A client has prescriptions for albuterol (Proventil HFA) and salmeterol (Serevent). Which instruction should the nurse provide for this client?

A. Chronic diarrhea: Overuse of laxatives is more likely to cause chronic constipation rather than chronic diarrhea. While some types of laxatives can lead to diarrhea as a side effect, chronic diarrhea is less common with laxative overuse compared to chronic constipation.

B. Chronic constipation
When the smooth muscle in the colon loses its tone due to overuse of laxatives, it can lead to chronic constipation. Laxatives work by stimulating bowel movements, but frequent or excessive use can lead to dependency and decreased natural bowel function. Over time, the colon may become less responsive to normal stimuli, resulting in difficulty passing stool and chronic constipation.

C. Frequent vomiting: Overuse of laxatives is not directly associated with frequent vomiting. Vomiting can occur as a result of various gastrointestinal issues, but it is not a typical consequence of laxative overuse.

D. Chronic nausea: While gastrointestinal symptoms such as nausea may occur as a side effect of some laxatives, chronic nausea is not a common consequence of laxative overuse. It is more likely to result from other underlying medical conditions or gastrointestinal disturbances.

A) Treatment with PPIs to decrease stomach acid:
Proton-pump inhibitors (PPIs) are used to decrease stomach acid production and are commonly prescribed for conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. However, they do not address the underlying cause of pancreatic insufficiency, which is the deficiency of pancreatic enzymes.

B) Treatment with stimulant laxatives:
Stimulant laxatives are used to stimulate bowel movements and are not indicated for the treatment of pancreatic insufficiency. Pancreatic insufficiency primarily affects the digestion of nutrients rather than bowel motility.

C) Replacement therapy with pancreatic enzymes.
Pancreatic insufficiency occurs when the pancreas does not produce enough digestive enzymes to properly digest food, leading to malabsorption of nutrients. Replacement therapy with pancreatic enzymes is the mainstay of treatment for pancreatic insufficiency. These enzymes, often prescribed in the form of pancreatic enzyme replacement therapy (PERT), help to supplement the deficient enzymes and aid in the digestion of fats, proteins, and carbohydrates.

D) Decrease food intake:
Decreasing food intake is not an appropriate treatment for pancreatic insufficiency. In fact, individuals with pancreatic insufficiency may need to increase their food intake to compensate for malabsorption and ensure adequate nutrition. Restricting food intake would worsen nutritional deficiencies and symptoms associated with malabsorption.