Question 1

The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day.The nurse determines that the child has had three wet diapers in the past 6 hours.What will the nurse recommend for this child?

Accepted Answer

The child is not dehydrated as evidenced by adequate wet diapers,so nonpharmacologic measures,such as oral fluids,are recommended.Antiemetics are not recommended unless dehydration occurs.Intravenous fluids are given when dehydration is present.

Question 2

A patient asks the nurse the best way to prevent traveler's diarrhea.The nurse will provide which recommendation to the patient?

Accepted Answer

Patients traveling to areas with potential traveler's diarrhea should be taught to drink bottled water and eat meats that are well cooked.Prophylactic antibiotics are not recommended.Patients should eat cooked,washed fruits and vegetables.Loperamide can increase exposure to pathogens by slowing motility.

Question 3

The nurse is caring for a patient who has postoperative nausea and vomiting.The surgeon has ordered promethazine HCl (Phenergan).Which aspect of this patient's health history would be of concern?

Accepted Answer

Promethazine is contraindicated in patients with glaucoma since it is an anticholinergic medication.It should be used with caution in patients with asthma.The other two conditions are not concerning with this medication.

Question 4

A patient who is taking diphenoxylate with atropine (Lomotil)to treat diarrhea asks the nurse why it contains atropine.The nurse will explain that atropine is added to

Accepted Answer

Atropine is added to decrease abdominal cramping and intestinal motility.It does not affect nausea and vomiting or pain.

Question 5

The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes.The nurse will explain that,when given as antiemetics,these drugs are given

Accepted Answer

Antipsychotic medications have antiemetic properties in smaller doses.

Question 6

A patient who is receiving chemotherapy will be given dronabinol (Marinol)to prevent nausea and vomiting.The nurse will tell the patient that this drug will be given at which time?

Accepted Answer

Cannabinoids are given prior to chemotherapy and for 24 hours after chemotherapy.

Question 7

The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan)is not being used to suppress vomiting.The nurse will explain that,in children,this drug is more likely to cause which effect?

Accepted Answer

Metoclopramide can cause extrapyramidal symptoms,and these effects are more likely in children.Children are not more prone to sedative effects,paralytic ileus,or vertigo while taking this drug.

Question 8

The child who is a candidate for treatment with an emetic after ingestion of a toxic substance or overdose is the child who has ingested which substance?

Accepted Answer

An emetic,such as Ipecac,should not be given to patients who have ingested caustic substances or petroleum distillates since regurgitation carries a risk of aspiration.Acetaminophen is not a caustic substance or a petroleum distillate.Chlorine bleach and toilet cleanser are caustic substances.Kerosene is a petroleum distillate.

Question 9

A patient asks the nurse about using loperamide (Imodium)to treat infectious diarrhea.Which response will the nurse give?

Accepted Answer

Patients with infectious diarrhea should be cautioned about using loperamide since slowing transit through the intestines may prolong the exposure to the infectious agent.Loperamide causes less CNS depression than other antidiarrheals.It is taken after each loose stool.

Question 10

A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medications to treat this problem.The nurse will recommend that the patient take which action first?

Accepted Answer

Pregnant women should avoid antiemetics during the first trimester of pregnancy because of possible teratogenic effects.The nurse should recommend nonpharmacologic measures such as saltines.If this is not effective,intravenous fluids may become necessary.Pregnant women should consult with their provider before taking prescription or over-the-counter antiemetics.

Question 11

A child is brought to the emergency department after ingestion of a toxic substance.The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior.The nurse will anticipate administering

Accepted Answer

Activated charcoal is used when patients have ingested a caustic substance or a petroleum distillate in a patient who is alert and awake.Gastric lavage is no longer used as therapy.Syrup of ipecac is not recommended.

Question 12

A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight.The nurse will instruct the patient to take the medication at which time?

Accepted Answer

Motion sickness medication has its onset in 30 minutes.The patient should be instructed to take the medication a half hour prior to takeoff.It is not used as needed.

Question 13

The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil)to treat severe diarrhea.The nurse will monitor this patient closely for which effect?

Accepted Answer

Diphenoxylate is an opium agonist and can cause respiratory depression.Children and older adults are more susceptible to this effect.It contains atropine,so it will increase heart rate.It does not contribute to fluid retention.Lomotil causes central nervous system depression and will not cause nervousness and tremors.

Question 14

The nurse is caring for a patient who has unexplained,recurrent vomiting and who is unable to keep anything down.Until the cause of the vomiting is determined,the nurse will anticipate administering which medications?

Accepted Answer

Antiemetics can mask the underlying cause of vomiting and should not be used until the cause is determined unless vomiting is so severe that dehydration and electrolyte imbalance occur.Nonpharmacologic measures,such as fluid and electrolyte replacement,should be used.Antibiotics are only used if an infectious cause is determined.

Question 15

The nurse is instructing a patient who will take psyllium (Metamucil)to treat constipation.What information will the nurse include when teaching this patient?

Accepted Answer

Insufficient fluid intake can cause the drug to solidify in the gastrointestinal tract.Psyllium is not digestible,so it does not have systemic side effects.Onset of action for psyllium is between 10 and 24 hours.The dry form can cause cramping.

Question 16

A patient reports having three to four stools,which are sometimes hard,per week.The nurse will perform which action?

Accepted Answer

This patient is having stools that are within the normal range for frequency.Nonpharmacologic measures should be used first to help soften stools.

Question 17

The nurse is teaching a group of parents about the use of syrup of ipecac.Which instruction will the nurse provide?

Accepted Answer

Ipecac should not be used for caustic substances or petroleum distillates.Ipecac should be given only after determining whether it is safe.The onset of emesis is within 15 to 30 minutes.Ipecac should not be given with milk or carbonated beverages.Ipecac syrup should be used.

Question 18

An appropriate goal when teaching a patient who has diarrhea is that the patient

Accepted Answer

An appropriate goal is that patients will have formed less frequent stools,not an absence of stools.Receiving adequate intravenous fluids or antibiotic therapy are interventions,not goals.

Question 19

The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine)to prevent motion sickness.What information is important to include when teaching this patient?

Accepted Answer

Drowsiness is a common side effect of dimenhydrinate,so patients should be cautioned against driving while taking this drug.Dry mouth is a common side effect and not a sign of toxicity.The drug should be taken 30 minutes prior to travel.The maximum recommended dose is 400 mg per day.

Quiz 42: Gastrointestinal Tract Disorders

The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day.The nurse determines that the child has had three wet diapers in the past 6 hours.What will the nurse recommend for this child?

A patient asks the nurse the best way to prevent traveler's diarrhea.The nurse will provide which recommendation to the patient?

The nurse is caring for a patient who has postoperative nausea and vomiting.The surgeon has ordered promethazine HCl (Phenergan) .Which aspect of this patient's health history would be of concern?

A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse why it contains atropine.The nurse will explain that atropine is added to

The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes.The nurse will explain that,when given as antiemetics,these drugs are given

A patient who is receiving chemotherapy will be given dronabinol (Marinol) to prevent nausea and vomiting.The nurse will tell the patient that this drug will be given at which time?

The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan) is not being used to suppress vomiting.The nurse will explain that,in children,this drug is more likely to cause which effect?

The child who is a candidate for treatment with an emetic after ingestion of a toxic substance or overdose is the child who has ingested which substance?

A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea.Which response will the nurse give?