Nokea
Which of the following drugs used to manage lower gastrointestinal disorders increase the risk of bleeding when administered to clients taking warfarin (Coumadin)?
- A. Mesalamine (Asacol)
- B. Bisacodyl (Dulcolax)
- C. Psyllium (Metamucil)
- D. Polyethylene glycol (MiraLAX)
- E. Olsalazine (Dipentum)
Correct Answer: A,E
Rationale: Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), can increase the risk of bleeding in clients taking warfarin (Coumadin).
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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 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.
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.
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.
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.