A client recently had a myocardial infarction. Which medication would the nurse anticipate the provider prescribing?

A) Polyethylene Glycol: Polyethylene glycol is a medication typically used to treat constipation by promoting bowel movements. While it can be useful in managing constipation, it is not commonly prescribed after a myocardial infarction. In this situation, the focus is more on medications that promote heart health, reduce cardiac workload, and prevent complications related to the heart attack.

B) Bisacodyl: Bisacodyl is a stimulant laxative used to relieve constipation. However, this medication is not typically prescribed immediately following a myocardial infarction. Stimulant laxatives can cause dehydration and excessive fluid shifts, which can be harmful to a client recovering from a heart attack. The focus would be on safer options for bowel management in this context.

C) Senna: Senna is also a stimulant laxative, used for relieving constipation. Similar to bisacodyl, it is not ideal for clients who have recently experienced a myocardial infarction due to its potential for causing dehydration and electrolyte imbalances, which could negatively affect heart function. A gentler approach to bowel management is preferred for these clients.

D) Docusate Sodium: Docusate sodium is a stool softener commonly prescribed to prevent constipation, especially in clients who have recently had a myocardial infarction. After a heart attack, it's important to avoid straining during bowel movements, as this could increase pressure on the heart. Docusate sodium helps soften stools and promotes smoother bowel movements without stimulating the gastrointestinal system in a way that would elevate cardiac stress. It is the most appropriate choice for this client.

A) Metoprolol XL: Metoprolol XL (extended-release) should not be crushed. Crushing extended-release formulations can result in the rapid release of the drug, leading to an overdose or adverse effects due to the immediate release of the full dose. The nurse should advise the client to swallow this medication whole.

B) Ibuprofen EC (enteric-coated): Enteric-coated medications should not be crushed. The enteric coating is designed to protect the stomach lining by preventing the medication from being released in the stomach. Crushing the tablet would destroy this protective mechanism and could irritate the stomach lining, leading to discomfort or ulceration.

C) Morphine ER (extended-release): Extended-release formulations of morphine should never be crushed. Crushing extended-release formulations can lead to a potentially fatal overdose because it releases the entire dose of medication at once. This can cause respiratory depression and other life-threatening effects.

D) Acetaminophen: Acetaminophen in its regular tablet form can be safely crushed if needed. Crushing acetaminophen does not affect its effectiveness or safety, and it is a non-extended-release formulation, making it safe for manipulation when necessary, such as for clients with difficulty swallowing. However, it's essential to verify with the specific prescription, as acetaminophen is also available in extended-release formulations, which should not be crushed.