Nokea
The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? (Select all that apply.)
- A. Irritable bowel syndrome
- B. Undiagnosed abdominal pain
- C. Nausea and vomiting
- D. Fecal impaction
- E. Ingestion of toxic substances
- F. Acute surgical abdomen
Correct Answer: B,C,D,F
Rationale: Cautious use of laxatives is recommended in the presence of these: acute surgical abdomen; appendicitis symptoms, such as abdominal pain, nausea, and vomiting; intestinal obstruction; and undiagnosed abdominal pain. Oral laxatives must not be used with fecal impaction; mineral oil enemas are indicated for fecal impaction. The other options are indications for other laxative use.
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A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?
- A. Bulk-forming laxative, such as psyllium
- B. Stool softener, such as docusate salts
- C. Magnesium hydroxide
- D. Magnesium oxide tablets
Correct Answer: C
Rationale: Saline laxatives such as magnesium hydroxide produce a watery stool, usually within 3 to 6 hours of ingestion. Bulk-forming laxatives such as psyllium do not produce a bowel movement rapidly. Stool softeners such as docusate salts do not cause patients to defecate; they simply soften the stool to ease its passage. Magnesium oxide tablets are used as magnesium supplements, not as laxatives.
A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?
- A. Emollient laxatives
- B. Bulk-forming laxatives
- C. Hyperosmotic laxatives
- D. Stimulant laxatives
Correct Answer: B
Rationale: Bulk-forming laxatives are the only laxatives recommended for long-term use. Stimulant laxatives are the most likely of all the laxative classes to cause dependence. The other options are incorrect.
The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?
- A. Fecal impaction
- B. Electrolyte imbalances
- C. Lipid pneumonia
- D. Esophageal blockage
Correct Answer: C
Rationale: Lipid pneumonia may occur if the oral mineral oil is accidentally aspirated into the respiratory tract. The other options are incorrect.
A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?
- A. Docusate sodium
- B. Lactulose
- C. Mineral oil
- D. Polyethylene glycol 3350
Correct Answer: D
Rationale: Polyethylene glycol is a very potent laxative that induces total cleansing of the bowel and is most commonly used before diagnostic or surgical bowel procedures. 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.