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Chapter 30: Gastrointestinal Disorder Drugs

12 problems · 0 figures

Case Study 30.3.1 §30.3 source ↗

Read the following clinical scenario to answer the questions that follow.

Mae Belle Smith is a 24-year-old logistics manager. Her job requires long hours of sitting at a desk with few breaks for hydration. Mae Belle presented to her provider with complaints of severe abdominal pain and distention and has not had a bowel movement in 6 days other than occasional leakage of scant amounts of liquid stool. Current medications include over-the-counter ibuprofen for occasional headaches.

The health care provider suspects Mae Belle has a fecal impaction. Which of the following medications should the nurse anticipate will be ordered?
  1. a.
    Methylcellulose
  2. b.
    Sorbitol
  3. c.
    Mineral oil
  4. d.
    Docusate sodium
Table 30.7 in the book ↗
Vital Signs Physical Examination
Temperature: 99.5°F

• Head, eyes, ears, nose, throat (HEENT): Within normal limits

• Cardiovascular: No jugular vein distention; S1, S2 noted

• Respiratory: Clear to auscultation bilateral all lung fields

• GI: Abdomen distended, lower abdomen firm, hypoactive bowel sounds in all 4 quadrants

• Neurological: Within normal limits

• Integumentary: No wounds noted; skin appropriate for age.

Blood pressure: 122/68 mm Hg
Heart rate: 93 beats/min
Respiratory rate: 20 breaths/min
Oxygen saturation: 99% on room air
Height: 5'7"
Weight: 125 lb

Answer

C. Mineral oil
Mineral oil is a lubricant laxative for constipation and fecal impaction.

Case Study 30.3.2 §30.3 source ↗

Read the following clinical scenario to answer the questions that follow.

Mae Belle Smith is a 24-year-old logistics manager. Her job requires long hours of sitting at a desk with few breaks for hydration. Mae Belle presented to her provider with complaints of severe abdominal pain and distention and has not had a bowel movement in 6 days other than occasional leakage of scant amounts of liquid stool. Current medications include over-the-counter ibuprofen for occasional headaches.

After the impaction is resolved, which of the following medications should the nurse anticipate the health care provider will order to help promote the client’s natural bowel function?
  1. a.
    Psyllium
  2. b.
    Loperamide
  3. c.
    Linaclotide
  4. d.
    Ondansetron
Table 30.7 in the book ↗
Vital Signs Physical Examination
Temperature: 99.5°F

• Head, eyes, ears, nose, throat (HEENT): Within normal limits

• Cardiovascular: No jugular vein distention; S1, S2 noted

• Respiratory: Clear to auscultation bilateral all lung fields

• GI: Abdomen distended, lower abdomen firm, hypoactive bowel sounds in all 4 quadrants

• Neurological: Within normal limits

• Integumentary: No wounds noted; skin appropriate for age.

Blood pressure: 122/68 mm Hg
Heart rate: 93 beats/min
Respiratory rate: 20 breaths/min
Oxygen saturation: 99% on room air
Height: 5'7"
Weight: 125 lb

Answer

A. Psyllium
Psyllium is a bulk-producing laxative that promotes natural elimination through water absorption and fiber that softens feces.

30-1 §30.RQ source ↗

A nurse is instructing a client being discharged with a prescription for diphenoxylate with atropine. Which of the following instructions should be given to the client?
  1. a.
    It will take 2 weeks before the full effects of the medication are achieved.
  2. b.
    Take the prescribed amount of medication every day, even if your symptoms improve.
  3. c.
    Keep some throat lozenges handy as dry mouth is a common side effect of this medication.
  4. d.
    This medication will not make you drowsy.

Answer

C. Keep some throat lozenges handy as dry mouth is a common side effect of this medication.
Dry mouth and other anticholinergic effects are common adverse effects of diphenoxylate with atropine.

30-2 §30.RQ source ↗

A nurse is preparing to administer a bisacodyl suppository to a client. Which of the following interventions is appropriate to ensure safe and effective administration?
  1. a.
    Have the client lie on their right side with their left knee raised to their chest.
  2. b.
    Have the client lie on their left side with their right knee raised to their chest.
  3. c.
    Remove the suppository from the refrigerator at least 15 minutes before administration to allow it to soften.
  4. d.
    Instruct the client to stand and get dressed immediately after administration.

