminosalicylate, which is an aspirin-like compound with anti-inflammatory action. The combination of mesalamine and warfarin does not increase the risk of immunosuppression, increase the blood glucose level, or increase the risk of CNS depression. There is an increased risk of immunosuppression if an aminosalicylate interacts with methotrexate used in cancer and autoimmune conditions. There is an increased blood glucose level when oral hypoglycemic drugs interact with aminosalicylates. There is an increased risk of CNS depression when opioids are administered with aminosalicylates.
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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.
When describing the drugs used as treatment for clients with ulcerative colitis to a group of nursing students, the instructor discusses aspirin-like compounds with anti-inflammatory properties. Which of the following would the instructor most likely include?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Magnesium oxide (Mag-Ox)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), are aspirin-like compounds with anti-inflammatory properties used in the treatment of clients with ulcerative colitis.
When reviewing a client's history, a nurse determines that the use of laxatives would be contraindicated if the client has a history of which of the following?
- A. Chronic hepatitis
- B. Type 1 diabetes
- C. Acute appendicitis
- D. Intestinal obstruction
- E. Fecal impaction
Correct Answer: C,D,E
Rationale: Laxatives are contraindicated in clients with known hypersensitivity and those with persistent abdominal pain, nausea, vomiting, or pain of unknown cause or signs of acute appendicitis, fecal impaction, intestinal obstruction, or acute hepatitis.
A nurse is caring for a client with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the client shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction?
- A. Administer the drug with adequate fluid intake
- B. Give mineral oil to the client after meals.
- C. Administer the drug after chilling it
- D. Provide foods high in bulk or roughage.
Correct Answer: A
Rationale: The nurse should administer the drug with adequate fluid intake to avoid obstruction of the esophagus, stomach, small intestine, and colon in a client with intestinal stenosis. Mineral oil is given to the client as a laxative on an empty stomach in the evening. The nurse should provide foods high in bulk or roughage to avoid constipation in a client receiving laxatives. The nurse administers a laxative with an unpleasant or salty taste after chilling it to disguise its taste.
A nursing student is preparing a presentation on antidiarrheal drugs. Which of the following drugs would the student include as being chemically related to opioid drugs and used to treat diarrhea by decreasing intestinal peristalsis?
- A. Bisacodyl (Dulcolax)
- B. Difenoxin (Motofen)
- C. Alosetron (Lotronex)
- D. Diphenoxylate (Lomotil)
- E. Bismuth (Pepto-Bismol)
Correct Answer: B,D
Rationale: Difenoxin (Motofen) and diphenoxylate (Lomotil) are chemically related to opioid drugs and treat diarrhea by decreasing intestinal peristalsis.