GI Output-Diarrhea & Constipation

Question 1

Antiemetics: action and medications

Answer 1

-suppress nausea and vomiting
prototype medications:
1) serotonin receptor antagonists 
odansetron (Zofran)
2) glucocorticoids
dexamethasone (Decadron)
3) substance p/neurokinin1 antagonists
aprepitant (Emend)
4) benzodiazepines
lorazepam (Ativan), diazepam (Valium)
5) dopamine antagonists
prochlorperazine (Compazine), metoclopramide (Reglan), promethazine (Phenergan)
6) cannabinoids
dronabinol (Marinol)

Question 2

Antiemetics: therapeutic use and medications

Answer 2

-used for motion sickness
1) anticholinergics
scopolamine (Transderm Scop)
2) antihistamine
dimenhydrinate (Dramamine),
hydroxyzine (Vistaril)

Question 3

Substance P/neurokinin antagonist: aprepitant (Emend): complications

Answer 3

1) fatigue
2) diarrhea
3) dizziness
4) liver damage
5) IV
6) monitor for these effects
7) contact provider

Question 4

Serotonin antagonist: ondansetron (Zofran): complications

Answer 4

1) headache
2) diarrhea
3) dizziness
4) monitor for these effects
5) administer nonopioid analgesics

Question 5

Dopamine antagonists: prochlorperazine: complications

Answer 5

1) extrapyramidal symptoms (EPSs)
- restlessness
- anxiety
- spasms of face and neck
2) hypotension
3) sedation
4) anticholinergic effects
- dry mouth
- urinary retention
- constipation

Question 6

Dopamine antagonists: prochlorperazine: nursing interventions

Answer 6

1) stop medication and notify providre if EPSs occur
2) monitor BP
3) inform client of sedation
4) no driving
5) increase fluid intake
6) increase physical activity
7) suck on hard candy or chew gum
8) administer stool softeners

Question 7

Cannabinoids: dronabinol

adverse effects

Answer 7

1) potential for dissociation, dysphoria
2) hypotension
3) tachycardia

Question 8

Cannabinoids: dronabinol nursing interventions

Answer 8

1) avoid in clients who have mental health disorders

2) use cautiously in clients who have CV disorders

Question 9

Anticholinergics: scopolamine
Antihistamines: dimenhydrinate
adverse effects

Answer 9

sedation

Question 10

Anticholinergics: scopolamine
Antihistamines: dimenhydrinate
nursing interventins

Answer 10

1) instruct not to drive
2) increase fluid intake
3) increase physical activity
4) suck on hard candy or chew gum
5) administer laxatives

Question 11

Laxatives: classifications and medications

Answer 11

1) bulk-forming
prototype: psyllium (Metamucil)
2) surfactant
prototype: docusate sodium (Colace)
3) stimulant
prototype: bisacodyl (Dulcolax)
4) osmotic
prototype: magnesium hydroxide (Milk of Magnesia)
5) Miscellaneous
prototypes: senna (Senokot), lactulose

Question 12

Bulk-forming: Psyllium (Metamucil)

action and therapeutic uses

Answer 12

1) softens fecal mass and increases bulk
2) -decrease diarrhea in diverticulosis and irritable bowel syndrome
- promote defecation in older adults with decrease in peristalsis

Question 13

Surfactant: docusate sodium (Colace)

action and therapeutic uses

Answer 13

1) lowers surface tension of stool to allow penetration of water
2) -constipation r/t pregnancy or opioid use
- prevention of painful elimination
- prevention of straining
- decrease risk of fecal impaction

Question 14

Stimulant: bisacodyl (Dulcolax)

action and therapeutic uses

Answer 14

1) stimulation of intestinal peristalsis
2) -prior to surgery or diagnostic tests
- short-term treatment of constipation caused by opioid use

Question 15

Osmotic: magnesium hydroxide (Milk of Magnesia)

action and therapeutic uses

Answer 15

1) draw water into intestine to increase mass of stool, resutling in presistalsis
2) -low dose: prevent painful elimination
- high dose: prepare for surgery or diagnostic tests

Question 16

Complications of Laxatives

Answer 16

• GI irritation
• rectal burning sensation, leading to proctitis
• high levels of magnesium
• fluid retention
• dehydration

Question 17

Laxatives: nursing interventions/client education

Answer 17

• do not crush or chew EC tablets
• discourage use of bisacodyl suppositories on regular basis
• advise client who has renal failure and heart disease to read labels carefully and avoid laxatives containing sodium
• encourage fluid intake
• monitor I&O
• assess for indications of dehydration

Question 18

Laxatives: nursing administration

Answer 18

• obtain complete hx of laxative use
• teach that chronic laxative use can lead to fluid and electrolyte imbalances
• instruct on diet
• encourage to maintain a regular exercise regimen
• teach to drink plenty of water

Question 19

Antidiarrheals: medications

Answer 19

1) prototype = diphenoxylate plus atropine (Lomotil)
2) other medications =
- loperamide (Imodium)
- difenoxin (Motofen)

Question 20

Antidiarrheals: expected action and therapeutic uses

Answer 20

1) decrease intestinal motility and increase absorption of fluid and sodium in intestine
2) -underlying cause of diarrhea
- symptomatic treatment

Question 21

Antidiarrheals: nursing administration

Answer 21

1) administer initial dose 4 mg and then additional doses of 2 mg
2) analog of opioid meperidine
3) drink small amounts of clear liquids or commercial electrolyte solution
3) avoid coffee (increases GI motility)
4) monitor for dehydration