Deck 29: Antidiarrheals

Question 1

A patient who has had four to five liquid stools per day for 4 days is seen by the primary care NP.The patient asks about medications to stop the diarrhea.The NP tells the patient that antidiarrheal medications are:

A) not curative and may prolong the illness.
B) useful in cases of acute infection with elevated temperature.
C) most beneficial when symptoms persist longer than 2 weeks.
D) useful when other symptoms, such as hematochezia, develop.

Answer 1

not curative and may prolong the illness.

Question 2

A patient has been taking antibiotics to treat recurrent pneumonia.The patient is in the clinic after having diarrhea for 5 days with six to seven liquid stools each day.The primary care NP should:

A) obtain a stool specimen and order vancomycin.
B) order testing for Clostridium difficile and consider metronidazole therapy.
C) prescribe diphenoxylate (Lomotil) to provide symptomatic relief.
D) reassure the patient that diarrhea is a common side effect of antibiotic therapy.

Answer 2

order testing for Clostridium difficile and consider metronidazole therapy.

Question 3

A patient comes to the clinic with a 4-day history of 10 to 12 liquid stools each day.The patient reports seeing blood and mucus in the stools.The patient has had nausea but no vomiting.The primary care NP notes a temperature of 37.9° C,a heart rate of 96 beats per minute,and a blood pressure of 90/60 mm Hg.A physical examination reveals dry oral mucous membranes and capillary refill of 4 seconds.The NP's priority should be to:

A) obtain stool cultures.
B) begin rehydration therapy.
C) consider prescribing metronidazole.
D) administer opioid antidiarrheal medications.

Answer 3

begin rehydration therapy.

Question 4

A woman who is 4 months pregnant comes to the clinic with acute diarrhea and nausea.Her husband is experiencing similar symptoms.The primary care nurse practitioner (NP)notes a temperature of 38.5° C,a heart rate of 92 beats per minute,and a blood pressure of 100/60 mm Hg.The NP should:

A) prescribe attapulgite to treat her diarrhea.
B) obtain a stool culture and start antibiotic therapy.
C) instruct her to replace lost fluids by drinking Pedialyte.
D) refer her to an emergency department for intravenous (IV) fluids.

Question 5

A 12-year-old patient has acute diarrhea and an upper respiratory infection.Other family members have had similar symptoms,which have resolved.The primary care NP should recommend:

A) diphenoxylate (Lomotil).
B) attapulgite (Kaopectate).
C) an electrolyte solution (Pedialyte).
D) bismuth subsalicylate (Pepto-Bismol).

Question 6

A 2-year-old child has chronic "toddler's" diarrhea,which has an unknown but benign etiology.The child's parent asks the primary care NP if a medication can be used to treat the child's symptoms.The NP should recommend giving:

A) diphenoxylate (Lomotil).
B) attapulgite (Kaopectate).
C) an electrolyte solution (Pedialyte).
D) bismuth subsalicylate (Pepto-Bismol).

Question 7

A patient who has experienced five to seven liquid stools for 3 days is seen in the clinic by the primary care NP.The patient reports having had fever,mucoid stools,and nausea without vomiting.The patient has been drinking Gatorade to stay hydrated.The NP obtains a stool specimen for culture and should prescribe:

A) diphenoxylate (Lomotil).
B) attapulgite (Kaopectate).
C) bismuth subsalicylate (Pepto-Bismol).
D) loperamide hydrochloride (Imodium).