Anti-diarrheals
The job of anti-diarrheal medications is to
slow the motility of the GI tract.
Phenothiazines can be used to treat nausea and vomiting associated with which intractable condition?
Intractable hiccoughs.
List 3 nonpharmacological interventions for a patient complaining of constipation.
Increase water intake, increase physical activity, increase dietary fiber intake. Bowel training program may be helpful in some patients.
neutralize stomach acid.
The most important vital sign for the nurse to assess when giving nitroglycerin is what?
Blood pressure. Nitro is a powerful vasodilator and can cause precipitous drops in systemic blood pressure.
There are 3 types of anti-diarrheal medications, including
- Bismuth subsalicylate
- Loperamide
- Opioid derivatives
Promethazine (or Phenergan) is used to treat what?
Promethazine is a first-generation antihistamine used to treat severe nausea and vomiting. It has side effects of sedation.
Laxatives should NOT be administered in which conditions (name at least 1).
Acute abdominal pain, nausea, or vomiting. This may signify the presence of a more serious condition.
Antacids have LOTS of medication interactions. Why is this?
They greatly affect absorption from the GI tract.
Physical assessment of which body system should be completed when GI medications are ordered?
Abdominal assessment - including gathering detailed history of symptoms. Also including:
- Inspection of abdomen - distension, waves of peristalsis, scars
-Auscultation - activity of bowel sounds
-Palpation - pain/tenderness, masses,
Loperamide is administered orally and is metabolized by the liver. Adverse effects the nurse should be aware of include
Abdominal pain, abdominal distension, dizziness, and drowsiness.
Name at least 3 side/adverse effects of ondansetron?
Headache, dizziness, drowsiness, myalgia, urinary retention, constipation; potentially hypotension
The most common side effects of all laxatives are what?
GI distress - abdominal cramping, diarrhea, nausea, vomiting, distension.
Which side effects of H2-antagonists are most concerning for the nurse?
The potential CNS side effects - including confusion and hallucinations.
The potential cardiac side effects - cardiac arrhythmias if medication is given IV/IM.
Metoclopramide is a gastrointestinal stimulant used to treat what?
Nausea/vomiting and gastroparesis. Short-term treatment of GERD. Stimulates movement of upper GI tract without stimulating secretion of digestive enzymes.
Bismuth subsalicylate is a popular OTC medication for the treatment of diarrhea. What side effects does the nurse need to be aware of when a patient states they have been using this medication?
The most important to be aware of are: constipation, distension, abdominal discomfort, nausea, vomiting, dry mouth. The most severe: toxic megacolon.
In general, coma or severe CNS depression is a a potential contraindication to antiemetics. Why?
Most antiemetics will cause further CNS depression, resulting in further decreased level of consciousness in these patients.
Lubricant laxatives (such as docusate) ARE or are NOT absorbed systemically?
They are NOT. This makes the side effects limited to the GI system including diarrhea, abdominal cramping, and nausea.
Proton-pump inhibitors are given with antibiotics to treat which condition?
Helicobacter pylori infection (infectious cause of GI ulcers).
Famotidine slows the metabolism of warfarin when these medications are taken together. This would increased serum levels of warfarin. What dangerous signs does the nurse watch for in this situation?
Signs of bleeding. Oozing of blood from IV/phlebotomy sites, bruising, petechiae. Signs of severe hemorrhage may include bleeding from gums, hypotension, and anemia.
How does the nurse know if the antidiarrheal medications is effective for patients?
Stool will be well-formed and soft. Frequency of stool may decrease as well.
Older adults are at higher risk for which of the side effects of antiemetic medications?
Sedation and confusion.
Lactulose treats 2 different conditions. What are they?
Constipation (by pulling fluid into the small intestine)
Hepatic encephalopathy (by pulling ammonia into the intestines, thus decreasing ammonia levels)
There is 1 medication currently approved for use as a gastrointestinal protectant. Its action is to coat any injured areas of the stomach to prevent further damage by exposure to gastric acid. What is this medication?
Sucralfate.
Name 2 cardio-selective beta-blockers.
Atenolol and metoprolol.