You have been asked by one of the clinic nurse practitioners that you work with to give a recommendation for the treatment of acute diarrhea. The patient, JW, is a 27-year- old female, is not pregnant, and has no known allergies to medications or foods. She has not been diagnosed with any chronic diseases and thus does not take prescription medications. JW attended a picnic with her classmates and has had frequent, watery stools. She estimates she has had at least four stools within the past 24 hours Several other people had the same symptoms.
What do you recommend that JW do to treat her symptoms of diarrhea?
Loperamide 2 mg tablets - She should take 4 mg x 1 dose by mouth then 2 mg for each loose stool, do not exceed 8 mg/day, duration of use 48 hours
Bismuth subsalicylate liquid or tablets - She should take 525 mg every 30-60 minutes up to 4200 mg/day, duration of use 48 hours
A or B
There are no appropriate recommendations for JW's diarrhea given in the options listed
The Correct Answer is C
A. Loperamide 2 mg tablets - She should take 4 mg x 1 dose by mouth then 2 mg for each loose stool, do not exceed 8 mg/day, duration of use 48 hours: Loperamide is appropriate for acute, non-bloody diarrhea in otherwise healthy adults. It reduces intestinal motility, helping decrease stool frequency and improve comfort.
B. Bismuth subsalicylate liquid or tablets - She should take 525 mg every 30–60 minutes up to 4200 mg/day, duration of use 48 hours: Bismuth subsalicylate is effective for mild to moderate acute diarrhea and has antimicrobial and anti-secretory effects. It is particularly useful in cases of suspected infectious diarrhea from food exposure, such as a picnic setting, making it appropriate
C. A or B: Both loperamide and bismuth subsalicylate are appropriate first-line OTC treatments for acute diarrhea in a healthy adult without contraindications. Either can be selected based on patient preference, symptom severity, and tolerance, making this the best overall answer.
D. There are no appropriate recommendations for JW's diarrhea given in the options listed: JW’s presentation is consistent with uncomplicated acute diarrhea likely due to foodborne illness. She has no contraindications, so OTC options like loperamide or bismuth subsalicylate are appropriate and recommended.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Short-term, transient insomnia due to lifestyle changes: This type of insomnia is often caused by stress, travel, or temporary schedule disruptions. Mild interventions such as caffeine consumption, limiting naps, and improving sleep hygiene can provide symptom relief, making it appropriate for self-care measures like drinking a Red Bull.
B. Narcolepsy: Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness, cataplexy, and sleep paralysis. It requires prescription management and behavioral interventions, so self-care measures alone are insufficient.
C. Restless leg syndrome: Restless leg syndrome causes uncomfortable sensations in the legs and an urge to move them, often interfering with sleep. Treatment often includes pharmacologic therapy and lifestyle modifications; caffeine may actually worsen symptoms.
D. Obstructive sleep apnea: Obstructive sleep apnea involves repeated airway obstruction during sleep, leading to excessive daytime sleepiness. Management typically requires CPAP therapy, weight management, or surgery, making self-care measures like caffeine inadequate.
Correct Answer is A
Explanation
A. Emollient laxatives: Emollient (stool-softening) laxatives, such as docusate sodium, are considered safe for short-term use in pregnancy. They work by softening the stool and easing passage without stimulating the bowel or causing fluid shifts, making them appropriate for up to two weeks.
B. Stimulant laxatives: Stimulant laxatives, like bisacodyl or senna, directly stimulate intestinal motility and can cause cramping or electrolyte imbalances. They are generally avoided in pregnancy because they may induce uterine contractions or dehydration.
C. Saline laxatives: Saline laxatives, such as magnesium hydroxide or magnesium citrate, draw water into the intestines and can cause fluid and electrolyte disturbances. They are typically not recommended in pregnancy due to potential maternal and fetal complications.
D. None of these categories of laxatives would be safe to use in a pregnant female: This is inaccurate because emollient laxatives have a good safety profile in pregnancy and are commonly recommended for short-term relief of constipation.
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