Test 2 - Laxatives (Josh) Flashcards
Constipation is determined more by stool —– than by —— of BM’s
consistency (hardness)
frequence of BM’s
Common causes of constipation:
- decrease in fiber and fluid
- dysfunction in ANS
- meds (anticholinergics, opioids, verapamil)
Which neurological disease can cause constipation?
Hirschsprung’s Disease
Laxative overuse can lead to which adverse effects?
- dehydration
- electrolyte imbalances
- loss of normal defecation reflex (ie: you will now depend on laxative to have a BM)
Rank the laxatives from mild to strong:
- Stool softeners
- Osmotic laxatives
- Stimulant laxatives
- Bowel preparation
Most common stool softener is ——
docusate sodium
Which laxative is similar to soap?
docusate sodium (stool softener)
has two lipophilic ends and a hydrophilic center, that works like a laundry detergent mixing into the stool and softening it up
After taking docusate sodium, the client should expect a BM in ——
several days (it’s very mild)
doesn’t make you poop, just softens it up
Client teaching for docusate sodium.
- take w/ a full glass of water (b/c of the soap thing)
- wait a few days
What is docusate sodium used for?
- clients taking opioids (ex: morphine)
- clients needing to avoid straining (ex: hemorrhoids, CV issues [prevent vagal response], episiotomy)
Which laxative would we give to Cousin Eddie to relieve his hemorrhoids?
docusate sodium (stool softener)
also for Elvis (vagal response) and new moms (episiotomy)
PEG 3350 is an example of which type of laxative?
Osmotic Laxative
works by pulling water into the GI tract
Miralax is —-
PEG 3350 (Osmotic Laxative)
Which laxative will increase the size of the stool while softening it?
PEG 3350 (Osmotic Laxative)
works by pulling water into the GI tract, softening up the turd)
Why does the unique MOA of PEG 3350 work?
Osmotic Laxative that pulls water into GI tract
it both softens the turd (with the excess water) and also uses that excess water to stretch the intestines, stimulating peristalsis
Baby’s are given which laxative?
PEG 3350 (Osmotic Laxative)
pulls water into GI tract to soften the turd and stretch the intestines, stimulating peristalsis
A client taking PEG 3350 should expect to see turds in —–
2-4 days
Which laxative is good with chronic constipation?
PEG 3350 (Osmotic Laxative)
Main adverse effect w/ PEG 3350?
Bloating and Cramping from pulling all the water in
Client teaching for PEG 3350?
Osmotic Diuretic
teach client to dissolve in 4-8 ounces of water/sprite/juice
teach them to let it sit for 5-10 mins to dissolve if they don’t like swallowing it when it’s grainy
Which class of laxatives work by irritating the GI tract?
What does this irritation do?
Stimulant Laxatives (Senna, Bisacodyl, Senna/docusate)
irritating the GI tract INCREASES MOTILITY
How long will it take to have a BM while taking a Stimulant Laxative?
12 hours (PO)
1 hour (PR)
A patient taking Bisacodyl by mouth will crap in — hours and — hours if taking by rectum.
12 hours PO
1 hours PR
Which Stimulant laxative is PO only?
What does this mean?
Senna
will work in ~12 hours, not as fast as the rectum stimulants
Adverse effects of Senna, Bisacodyl & Senna/docusate?
These are Stimulant Laxatives
- GI discomfort (Nausea, Cramping, Bloating)
- Yellowish Brown or Pink Urine (Senna)
A patient reports pink urine, which laxative is she taking?
Senna
Bowel preparation a combination of —– and —– and the brand name is ——
PEG 3350
Electrolytes
GoLYTELY
GoLYTLEY is a —– —– laxative. What is an issue w/ administration?
Bowel Preparation Laxative
it’s hard to drink (high Na+ concentration)
What can we do to help a patient swallow GoLYTLEY?
- Chill it first
- Crystal Light
- Chug it fast
- Crap it fast (ie: have a pot ready cuz they’re gonna blow)
