drug therapy for constipation and elimination problems

Question 1

definition of constipation

Answer 1

slower than normal evacuation of large intestine

Question 2

causes of constipation

Answer 2

medications (opioids, anticholinergics, antacids, iron supplements), foods (flour, dairy), diseases (hypothyroidism, DM, IBS)

Question 3

constipation may cause what complications

Answer 3

HTN, fecal impaction, hemorrhoids, fissures, megacolon, bowel perforation

Question 4

example meds of laxatives

Answer 4

psyllium (bulk forming laxatives)

Question 5

use of laxatives

Answer 5

add bulk and absorbs water to stimulate, 12-24 hrs to work, treats occasional constipation, adds bulk to diarrhea

Question 6

adverse effects of laxatives

Answer 6

severe flatulence, bloating

Question 7

contradictions for laxatives

Answer 7

acute abd pain, bowel obstruction, fecal impaction

Question 8

nursing considerations for laxatives

Answer 8

may reduce absorption of meds, take 1 hr before or 3 hours after taking other meds, take with full glass of water

Question 9

other laxatives

Answer 9

lubricants, surfactants

Question 10

lubricants as laxative med

Answer 10

mineral oil

Question 11

lubricants do what

Answer 11

lubricate fecal mass, takes 6-8 hrs to work, given oral or enema

Question 12

surfactants or stool softeners are used as a laxative how

Answer 12

allows water to enter stool making softer, little laxative effect, 1-3 days to work, take daily

Question 13

example meds of cathartics

Answer 13

bisacodyl (stimulant laxative)

Question 14

uses of cathartics

Answer 14

irritate GI mucosa, rapid movement of stool, bowel prep/ constipation, 6-12 hrs to work

Question 15

contraindications for cathartics

Answer 15

acute abd. pain, bowel obstruction, fecal impaction

Question 16

adverse effects of cathartics

Answer 16

cramping and diarrhea

Question 17

nursing considerations for cathartics

Answer 17

take on empty stomach, do not take with antacids or milk

Question 18

uses of saline cathartics

Answer 18

used for bowel prep pre-op (magnesium citrate, milk of magnesia, polyethylene glycol), 30-60 mins to work, use caution with electrolyte imbalances, causes diarrhea

Question 19

laxative: lactulose use

Answer 19

pulls water into intestine, treats constipation or high ammonia levels

Question 20

laxative: lubiprostone use

Answer 20

treats IBS-C, opioid induced constipation

Question 21

laxative: linaclotide use

Answer 21

treats IBS-C

Question 22

laxative: sodium polystyrene use

Answer 22

treats constipation or hyperkalemia

Question 23

nursing considerations when taking laxatives

Answer 23

assess bowel habits, diet, activity and fluid intake; assess abdomen, insert suppositories high into the rectum; give bulk laxatives with full glass of water; fall risk

Question 24

patient education when taking laxatives

Answer 24

high fiber diets, increase fluid intake, exercise, for short term use only