A patient who is taking the loop diuretic furosemide is being prescribed the osmotic laxative polyethylene glycol. Which of the risks below should the patient be aware of before starting this new medication?

An increased risk for fluid and electrolyte imbalances

An increased risk for hepatotoxicity

An increased risk for constipation

An increased risk for developing peptic ulcers

Answer and Explanation

The Correct Answer is A

A. An increased risk for fluid and electrolyte imbalances: Furosemide, a loop diuretic, causes loss of sodium, potassium, and water. Polyethylene glycol, an osmotic laxative, draws water into the intestines, potentially worsening fluid loss and electrolyte disturbances. Combining these medications increases the risk of dehydration, hypokalemia, and other imbalances.

B. An increased risk for hepatotoxicity: Neither furosemide nor polyethylene glycol commonly causes liver toxicity. Hepatotoxicity is not a significant concern when these medications are combined.

C. An increased risk for constipation: Polyethylene glycol is used to relieve constipation, not cause it. The risk of constipation decreases rather than increases when this laxative is administered.

D. An increased risk for developing peptic ulcers: There is no direct association between polyethylene glycol and peptic ulcer formation. Ulcer risk is unrelated to the combination of this laxative with furosemide.

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Correct Answer is A

Explanation

A. Instruct the client to immediately discontinue St. John's wort and notify the provider due to risk of serotonin syndrome:St. John's wort can increase serotonin levels and, when combined with an SSRI like fluoxetine, significantly raises the risk of serotonin syndrome. Prompt discontinuation and provider notification are critical to prevent this potentially life-threatening adverse effect.

B. Encourage the client to increase fluid intake to prevent dehydration from diarrhea:While hydration is important, it does not address the primary risk of serotonin syndrome, which requires immediate intervention rather than supportive measures.

C. Advise the client to continue St. John's wort but monitor for mild gastrointestinal side effects:Serotonin syndrome can present with symptoms such as agitation, confusion, rapid heart rate, and hyperthermia. Monitoring for minor GI effects ignores the life-threatening risk.

D. Suggest the client reduce the dose of fluoxetine while taking St. John's wort to minimize serotonin effects:Self-adjusting SSRI doses is unsafe and may lead to subtherapeutic treatment or increased adverse effects. Dose changes must be guided by a healthcare provider, not the patient.

A. "That doesn't sound all that bad. Take some acetaminophen to treat the pain and continue with the medication” B. “This is an unexpected side effect of the medication. Stop the medication immediately and find another medication for your constipation” C. "This is a sign of gastrointestinal bleeding. Stop the medication immediately and seek medical attention." D. "This is an expected side effect of the medication, if it becomes intolerable, stop the medication and see your provider."

Correct Answer is D

Explanation

A. "That doesn't sound all that bad. Take some acetaminophen to treat the pain and continue with the medication":While mild cramping is common with stimulant laxatives, dismissing the patient’s discomfort and suggesting acetaminophen may not address the underlying cause. Education about expected effects and monitoring is safer.

B. “This is an unexpected side effect of the medication. Stop the medication immediately and find another medication for your constipation”:Mild abdominal cramping is a known and expected effect of bisacodyl. Stopping the medication immediately is unnecessary unless the cramping is severe or accompanied by other concerning symptoms.

C. "This is a sign of gastrointestinal bleeding. Stop the medication immediately and seek medical attention.":Mild cramping alone is not indicative of gastrointestinal bleeding. Signs of GI bleeding include black, tarry stools or bloody stools, which are not reported here. Immediate medical attention is not required for mild cramping.

D. "This is an expected side effect of the medication, if it becomes intolerable, stop the medication and see your provider.":Mild abdominal cramping is a common response to stimulant laxatives like bisacodyl. Educating the patient that it is expected while advising to report severe or persistent symptoms promotes safe use and patient understanding.

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A patient who is taking the loop diuretic furosemide is being prescribed the osmotic laxative polyethylene glycol. Which of the risks below should the patient be aware of before starting this new medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with bipolar disorder who is prescribed fluoxetine, an SSRI. The client has recently started taking St. John's wort on a friend's recommendation. Which nursing action is the priority to prevent a serious adverse effect?

Correct Answer is A

Explanation

A patient was started on Bisacodyl, a stimulant laxative, one day ago and is reporting mild abdominal cramping soon after taking the medication. Which statement made by the nurse reflects an appropriate response to this patient?

Correct Answer is D

Explanation

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