Indications & Mechanisms of Lower GI Drugs
Lower GI medications like stool softeners and laxatives are primarily indicated to treat or prevent this common bowel condition.
What is constipation?
Docusate sodium belongs to this specific class of laxatives that allows water and lipids to penetrate the fecal mass.
What are surfactant laxatives (or stool softeners)?
Over-the-counter loperamide is indicated to control and relieve symptoms of acute and non-specific chronic __________.
What is diarrhea?
Patients taking bulk-forming laxatives like psyllium must take the medication with a full glass of water to prevent this structural GI complication.
What is esophageal obstruction (or impaction/choking)?
Epinephrine is frequently added to local anesthetics like lidocaine to cause vasoconstriction, which prolongs the anesthetic effect and achieves this cardiovascular goal at the site.
What is decreasing local bleeding (or reducing systemic absorption)?
Laxatives work in part by increasing this action to help move intestinal contents through the GI tract.
What is peristalsis (or GI motility)?
Psyllium and methylcellulose belong to this laxative class, which absorbs water to add size to the fecal mass and stimulate peristalsis.
What are bulk-forming laxatives?
Antidiarrheal agents should generally be avoided if diarrhea is caused by infectious organisms or toxic substances, because stopping diarrhea prevents the body from doing this.
What is expelling/eliminating the pathogen or toxin?
Long-term, daily use of stimulant laxatives can lead to laxative dependence and loss of normal __________ tone.
What is bowel (or neuromuscular) tone?
Early signs of systemic toxicity from local anesthetics include metallic taste, numbness around the mouth, and this auditory symptom.
What is tinnitus (ringing in the ears)?
Stool softeners like docusate sodium help prevent straining during defecation, which is especially critical for patients recovering from surgery or this cardiovascular event.
What is a myocardial infarction (heart attack) or cardiac event?
Stimulant laxatives like bisacodyl and senna work by directly irritating this layer of the intestinal wall to induce peristalsis.
What is the intestinal mucosa (or smooth muscle)?
Diphenoxylate with atropine is a combination antidiarrheal; atropine is added in small sub-therapeutic doses to discourage this client behavior.
What is abuse/misuse (or overdose)?
Diphenoxylate is chemically related to some narcotics and may be habit-forming if taken in doses that are larger than prescribed. If higher than normal doses of the combination are taken, the atropine will cause unpleasant effects.
Before administering lower GI medications, the nurse should perform this physical assessment of the abdomen, including listening to bowel sounds.
What is auscultation (and palpation/inspection)?
Anticholinergic drugs like atropine or glycopyrrolate are given preoperatively to reduce these respiratory secretions.
What are oral and airway secretions (preventing aspiration)?
Antidiarrheal medications like loperamide work by slowing intestinal motility, which allows for increased absorption of water and this key component from the stool.
What are electrolytes?
Osmotic laxatives like polyethylene glycol and milk of magnesia work by drawing water into the stool using this process.
What is osmosis (or pulling water into the intestinal lumen)?
Chronic, unmanaged diarrhea places patients at high risk for dehydration and this specific electrolyte imbalance
What is hypokalemia (or electrolyte imbalance/metabolic acidosis)?
Patients prescribed stool softeners should be instructed to increase their daily intake of dietary fiber and this essential fluid.
What is water (fluids)?
Preoperative teaching for a client scheduled for surgery with general anesthesia should include instruction on these two pulmonary hygiene exercises to prevent atelectasis.
What are deep breathing and coughing exercises (and incentive spirometry)?
Pre-procedural bowel evacuants are administered prior to bowel surgery or this diagnostic endoscopic procedure.
What is a colonoscopy?
Mineral oil is an example of this class of laxative, which coats the stool and intestinal tract to prevent water reabsorption.
What are lubricant laxatives?
Bismuth subsalicylate (Pepto-Bismol) should be avoided in children recovering from viral illnesses due to the presence of salicylate, which carries a risk for this condition.
What is Reye's syndrome?
Laxatives are strictly contraindicated in patients presenting with undiagnosed acute abdominal pain to prevent rupturing this organ if inflamed
What is the appendix (preventing appendiceal rupture/peritonitis)?
Prior to administering preanesthetic medications, the nurse must confirm that this legal document has been signed by the client and witnessed.
What is the informed consent form?