Answer

B. Have the client lie on their left side with their right knee raised to their chest.
The proper client positioning for suppository administration is lying on their left side with their right knee raised to their chest.

30-3 §30.RQ source ↗

The nurse is assessing a client with a new prescription for chlorpromazine. The nurse recognizes the client is having an adverse effect when the client complains of:
  1. a.
    Dry mouth
  2. b.
    Flu-like symptoms
  3. c.
    Increased urination
  4. d.
    Diarrhea

Answer

A. Dry mouth
Chlorpromazine causes anticholinergic effects such as dry mouth, blurred vision, urinary retention and constipation.

30-4 §30.RQ source ↗

A client is admitted to the hospital with Stage III chronic kidney disease and constipation. Which of the following laxatives is contraindicated for this client?
  1. a.
    Magnesium citrate
  2. b.
    Bisacodyl
  3. c.
    Psyllium
  4. d.
    Polyethylene glycol

Answer

A. Magnesium citrate
Magnesium citrate is contraindicated with renal impairment due to a risk of hypermagnesemia.

30-5 §30.RQ source ↗

An ED nurse is triaging a client who was recently started on ondansetron for chemotherapy-induced nausea and vomiting (CINV). The nurse recognizes the following symptom as a side effect of ondansetron:
  1. a.
    Photosensitivity
  2. b.
    Increased urination
  3. c.
    Peripheral edema
  4. d.
    Headache

Answer

D. Headache
Headache is a common side effect of ondansetron.

30-6 §30.RQ source ↗

The nurse is discharging a client home with a new prescription for docusate sodium. What information should the nurse include in discharge teaching?
  1. a.
    This medication must be taken at bedtime.
  2. b.
    Take the medication with a full glass of water.
  3. c.
    This medication must be taken long term for it to be fully effective.
  4. d.
    Take the medication on an empty stomach.

Answer

B. Take the medication with a full glass of water.
This medication should be taken with a full glass of water to promote effectiveness.

30-7 §30.RQ source ↗

When assessing a client who has just started taking loperamide after experiencing diarrhea for a week, which of the following findings would be most concerning?
  1. a.
    Nausea
  2. b.
    Decreased appetite
  3. c.
    Changes in stool consistency
  4. d.
    Decreased blood pressure

Answer

D. Decreased blood pressure
Clients with diarrhea should be assessed for signs and symptoms of dehydration, including decreased blood pressure and increased heart rate.

30-8 §30.RQ source ↗

The nurse is administering linaclotide for a client. For which of the following conditions is this laxative contraindicated?
  1. a.
    Bowel obstruction
  2. b.
    Irritable bowel syndrome
  3. c.
    Chronic idiopathic constipation
  4. d.
    Bowel irritation

Answer

A. Bowel obstruction
Linaclotide is contraindicated with a GI obstruction; it is used for constipation disorders.

30-9 §30.RQ source ↗

The nurse is treating a client with nausea, vomiting, and dizziness secondary to inner-ear problems. Which of the following medications should the nurse anticipate will be prescribed?
  1. a.
    Ondansetron
  2. b.
    Aprepitant
  3. c.
    Meclizine
  4. d.
    Prochlorperazine

Answer

C. Meclizine
Meclizine is an antiemetic and antivertigo agent that reduces the vestibular stimulation.

30-10 §30.RQ source ↗

The nurse is teaching a client how to use a scopolamine patch. Which of the following statements by the client indicates the need for further instruction?
  1. a.
    “I need to put this on as soon as I start to feel nauseated.”
  2. b.
    “One patch should last 3 days.”
  3. c.
    “I need to wash my hands after applying the patch.”
  4. d.
    “I should not touch the adhesive section when applying the patch.”

Answer

A. “I need to put this on as soon as I start to feel nauseated.”
Scopolamine patches are used for motion sickness and should be applied 4 hours prior to traveling.

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Problems and answers are adapted from Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris and Dorie Weaver, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/pharmacology/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.