Which would the nurse be prepared to administer to a client who has overdosed on diphenoxylate with atropine?

A. Hemorrhoids: Magnesium hydroxide may actually be helpful in clients with hemorrhoids, as it softens stools and reduces straining during bowel movements. It is not contraindicated and may even provide symptom relief in these clients.

B. Prostatitis: There is no direct interaction between magnesium hydroxide and prostatitis. While bowel function should be monitored, use of this antacid/laxative is not typically restricted based on prostate inflammation.

C. Chronic renal failure: Magnesium is excreted through the kidneys, and in clients with chronic renal failure, its use may lead to magnesium toxicity. This can result in lethargy, bradycardia, hypotension, and even cardiac arrest, making this a clear contraindication.

D. Cirrhosis: While caution is required in cirrhosis due to risk of hepatic encephalopathy and electrolyte imbalances, magnesium hydroxide may still be used if monitored. It is not an absolute contraindication the way renal failure is.

A. Abdominal pain and abnormal liver function tests are expected effects: While rare side effects like abdominal discomfort or liver enzyme elevations can occur, they are not expected or common. Clients should report such symptoms promptly.

B. The medication is to be swallowed whole and taken before meals: Delayed-release PPIs (e.g., omeprazole, lansoprazole) must be swallowed whole to preserve the enteric coating that protects the drug from stomach acid. They should be taken before meals for optimal acid suppression when the proton pumps are most active.

C. May cause proctitis: Proctitis (inflammation of the rectum) is not a recognized side effect of oral proton pump inhibitors. This side effect is unrelated to PPI therapy and is more often associated with infections, radiation, or inflammatory bowel diseases.

D. Do not take with alcohol or any other CNS depressants: PPIs do not have CNS depressant effects and do not interact significantly with alcohol or CNS depressants. While limiting alcohol is generally advisable for gastrointestinal health, it is not specific to PPI use.