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201D > Antidiarrheals And Laxatives > Flashcards

Antidiarrheals And Laxatives Flashcards

1
Q

What causes diarrhea

A

Drugs
Bacteria
Viruses
Dietary intolerances
Chronic conditions

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2
Q

How does diarrhea effect BMs

A

Increases fluidity and frequency

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3
Q

Acute diahrea lasts for how long

A

Self limiting (resolves on its own)
Usually within 3 days to 2 weeks

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4
Q

How long can chronic diarrhea last for

A

May last 3-4 weeks

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5
Q

When a person has diarrhea what are you treating for

A

Treat the cause of the diarrhea (to prevent weight loss)
Nutritional deficits
Fluid and electrolyte imbalances

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6
Q

Anti-diarrheals are contraindicated in

A

C diff.
E. Coli
(Body wants to flush toxin through)

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7
Q

What is an absorbent anti-diarrheal

A

Bismuth subsasicyate

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8
Q

bismuth subsalicylate

A

Is an absorbent diarrheal so it binds to the bacteria/toxins

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9
Q

Nursing implications for bismuth subsalicylate

A

May cause tongue and stools to darken

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10
Q

bismuth subsalicylate has drug drug interaction with

A

aspirin
warfarin
NSAIDS

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11
Q

Diarrhea is

A

The passage of 3 loose or liquid stools per day
(Could be acute or chronic)

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12
Q

Health care associated diarrhea

A

Diarrhea in a hospitalized patient that was not present on admission and starts 3 days after being hospitalized
(Occurs in 1/3 patients)

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13
Q

Clostridioides difficile
manifestation

A

Watery diarrhea
Fever
Anorexia
Abdominal pain

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14
Q

Clostridioides difficile
source of infection and susceptibility

A

Prolonged use of antibiotics followed by exposure to feces contaminated surfaces
(Spores on hands/environment very hard to kill)

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15
Q

Enterohemorrhagic escherichia coli
Manifestations

A

Severe abdominal cramping, bloody diarrhea, vomiting
Low grade fever
Lasts 5-7 days

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16
Q

Enterohemorrhagic Escherichia coli
Source of infection/susceptibility

A

• Can cause serious illness, especially in older adults
• May progress to life-threatening renal failure
• Transmitted in water or food contaminated with infected feces

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17
Q

Enterotoxigenic E. coli
Manifestations

A

Watery or bloody diarrhea, abdominal cramps
Nausea, vomiting, fever may be present
Lasts 3–4 days

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18
Q

Enterotoxigenic E. coli
Manifestations

A

• Watery or bloody diarrhea, abdominal cramps
• Nausea, vomiting, fever may be present
• Lasts 3–4 days

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19
Q

Enterotoxigenic E. coli
Infection/ susceptibility

A

Most common cause of travelers’ diarrhea
Transmitted in water or food contaminated with infected feces

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20
Q

What influences a pernon’s susceptibility to pathogens

A

Age
Gastric acidity
Intestinal microflora
Immune status
*older adults most likely to have life threatning diarrhea

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21
Q

Proton pump inhibitors

A

Since the stomach acid kills ingested pathogens, taking drugs to decrease stomach acid will increase the chance the pathogens will survive

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22
Q

The normal flora contains? Does?

A

Contains bacteria (ex. E. Coli)
Viruses
Fungi
*aid in fermentation
*provide a microbial barrier against pathogens

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23
Q

Who is susceptible to GI tract infection

A

People who are immunocompromised because of disease, or taking immunosuppressive drugs

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24
Q

Drug and food intolerance diarrhea occurs why

A

Rapid GI transition prevents fluid and electrolyte absorption, bile salts and undigested fats lead to excess fluid secretion into the GI tract
(Osmotic diarrhea)

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25
Q

Severe diarrhea may cause

A

life-threatening dehydration, electrolyte problems (e.g., hypokalemia), and acid-base imbalances (metabolic acidosis).

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26
Q

Major concerns of in self-limiting diarrhea

A

Preventing transmission
Replacing fluid and electrolytes
Protecting the skin
*if severe may need to give fluids, electrolytes, vitamins, and nutrition through IV

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27
Q

Why would an antidiarrheal not be used in treating some infectious diarrheas

A

they potentially prolong exposure to the organism

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28
Q

bismuth subsalicylate
Mechanism of action

A

Decreases secretions and has weak antibacterial activity. Used to prevent travelers’ diarrhea

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29
Q

Bismuth subsalicylate
Nursing considerations

A

May cause tinnitus and confusion. Do not use with GI bleeding

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30
Q

diphenoxylate/atropine
Mechanism of action

A

Opioid and anticholinergic. Decreases peristalsis and intestinal motility

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31
Q

diphenoxylate/atropine
Nursing implications

A

Blurred vision, dry mouth, drowsiness may occur. Take as directed. Overdose may be life-threatening.

