Chapter 40: Antidiarrheal Drugs and Laxatives

Question 1

What is the goal of the small intestine?

Answer 1

absorption of nutrients, enzymes and vitamins

Question 2

What is the goal of the large intestine?

Answer 2

absorbs water and electrolytes

Question 3

What does the pancreas secrete?

Answer 3

secretin, high in bicarb that neutralizes the stomach acid in the duodenum and helps prevent ulcers

Question 4

What is the normal transit time for food to move through the intestine?

Answer 4

24-36 hours

Question 5

What are the treatments for constipation?

Answer 5

Surgical or nonsurgical, more fiber, more fluid, pharmacological

Question 6

What are the types of laxatives?

Answer 6

bulk forming, emolient, hyperosmotic, saline, stimulants

Question 7

What are bulk forming laxatives?

Answer 7

adds bulk, high in fiber, adds water to increase the bulk which distends the bowel and stimulates the nerve that causes bowel movements

Question 8

What is an example of bulk forming laxatives?

Answer 8

metamucil

Question 9

What are emollient laxatives?

Answer 9

stool softener and lubricant. Adds water and lubricates the intestinal walls and fecal matter

Question 10

What are hyperosmotic laxatives?

Answer 10

works only in the large intestine. Increases the water content of the fecal matter, distends the bowel and promotes a bowel movement and increases peristalsis

Question 11

What are examples of hyperosmotic laxatives?

Answer 11

enemas, polyethylene glycol

Question 12

What are saline laxatives?

Answer 12

increase the pressure in the intestinal tract which causes water attraction and more water = distention = bowel movement

Question 13

What are stimulant laxatives?

Answer 13

increase peristalsis due to intestinal nerve stimulation.

Question 14

What do you need to assess for with use of hyperosmotic and saline laxatives?

Answer 14

Monitor for water and electrolyte loss because water that moves into the bowel comes from the blood stream

Question 15

What advice do you give pts using laxatives?

Answer 15

take with a full glass of water, keep an eye on fluid and electrolyte levels, document any changes in bowel patterns, avoid giving bismuth to children to avoid Reyes

Question 16

What position should you a pt in for suppositories?

Answer 16

Laying on their left side, leg up and bent. Continue to lay on your side for 15-30 minutes after to allow for absorption

Question 17

What is acute vs chronic diarrhea?

Answer 17

Acute: sudden onset, 3 days -2 weeks, caused by meds, bacteria, viruses and usually self limiting
Chronic: longer than 3-4 weeks, symptom of underlying issues like IBD, tumors, immunodeficiency, diabetes, hyperthyroidism, Addisons…

Question 18

What are the types of Antidiarrheals?

Answer 18

adsorbent, antimotility, and probiotics

Question 19

What are adsorbent drugs?

Answer 19

Coats the walls of the GI tract, binds to the cause of diarrhea then is eliminated through stool.

Question 20

What are things to watch out for with adsorbent drugs?

Answer 20

Increase in bleeding, constipation, dark stools, black tongue

Question 21

What is an example of adsorbent drugs?

Answer 21

pepto bismol

Question 22

What are antimotility drugs?

Answer 22

slows the peristalsis, dries out the stool, decreases gastric secretions, promotes longer contact with intestinal contents. Can treat bowel spasms, can cause urinary retention, headache, confusion, dry skin, blurred vision

Question 23

What are probiotics?

Answer 23

good bacteria to replenish the natural flora of the intestine

Question 24

What are the 2 classes of antimotility drugs?

Answer 24

opioids and anticholinergics

Question 25

What should you avoid using with antidiarrheals?

Answer 25

other CNS depressants when using opioid based antidiarrheals

Question 26

What nursing assessments should you look at with antidiarrheals?

Answer 26

Assess if there is an issue causing their diarrhea, bowel movement history, assess fluid and electrolyte levels, ask for what meds they have taken, look at mucous membranes for dehydration