Nokea
The nurse is preparing to administer a laxative that adds bulk and water to the contents of the intestines, thereby stimulating intestinal peristalsis. Which of the following would the nurse be likely to administer?
- A. Docusate (Colace)
- B. Methylcellulose (Citrucel)
- C. Polycarbophil (FiberCon)
- D. Bisacodyl (Docusate)
- E. Lactulose (Chronulac)
Correct Answer: B,C
Rationale: Bulk-producing laxatives, like methylcellulose (Citrucel) and polycarbophil (FiberCon), produce their laxative effect by adding bulk and water to the contents of the intestines, thereby stimulating intestinal peristalsis. Docusate is a stool softener. Bisacodyl is a stimulant laxative. Lactulose is a hyperosmotic agent.
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During a routine clinic visit, a client tells the nurse that he is taking an over-the-counter antidiarrheal agent for treatment of diarrhea. The nurse reviews the drug information with the client. Afterward, the nurse determines that the teaching was successful when the client states that he will contact his primary health care provider if the diarrhea is not resolved within which time frame?
- A. 24 hours
- B. 48 hours
- C. 72 hours
- D. 96 hours
Correct Answer: B
Rationale: If diarrhea persists for more than 2 days when over-the-counter (OTC) antidiarrheal drugs are being used, the client should discontinue use and seek treatment from the primary health care provider.
A client is prescribed diphenoxylate. The nurse informs the client that he may experience which of the following effects?
- A. Euphoric effects
- B. Analgesic effects
- C. Anti-inflammatory effects
- D. Sedative effects
- E. Slowed GI effects
Correct Answer: A,D,E
Rationale: Because diphenoxylate (Lomotil) is opioid related, it may have sedative, slowed GI, and euphoric effects but no analgesic or anti-inflammatory activity.
Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis?
- A. Sennosides (Senokot)
- B. Methylcellulose (Citrucel)
- C. Glycerin (Fleet Babylax)
- D. Bisacodyl (Dulcolax)
- E. Lactulose (Chronulac)
Correct Answer: A,D
Rationale: Irritant or stimulant laxatives, like sennosides (Senokot) and bisacodyl (Dulcolax), produce their laxative effect by direct action on the intestine to increase peristalsis. Methylcellulose is a bulk-forming laxative. Glycerin and lactulose are hyperosmolar drugs.
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.
A client is using chamomile tea as a remedy to treat gastrointestinal upset. When discussing the use of this herb, the nurse would alert the client that contact dermatitis is a possibility if the client has a hypersensitivity to which of the following plants?
- A. Ragweed
- B. Fox glove
- C. Asters
- D. Lavender
- E. Chrysanthemums
Correct Answer: A,C,E
Rationale: Although chamomile is generally safe and nontoxic, the tea is prepared from the pollen-filled flower heads and has resulted in symptoms ranging from contact dermatitis to severe anaphylactic reactions in individuals hypersensitive to ragweed, asters, and chrysanthemums.