Ch. 51 Bowel Disorder Drugs

Question 1

The nurse is providing teaching to a patient who will be taking the laxative bisacodyl (Dulcolax). Which statement by the nurse is appropriate during this teaching session?

Answer 1

“Take the tablets with water, not milk or juice.”

Question 2

The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?

Answer 2

Lipid pneumonia

Question 3

When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?

Answer 3

These laxatives may cause esophageal obstruction if taken with insufficient water.

Question 4

A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When reviewing the patient’s other ordered medications, the nurse recognizes that which medication or medication class will interact significantly with the Pepto-Bismol?

Answer 4

Oral hypoglycemic drugs

Question 5

A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?

Answer 5

polyethylene glycol (GoLYTELY)

Question 6

While recovering from surgery, a 74-year-old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she likes how “regular” her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?

Answer 6

Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.

Question 7

A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?

Answer 7

“Imodium does not cause physical dependence.”

Question 8

A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?

Answer 8

Bulk-forming laxatives

Question 9

When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?

Answer 9

Fat-soluble vitamins

Question 10

The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?

Answer 10

Anticholinergics such as belladonna alkaloids

Question 11

The nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol) with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?

Answer 11

Dark stools and blue gums

Question 12

A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication class to be ordered to treat this diarrhea?

Answer 12

Probiotics

Question 13

A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When reviewing the patient’s other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?

Answer 13

warfarin (Coumadin), an anticoagulant

Question 14

A laxative has been ordered for a patient. The nurse checks the patient’s medical history and would be concerned if which condition is present?

Answer 14

Abdominal pain of unknown origin

Question 15

15. A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?

Answer 15

Magnesium hydroxide (MOM)

Question 16

16. A patient is receiving lactulose (Chronulac) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?

Answer 16

High ammonia levels due to liver failure

Question 17

17. A patient is taking tegaserod (Zelnorm) to treat irritable bowel syndrome (IBS). The nurse will monitor this patient for which adverse effect?

Answer 17

Chest pain

Question 18

18. The nurse is preparing to administer methylnaltrexone (Relistor), a peripherally acting opioid antagonist. This drug is appropriate for which patient?

Answer 18

A terminally ill patient who has opioid-induced constipation

Question 19

19. A patient has been treated with alosetron (Lotronex) for severe irritable bowel syndrome (IBS) for 2 weeks. She calls the clinic and tells the nurse that she has been experiencing constipation for 3 days. The nurse will take which action?

Answer 19

Instruct the patient to stop taking the drug and to come to the clinic right away to be evaluated

Question 20

1. The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? (Select all that apply.)

Answer 20

a. Irritable bowel syndrome
* **b. Abdominal pain of unknown origin
* **c. Nausea and vomiting
* **d. Fecal impaction
e. Ingestion of toxic substances
* **f. Acute abdominal pain