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32
Q

diphenoxylate/atropine does what?

A

reduce bowel motility and transit time
reduce rectal spam pain
↓ stool frequency and volume

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33
Q

diphenoxylate

A

synthetic opiate agonist
slows overactive bowel
weak opioid (schedule 5)
AE: drowsiness, dizziness

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34
Q

atropine

A

(anti-cholinergic effect with larger doses)
discourage recreational use

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35
Q

Loperamide

A

similar to diphenoxylate
• inhibits peristalsis and prolongs transit time
• direct effect on the nerves in the intestinal muscle wall
• ↓ fecal volume and frequency
• available OTC

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36
Q

loperamide
Mechanism of action

A

Inhibits peristalsis, delays transit, increases absorption of fluid from stools

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37
Q

loperamide
Nursing considerations

A

Caution patient to avoid alcohol. Do not use with GI bleeding. May cause drowsiness. Use caution with hazardous activities.

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38
Q

What are the opiate antidiarrheals

A

diphenoxylate/atropine

Loperamide

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39
Q

Lactobacillus acidophilus

A

Probiotic
Restore normal intestinal flora
May be helpful for diarrhea d/t antibiotics
Promote “good” bacteria & suppress “bad” bacteria
Affect the gut microbiome
Found in food (ie., fiber, fermented foods)

40
Q

What is constipation

A

infrequent passage of abnormally hard and dry stools (two or less per week)
feeling of incomplete evacuation
stools harden the longer it stays in the colon

41
Q

What do laxatives do

A

Increase fecal movement
facilitates defecation

42
Q

PO laxatives taken

A

Within 2 hours of other meds

43
Q

Common adverse effects for laxatives

A

bloating
gas
abdominal
discomfort
cramping

44
Q

Why are laxatives only for short term use

A

Overuse of certain laxatives may lead to dependency and decreased bowel function.

45
Q

risk for contracting CDI is highest in patients

A

patients receiving antimicrobial, chemotherapy, gastric acid–suppressing, or immunosuppressive drugs

46
Q

How do laxatives work?

A

They are drugs that promote bowel evacuation by increasing the bulk of feces, softening the stool, or lubricating the intestinal wall

47
Q

What are the causes of acute diarrhea

A

Drugs
Bacteria
Viruses
Nutritional factors
Protozoa

48
Q

What are the causes of chronic diarrhea

A

Tumors
Acquired immunodeficiency syndrome
Diabetes mellitus
Hyperthyroidism
Additions disease
IBS

49
Q

Absorbents work by

A

Coating the walls of GI tract, they bind the causative bacteria or toxin to their absorbent surface for elimination from the body through stool

50
Q

Laxatives are contraindicated in

A

GI obstruction
Bowel perforation

51
Q

psyllium

A

bulk forming
increases fecal mass
safest laxative & OTC
prevent and long-term management of constipation

52
Q

docusate sodium

A

emollient (stool softener)
promotes H2O & fat absorption
ease passage of stool

53
Q

Docusate sodium nursing implication

A

administer with full glass of water

54
Q

psyllium nursing implications

A

mixture congeals; drink immediately to prevent obstruction
Only administer if they’ll be able to drink 5-8 oz of water

55
Q

mineral oil

A

lubricates fecal material
eases passage of stool
Only lubricant laxative in the emollient category

56
Q

Emollient laxatives

A

Directly lubricate stool and the intestines, which prevent water moving out out of the intestines
(Softens and expands the stools)

57
Q

Bulk forming laxatives

A

Increase water absorption which results in greater total volume (bulk) of the intestinal contents
*over the counter, safest, recommended for long term use

58
Q

Probiotics

A

Suppress the growth of diarrhea causing bacteria and reestablish the flora that normally resides in the intestine

59
Q

polyethylene glycol 3350

A

Induce bowel cleansing
osmotic agent
bowel prep for colon procedures
reconstituted with water
Given the day before procedure
NI: drink 8oz. every 10-15mins.

