Laxatives Flashcards
What is the definition of constipation according to the Rome criteria?
Constipation is defined as having 2 or more of the following features, with symptom onset at least 6 months prior and present for the last 3 months:
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Less than 3 bowel movements per week, or at least 25% of bowel movements having hard or lumpy stools.
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Straining at stool.
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Use of digital maneuvers.
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Sensation of incomplete evaluation.
What are some general categories of laxatives?
Bulk forming.
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Emollient (stool softeners, lubricant laxatives).
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Hyperosmotic.
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Saline.
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Stimulant.
What are the indications for using bulk-forming laxatives?
Bulk-forming laxatives are indicated for acute and chronic constipation, irritable bowel syndrome, and diverticulosis
What are the indications for using emollient laxatives?
Emollient laxatives are indicated for acute and chronic constipation, fecal impaction, and facilitation of bowel movements in anorectal conditions.
What are the indications for using hyperosmotic laxatives?
Hyperosmotic laxatives are indicated for chronic constipation, and diagnostic and surgical procedures.
What are the indications for using saline laxatives?
Saline laxatives are indicated for constipation, and diagnostic and surgical procedures.
What are the indications for using stimulant laxatives?
Stimulant laxatives are indicated for acute constipation, and diagnostic and surgical procedures.
What are some contraindications for the use of laxatives?
Laxatives are contraindicated in cases of:
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Allergy.
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Cautious use is advised in the presence of: acute surgical abdomen; appendicitis symptoms such as abdominal pain, nausea, and vomiting; fecal impaction (mineral oil enemas excepted); intestinal obstruction; as a weight loss aid; and undiagnosed abdominal pain.
What are some important aspects of nursing assessment before initiating laxative therapy?
Before initiating laxative therapy, nurses should:
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Obtain a thorough history of presenting symptoms, elimination patterns, medications, and allergies.
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Assess fluid and electrolytes.
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Perform an abdominal assessment/rectal assessment.
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Ask when the last bowel movement was.
What are some nursing diagnoses related to constipation that might be identified?
Potential nursing diagnoses related to constipation include:
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Constipation related to improper or inadequate diet.
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Deficit fluid volume related to loss of fluids and electrolytes caused by frequent, loose stools.
What are some key nursing interventions when administering laxatives?
Key nursing interventions when administering laxatives include:
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Administering all laxative tablets with 180 to 240 mL of water.
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Administering bulk-forming laxatives as directed by the manufacturer with at least 240 mL (8 oz) of water.
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Giving bisacodyl with water on an empty stomach because of interactions with milk, antacids, and juices.
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Informing patients to contact their prescribers if they experience severe abdominal pain, muscle weakness, cramps, or dizziness, which may indicate possible fluid or electrolyte loss.
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Informing patients not to take a laxative or cathartic if they are experiencing nausea, vomiting, or abdominal pain.
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Monitoring for therapeutic effect.
What are some important nursing assessments related to the medication sennosides?
For patients receiving sennosides, nurses should assess:
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Abdominal distention.
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Presence of bowel sounds.
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Usual pattern of bowel function.
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Color, consistency, and amount of stool produced.
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Presence of contraindications or side effects.
What are some nursing diagnoses associated with sennosides?
Nursing diagnoses associated with sennosides include Constipation and Diarrhea.
What are some important nursing interventions and teaching points for patients taking sennosides?
Interventions and teaching for sennosides include:
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PO Take with a full glass of water.
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Administer at bedtime for evacuation 6–12 hr later.
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Administer on an empty stomach for more rapid results.
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Use for short-term therapy only (risk of dependence).
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May cause a change in urine color to pink, red, violet, yellow, or brown.
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Patients with cardiac disease should avoid straining during bowel movements (Valsalva maneuver).
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Don’t use laxatives when abdominal pain, nausea, vomiting, or fever is present.
What are some considerations for laxative use in older adults?
Older adults have several factors that increase their risk of constipation and influence laxative use, including:
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Polypharmacy.
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Dehydration/dysphagia/decreased thirst.
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Increased risk of falls.
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Increased risk of delirium.
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↓nutritional intake in dysphagia, lack teeth or dentures (eat less fiber!).
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↓muscle tone & motor activity in GI tract ↓=↑ time passing through intestines=more constipation.
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Inadequate exercise due to conditions that decrease mobility, being bedridden, ↓staff and time, lack of group exercises in long-term care.
What are bulk-forming laxatives?
Bulk-forming laxatives work by increasing the bulk of the stool, which helps to stimulate peristalsis.
What are emollient laxatives?
Emollient laxatives are also known as stool softeners and lubricant laxatives. They help to soften the stool, making it easier to pass.
What are hyperosmotic laxatives?
Hyperosmotic laxatives work by creating an osmotic effect that draws water into the intestines, which helps to soften the stool and stimulate bowel movements.
What are saline laxatives?
Saline laxatives work by increasing the osmotic pressure in the intestinal tract, causing water to be drawn into the colon, which produces a watery stool.
What are stimulant laxatives?
Stimulant laxatives work by irritating the intestinal mucosa, which increases peristalsis.
