Basic GI Exam 4 Flashcards
what is constipation
small, infrequent or difficult BM
-fewer than 3 BMs/week
fecal impaction
firm immovable mass obstructs the GI tract
- liquid can squeeze around so may get very liquidly stool
diarrhea
increase in frequency and fluidity of bowel movements
acute diarrhea
infection, emotional stress, some medications, and liquid stool around an impaction
chronic diarrhea
lasting more than 4 weeks
- chronic GI infection
- alterations in motility or integrity
- malabsorption
- endocrine disorders
osmotic diarrhea
increased amounts of osmotic active solutes
-magnesium sulfate
-epsom salt
common with tube feeding
secretory diarrhea
caused by bacteria or toxin
- bibrio cholerae
- Staph
exudative diarrhea
active sites of inflammation within bowel, open “wounds” pulling water into intestines forming diarrhea
- crohn disease
- ulcerative colitis
diarrhea related to motility disturbances
decreased absorption in small intestine
- dumping syndrome
- IBS
Why is diarrhea a problem
skin breakdown
loss of fluid and electrolytes
nutritional concerns
anti-diarrheals
drugs to treat diarrhea
-always given orally
adsorbent class
bismuth subsalicylate (Pepto-bismol)
bismuth subsalicylate MOA
coats the walls of the GI tract
bind the causative agent for elimination
bismuth subsalicylate SE
increased bleeding time, constipation, dark stools and darkening of tongue
antimotility class drugs
loperamide & diphenoxylate [atropine]
loperamide MOA
slow peristalsis
diphenoxylate [atropine] MOA
slow peristalsis and drying effect
diphenoxylate [atropine] SE
urinary retention headache, dizziness, anxiety, drowsiness bradycardia, hypotension dry skin flushing
Probiotic drugs
lactobacillius organisms - bacid, culturelle
MOA of probiotics
replenish these bacteria and restore normal flora
what are laxatives
used for treatment of constipation
what drug is in bulk-forming class
psyllium (Metamucil)
MOA of psyllium
act similar to dietary fiber
absorbs water into the intestine, increasing bulk
distends bowel to initiate reflex bowel activity and bowel movement
SE of psyllium
impaction above strictures
fluid/electrolyte imbalance
gas formation
esophageal blockage
Nursing considerations for psyllium
OK for long term use - THE ONLY LAXATIVE
give in a decent amount of water
contraindicated for any impaction or obstruction
drugs in emollient class
docusate sodium and mineral oil
MOA for docusate sodium
lubricates fecal material and walls, promotes fat absorption into fecal mass
prevent water from moving out of intestines
MOA for mineral oil
lubricates intestines
prevents water from moving out of intestines
What is docusate sodium used for?
prevent opioid-induced constipation
what is mineral oil used for
fecal impactions
SE of docusate sodium and mineral oil
skin rashes, decreased absorption of vitamin
drugs in hyperosmotic class
laxatives
glycerin
lactulose
polyethylene glycol
MOA for glycerin, lactulose and polyethylene glycol
increasing water content in feces
promotes distention, peristalsis, and evacuation
what are the uses of hyperosmotic drugs
evacuate bowels before diagnostics and surgical procedures
SE of glycerin , lactulose, polyethylene glycol
abdominal bloating
rectal irritation
electrolyte imbalance
saline class drugs
laxatives
magnesium salts and sodium salts
MOA for magnesium salts and sodium salts
increse osmotic pressure and draw water into colon
SE of sodium salts and magnesium salts
magnesium toxicity
electrolyte imbalance
cramping, diarrhea
stimulate class drugs
laxatives
bisacodyl and senna
MOA for bisacodyl and senna
Induce intestinal peristalsis work on GI tract
SE of bisacodyl and senna
nutrient malabsorption
gastric irritation
electrolyte imbalance
what class of laxative drugs are most likely to cause dependence
stimulants
bisacodyl and senna