Ex. Golytely &Miralax

60
Q

How often should Miralax be used

A

Daily for up to 7 days, any longer could become laxative dependent

61
Q

What are the hyperosmotic laxatives

A

polyethylene glycol 3350 (ex. Miralax and golytely)

62
Q

Saline laxatives

A

increases osmotic pressure and draws water into the colon

63
Q

Saline laxatives consists of

A

Various magnesium or sodium salts

64
Q

Saline laxatives produce

A

A watery stool, within 3-6 hours of ingestion

65
Q

What are the types of saline laxatives

A

Saline enema (fleet enema)
magnesium hydroxide (milk of magnesia)
Magnesium citrate (citroma)

66
Q

Saline laxatives are to be used cautiously in

A

renal insufficiency bc they can be absorbed enough to cause hypermagnesemia (high level of magnesium in blood bc can’t be excreted)

67
Q

Saline laxatives are most commonly used to

A

Evacuate the bowel rapidly in preparation for an endoscopic examination and to remove unabsorbed poisons from the GI tract

68
Q

Milk of magnesia

A

Contraindicated in renal disease
Laxative and antacid
Osmotically active

69
Q

Magnesium citrate

A

Bowel prep
Osmotically active

70
Q

Milk of magnesia nursing implications

A

Shake solution
Can lead to F & E imbalance

71
Q

Magnesium citrate nursing implications

A

Refrigerate
Can lead to F & E imbalance

72
Q

What are stimulant laxatives

A

Induce intestinal peristalsis

Stimulate intestinal nerves to do peristalsis and increase water in the colon

73
Q

What are the types of stimulant laxatives

A

Bisacodyl and senna

74
Q

What class of laxatives are most likely to cause dependence

A

Stimulant laxatives
(Such as bisacodyl and senna)

75
Q

bisacodyl and senna

A

treatment of constipation
stimulates intestinal nerves to do peristalsis and increase H20 in colon
F&E depletion
may be habit-forming

76
Q

bisacodyl and senna nursing implications

A

Electrolyte imbalances and increase peristalsis

77
Q

Forms of stimulant laxatives

A

Could be PO or suppository

78
Q

What can happen with laxative use and abuse

A

Loss of muscle and nerve response
Risk of dependence
Laxatives draw water into the lumen
Increase risk of dehydration in older individuals
Increase risk of F & E imbalances

79
Q

Aging changes that effect GI

A

Decrease water intake
Decrease fiber intake
Decrease activity
Chronic illness may delay evacuation
Increase use of laxatives

80
Q

lifestyle changes that effect GI

A

Fluid intake
Fiber
Physical activity

81
Q

Before giving any medications affecting bowel status what should the nurse do

A

Obtain a through history
Preform assesment of :
the patients bowel patterns
General state of health
Any recent illness
GI complaints
Dietary changes
Possible causes of diarrhea

82
Q

When listening to the bowel sounds hypoactive is considered

A

Less than 6 sounds per minute

83
Q

When listening to the bowel sounds hyperactive is considered

A

Greater then 32 sounds perfect minute

84
Q

When listening to the bowel sounds hyperactive is considered

A

Greater then 32 sounds perfect minute

85
Q

Probiotics can be obtained through

A

Supplements
Food such as: fruits and vegetables , whole grain and wheat products, yogurt, cheese, kefir

86
Q

Probiotics have been used to make better symptoms in

A

Inflammatory bowel disease
Crohn disease
IBS
Travelers diarrhea
CDI

87
Q

What health conditions benefit from probiotics

A

Obesity and gastric cancer

88
Q

Who should not use probiotics

A

Immunocropromised patients
Critically ill patients
(Could lead to sepsis in people who lack a normal immune response)

89
Q

What is fiber, what is it found in

A

Nondigestible material found in whole grains, fruits, vegetables and legumes

90
Q

Fibers are fermented by

A

The microflora in the GI tract, which provides bulk to the stool (insoluble fibers)

91
Q

What are the health benefits of fiber

A

Increases fecal mass and promotes laxation **
Promotes growth of beneficial colonic microflora **
Binds bile acids and cholesterol
Slows rise in blood glucose and insulin levels
Assists in weight managment
Protects against colorectal and gastric cancer

92
Q

An 88-year-old patient is undergoing bowel preparation for a colonoscopy.
What may be ordered for this patient?

A

Laxative polyethylene glycol or magnesium citrate to cleanse the bowel

93
Q

What are the nurse’s priorities regarding monitoring the patient during the bowel
preparation?

A

• Fluid and electrolyte imbalances from the bowel preparation
• Clear liquid diet to NPO status
• Older patients are at greater risk for dehydration and electrolyte disturbances

94
Q

What follow-up is needed after a colonoscopy?

A

Monitoring vital signs (BP, HR) for signs of dehydration

95
Q

If the patient needs to prevent constipation, what OTC drug is the best choice to help prevent
constipation? Why?

A

Psyllium (Metamucil) is a natural bulk-forming laxative (safest)

• Increases the intake of bulk and fiber, contributing to more normal patterns of bowel
elimination
• Prevents constipation without water and electrolyte loss

201D (4 decks)

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