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Nursing Pharmacology > C7- Lower GI Medications > Flashcards

C7- Lower GI Medications Flashcards

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1
Q

Adults- criteria for constipation

A

Fewer than three BM per week
Lumpy or hard stools for more than 25% of BM
Straining During more than 25% of BM

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2
Q

Infants and Children- Criteria for Constipation

A

Pebble-like, hard stools for a majority of BM for at least 2 wks
Firm stools 2X/week or less for at least 2 weeks

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3
Q

Constipation Causes- D.O.P.E.D.

A

D- drugs
O- obstruction
P- pain
E- endocrine
D- depression

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4
Q

Constipation contraindications

A

Abdominal pain
Possible appendicitis
Diverticulitis
Ulcerative colitis
Pregnancy/lactation

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5
Q

Constipation Contributing factors

A

Insufficient water intake
Fecal impaction
Bowel obstruction
Chronic laxative use
Neurological disorders
Ignoring the urge to defecate
Lack of exercise
Some drugs
anticholinergics
narcotics
certain antacids

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6
Q

Indications for Laxatives

A

Painful elimination
Cardiovascular disease
Elderly with weakened abdominal or perineal muscles
Correcting constipation from opioid use or prolonged bedrest

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7
Q

How are laxatives classified?

A

By response

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8
Q

Group 1 laxatives

A

Produce watery stools (osmotic)
Magnesium salts
Sodium salts
Castor oil
Polyethylene glycol
electrolyte solution

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9
Q

Group 1 Laxative response time

A

2-6 hours

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10
Q

Laxatives- Group 2

A

Produce Semi-fluid stool
osmotic in low doses
Magnesium salts
Sodium salt
Polyethylene glycol
Stimulant laxatives
bisacodyl
Senna

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11
Q

Group 2 laxative response time

A

6-12 hours

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12
Q

Laxatives- Group 3

A

Bulk forming laxatives
methyl cellulose
psyllium
polycarbophil
Surfactant Laxatives
Docusate sodium
Docusate Calcium
Others
lactulose
lubiprostone

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13
Q

Group 3 laxatives response

A

1-3 Days

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14
Q

Bulk forming laxatives - Generic Name

A

Psyllium (powder in water)

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15
Q

Bulk forming laxatives action

A

Similar to dietary fiber (swell in water)
Increase intestinal volume

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16
Q

Bulk forming laxatives- Indications

A

Preferred agent for temporary relief
works within 12-72 hours

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17
Q

Bulk forming laxatives- administration

A

Should be accompanied by a full glass of water

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18
Q

Bulk forming laxatives- Side effects

A

Esophageal obstruction
Intestinal obstruction

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19
Q

Do not give laxatives with this condition

A

Undiagnosed abdominal pain

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20
Q

Emollient laxatives:

A

Docusate

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21
Q

Emollient laxatives- Action

A

Allow water and fat to penetrate into stool

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22
Q

Emollient laxatives- Administration

A

Should be accompanied by a glass of water

HOLD MEDICATION FOR LOOSE STOOLS

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23
Q

Emollient laxatives- results show signs of improvement (how long)

A

12-72 hours

24
Q

Osmotic Laxatives-

A

Polyethylene glycol
Magnesium hydroxide (milk of mag)

25
Q

Osmotic Laxatives- action

A

Osmotic action draws water into the intestinal lumen

26
Q

Osmotic Laxatives- adverse effects

A

Fluid loss
Mg++ accumulation
Na+/Fluid retention

27
Q

Osmotic Laxatives- in a large volume

A

GoLytely
for colonoscopies

28
Q

Stimulant laxatives:

A

Bisacodyl
Senna

29
Q

Stimulant laxatives- RISK?

A

Frequently abused laxative

30
Q

Stimulant laxatives- Action

A

Stimulate nerves to increase intestinal motility

31
Q

Stimulant laxatives- Uses

A

Opioid induced constipation
Slow intestinal transit

32
Q

Stimulant laxatives- nursing teaching

A

May discolor urine

33
Q

Laxative abuse causes:

A

Belief that daily and bountiful BM is a requisite of good health

34
Q

Laxative abuse consequences:

A

Diminished Defecator reflexes
reliance on laxatives
electrolyte imbalances
Dehydration
colitis

35
Q

Laxative abuse treatment:

A

Cessation of laxative use
educate on normal bowel function
fix with diet

36
Q

Diarrhea

A

3+ loose/liquid stools per day

37
Q

Diarrhea Cautions

A

Fluid and electrolyte imbalance
monitor I/O

38
Q

Diarrhea Management

A

Diagnose and treat underlying condition
Replacement fluids/electrolytes
Relief of cramping
Reducing passage of unformed stools

39
Q

Antidiarrheal Medications (Adsorbents):

A

Bismuth Salicylate
(Pepto-Bismol)

40
Q

Antidiarrheal Medications (Antimotility agents)

A

Loperamide

Opiates and opiate-related agents

41
Q

Antidiarrheal Antimotility agents: (action)

A

Slow peristalsis

42
Q

Antidiarrheal combinations:

A

Diphenoxylate with atropine
narcotic and anticholinergic drug
reduces GI motility

43
Q

Probiotics:

A

Restore normal flora

44
Q

Adsorbents Action

A

Coats walls of GI tract and binds to causative bacteria or toxin (trouble maker)

Decreases flow of fluids

Reduces inflammation of intestine

45
Q

Adsorbents- Cautions

A

Allergy to aspirin
Children
contains aspirin
Anticoagulant use
DO NOT USE

46
Q

Adsorbents- Side effects

A

Black/dark tongue
Dark stools
Bleeding
Tinnitus

47
Q

Antimotility agents- Anticholinergic

A

Diphenoxylate with atropine (lomotil)

48
Q

Antimotility agents- Contraindications (when you should not take)

A

Glaucoma
Paralytic ileus

49
Q

Antimotility agents: Side effects

A

(Anticholinergic)
dry mouth
urinary retention
drowsiness

50
Q

Antimotility agents: Opioid like

A

Loperamide (Imodium)

51
Q

Antimotility agents: loperamide (Contraindication)

A

Not for children <2yo

52
Q

Antimotility agents: Loperamide (precaution)

A

Use as directed
higher doses cause lethal heart rhythms

53
Q

Antimotility agents: Loperamide (side effects)

A

CNS depression

54
Q

Diarrhea Nursing implications- Assessment

A

Monitor for therapeutic effect
assessment
patient condition b4 therapy and regularly after
fluid and electrolyte balance
hydration status
stool frequency and consistency

55
Q

Diarrhea Nursing Implications- Planning (outcomes)

A

Patient will have regular formed BM
Adequate fluid balance will be maintained

56
Q

Diarrhea Nursing implications (Implementation)

A

Correct fluid and electrolyte disturbances before starting the drug

Nursing Pharmacology (11 decks)

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