A client with an ileostomy has been experiencing excessive output for the past 48 hours. Which medication would the nurse expect the primary health care provider to prescribe?

cascara

octreotide

psyllium

loperamide

Answer and Explanation

The Correct Answer is D

A. cascara: Cascara is a natural stimulant laxative that promotes bowel movements by irritating the colon. It would increase gastrointestinal motility and worsen the client's ileostomy output, making it inappropriate in this situation.

B. octreotide: Octreotide is used for severe secretory diarrhea or conditions like carcinoid syndrome, but it is generally reserved for more complex cases and not first-line for managing high ileostomy output. It is also costly and requires subcutaneous or IV administration.

C. psyllium: Psyllium is a bulk-forming laxative that absorbs water and increases stool bulk to help with constipation. In clients with an ileostomy, it can risk causing obstruction or be ineffective at slowing output and is not typically recommended.

D. loperamide: Loperamide is an antidiarrheal that slows intestinal motility, allowing for increased absorption of fluids and electrolytes. It is commonly prescribed to manage high-output ileostomies.

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Correct Answer is A

Explanation

A. laxative dependence: Chronic use of stimulant laxatives can lead to the bowel becoming reliant on external stimulation for defecation. Over time, this weakens natural peristalsis and results in need for progressively stronger doses or continued use to maintain bowel movements.

B. stomach ulcers: Stomach ulcers are typically caused by factors such as Helicobacter pylori infection or NSAID overuse. Laxatives do not erode the gastric lining or contribute to ulcer formation as part of their mechanism of action.

C. reflux disease: Gastroesophageal reflux disease (GERD) results from lower esophageal sphincter dysfunction and is unrelated to laxative use. Laxatives affect the colon and rectum, not the upper gastrointestinal structures involved in reflux.

D. laxative toxicity: While laxative abuse can lead to electrolyte imbalances, especially hypokalemia, "laxative toxicity" is not a widely recognized or specific medical condition. The main clinical concern is dependence, not toxicity per se.

A. "Are you experiencing diarrhea?" B. "Do you ever experience flank pain?" C. "Have you noticed any blood in your urine?" D. "When is the last time you checked your blood pressure?"

Correct Answer is A

Explanation

A. "Are you experiencing diarrhea?": Long-term use of proton pump inhibitors (PPIs) is associated with an increased risk of Clostridium difficile–associated diarrhea. PPIs reduce stomach acid, which can alter gut flora and lower the body's defense against infections.

B. "Do you ever experience flank pain?": Flank pain may suggest kidney issues, but PPIs are not primarily linked to nephrolithiasis. Though there is a possible association with chronic kidney disease, flank pain is not a routine symptom assessed in long-term PPI users.

C. "Have you noticed any blood in your urine?": Hematuria is not a known common side effect of long-term PPI use. This symptom may suggest urinary tract or renal pathology, but it is not a priority assessment in the context of prolonged acid suppression therapy.

D. "When is the last time you checked your blood pressure?": PPIs do not significantly affect blood pressure regulation. While blood pressure monitoring is important in general assessments, it is not specifically related to long-term PPI use.

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A client with an ileostomy has been experiencing excessive output for the past 48 hours. Which medication would the nurse expect the primary health care provider to prescribe?

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Naxlex Comprehensive Predictor Exams

Regular, long term use of laxatives may cause:

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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