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Test 2 > Care of Aging Adult part 6 > Flashcards

Care of Aging Adult part 6 Flashcards

1
Q

Infrequent bowel movements or stools are hard, dry, small, or difficult to pass. Can be acute or chronic.

A

constipation

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2
Q

Is constipation a symptom or a disease?

A

symptom

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3
Q

What are the causes of constipation?

A 
medications 
chronic illness
weakness/immobility 
diet: low fiber, dehydration 
ignoring the urge 
emotions 
frequent use of enema, laxatives and suppositories
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4
Q

Clinical manifestations of constipation.

A
  • infrequent BM’s
  • abdominal distention
  • pain/bloating
  • sensation of incomplete evacuation
  • straining
  • small hard, lumpy dry stool
  • increased flatulence
  • increased rectal pressure
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5
Q

Complications of Constipation?

A
  • straining —> decrease cardiac output —> drop in BP —> drop in HR —> dizziness and or syncope
  • fecal impaction
  • incontinence
  • hemorrhoids
  • anal fisures
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6
Q

When are laxatives contraindicated?

A
  • with certain bowel disorders including acute surgical abdomen
  • fecal impaction or obstruction —> bowel perforation
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7
Q

What are the 5 classifications of laxatives??

A 
bulk forming 
surfactant 
stimulant 
osmotic 
misc.
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8
Q
  • acts like dietary fiber
  • swell in the intestine, softening fecal mass, and increasing in bulk —> stimulating peristalsis
  • preferred agent in treatment
  • bowel movement after 1-3 days
  • take with full glass of juice or water to prevent esophageal obstruction
A

bulk forming

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9
Q

What are 3 bulk forming laxatives?

A

Methylcellulose (citrucel)
Psyllium (metamucil)
Polycarbophil (fibercon)

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10
Q
  • lower surface tension, facilitate water movement into stool
  • can act on intestinal wall: inhibit fluid absorption, stimulate secretion of water and electrolytes into intestinal lumen
  • produces stool several days after onset
  • instruct patients to take with full glass of water
A

Surfactant laxatives

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11
Q

What are the surfactant laxatives?

A

docusate sodium (colace)

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12
Q

What 2 effects do stimulant laxatives have on the bowel?

A
  • stimulate intestinal motility

- increase amount of water and electrolytes in intestinal lumen

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13
Q

-produces semifluid stool in approx. 6-12 hours

A

stimulates laxatives

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14
Q

What are the 2 primary applications for stimulant laxatives?

A
  • opioid-induced constipation

- constipation from slow intestinal transit

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15
Q

What are 2 types of stimulation laxatives?

A
  • bisacodyl (correctol, ducolax, fleet laxatives) tablets and suppositories
  • senna (senokot)
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16
Q

What is the patient teaching for the stimulant laxative Bisacodyl?

A
  • no sooner than 1 hour after ingesting milk or antacids. Swallow the tablets intact, without crushing or chewing.
  • Suppositories may cause a burning sensation; prolonged use can cause proctitis (lining of rectum becomes inflamed)
17
Q

What is the patient teaching for the stimulant laxative Senna?

A

-may cause a harmless yellowish-brown or pink color to urine

18
Q
  • poorly absorbed
  • draws water into intestinal lumen
  • causes fecal mass to swell and soften —> stretching intestinal wall —> stimulates peristalsis
  • bowel movement in 6-12 hours or high dose 2-6 hours (for surgery/procedures)
A

Osmotic laxatives

19
Q

What are the 3 osmotic laxatives?

A
  • polyethylene glycol (glycolax, miralax, peglax)
  • lactulose (cephulac, cholac)
  • magnesium hydroxide (milk of mag, phillips milk of mag)
20
Q

What is the nursing education for osmotic laxatives?

A

-effects are dose dependent
low dose = soft or semifluid stool 6-12 hours
high dose = watery BM 2-6
-increase fluid intake prevent dehydration
-magnesium salts are contraindicated with renal dysfunction
-sodium phosphate is contraindicated in kidney disease and with drugs that alter renal function
-avoided in patients with heart failure, hypertension, or edema

21
Q

Basic nursing education for BM’s.

A
  • reduce laxative use
  • normal bowel function to correct misconceptions
  • provide instruction on establishing good bowel habits
  • used only when necessary and in the smallest effective dosage
22
Q

Who should not use osmotic laxatives?

A

patients with: renal dysfunction, kidney disease, HF, hypertension, or edema

Test 2 (7 decks)

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