GI Output-Diarrhea & Constipation Flashcards
Antiemetics: action and medications
-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)
Antiemetics: therapeutic use and medications
-used for motion sickness
1) anticholinergics
scopolamine (Transderm Scop)
2) antihistamine
dimenhydrinate (Dramamine),
hydroxyzine (Vistaril)
Substance P/neurokinin antagonist: aprepitant (Emend): complications
1) fatigue
2) diarrhea
3) dizziness
4) liver damage
5) IV
6) monitor for these effects
7) contact provider
Serotonin antagonist: ondansetron (Zofran): complications
1) headache
2) diarrhea
3) dizziness
4) monitor for these effects
5) administer nonopioid analgesics
Dopamine antagonists: prochlorperazine: complications
1) extrapyramidal symptoms (EPSs)
- restlessness
- anxiety
- spasms of face and neck
2) hypotension
3) sedation
4) anticholinergic effects
- dry mouth
- urinary retention
- constipation
Dopamine antagonists: prochlorperazine: nursing interventions
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
Cannabinoids: dronabinol
adverse effects
1) potential for dissociation, dysphoria
2) hypotension
3) tachycardia
Cannabinoids: dronabinol nursing interventions
1) avoid in clients who have mental health disorders
2) use cautiously in clients who have CV disorders
Anticholinergics: scopolamine
Antihistamines: dimenhydrinate
adverse effects
sedation
Anticholinergics: scopolamine
Antihistamines: dimenhydrinate
nursing interventins
1) instruct not to drive
2) increase fluid intake
3) increase physical activity
4) suck on hard candy or chew gum
5) administer laxatives
Laxatives: classifications and medications
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
Bulk-forming: Psyllium (Metamucil)
action and therapeutic uses
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
Surfactant: docusate sodium (Colace)
action and therapeutic uses
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
Stimulant: bisacodyl (Dulcolax)
action and therapeutic uses
1) stimulation of intestinal peristalsis
2) -prior to surgery or diagnostic tests
- short-term treatment of constipation caused by opioid use
Osmotic: magnesium hydroxide (Milk of Magnesia)
action and therapeutic uses
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
Complications of Laxatives
- GI irritation
- rectal burning sensation, leading to proctitis
- high levels of magnesium
- fluid retention
- dehydration
Laxatives: nursing interventions/client education
- 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
Laxatives: nursing administration
- 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
Antidiarrheals: medications
1) prototype = diphenoxylate plus atropine (Lomotil)
2) other medications =
- loperamide (Imodium)
- difenoxin (Motofen)
Antidiarrheals: expected action and therapeutic uses
1) decrease intestinal motility and increase absorption of fluid and sodium in intestine
2) -underlying cause of diarrhea
- symptomatic treatment
Antidiarrheals: nursing administration
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
