2350 Final Exam Questions And Already
Passed Answers.
constipation - Answer symptom caused by slower emptying of the large intestine; characterized by
fewer than 3 BM/week with hard stool, strain at stool or incomplete evacuation
rome criteria - Answer must experience 2 or more symptoms over the preceding two months;
symptoms include fewer than three spontaneous bowel movements per week, straining for more than
25% of defecation attempts, lumpy or hard stools for at least 25% of attempts, sensation of anorectal
blockage for at least 25% of attempts, sensation of incomplete defecation for 25% of attempts, manual
maneuvering required to defecate for 25% of attempts
drugs for contipation - Answer classes of drugs that are used to speed up, stimulate, or improve
motility; include bulk stimulants, stool softeners, stimulants, osmotics
bulk stimulants - Answer laxatives that bulk forming fiber and increase water causing fecal matter to
increase in bulk and turn gel like; bowel distends to initiate reflex bowel activity, good for long term use
Psyllium (Metamucil)
Methylcellulose (Citrucel) - Answer bulk stimulant laxatives
chemical stimulants - Answer laxatives that stimulate the nerve plexus in the intestinal wall to increase
peristalsis; cautions for cardiac disease-stimulation of vagus nerve with PR administration, bleeding
precautions with PR administration
Biscodyl (Dulcolax)
Senna (Senokot) Castor oil - Answer chemical stimulant laxatives
stool softeners - Answer promote more water and fat in the stools which lubricates the fecal material
and intestinal walls; act within 1-3 days; cautions with cardiac disease, can decrease absorption of fat
soluble vitamins A, D, E, K
,Ducusate (Colace) - Answer stool softener
Pericolace - Answer laxative and stool softener combined
saline laxatives - Answer laxatives that work by increasing water into the stool using mineral salt;
cautions in cardiac disease due to F/E imbalance; should monitor for diarrhea, cramps, F/E imbalances,
dehydration; need to be taken 30 minutes before or after other meds and taken with generous water
magnesium citrate (Citroma) - Answer saline laxaitve
osmotic laxative - Answer laxatives that work by pulling water back into the colon to soften stool
lactulose (Cephulac) polyethylene glycol (Miralax) - Answer osmotic laxative
Linaclotide (Linzess) - Answer guanylate cyclase-C agonist
guanylate cyclase-C agonist - Answer drug used for IBS with constipation or just constipation; increases
the production of cyclic guanosine monophosphate which increases fluid secretion into the intestine and
reduces the sensitivity of pain sensing nerves
(nursing concerns for) laxatives - Answer concerns include obtaining a thorough hx including
symptoms, elimination patterns, allergies; assess for fluid and electrolytes; encourage high fiber and high
fluids, long term use may lead to dependency, should be swallowed whole and taken with water; hold
for nausea, vomiting, abd pain, obstruction, post-op
diarrhea - Answer symptom of liquid, watery stool; caused by osmotic, motility disorders, secretory,
infections; dx needs stool samples and WBC count; treatment is fluids, lytes, antidiarrheals
Clostrodium difficile colitis - Answer common HCA infection that changes gut flora, may occur as the
result of ABX like clindamycin, PCN, cephalosporins, fluoroquinolones; treated with vancomycin, flagyl,
fidaxomixin (dificid); can re infect and can be deadly
,antidiarrheals - Answer drugs that are used to decrease GI tract movement and have a direct lining of
the GI tract, inhibits local reflexes, slows muscle activity
Loperamide (Imodium) - Answer antidiarrheal drug that acts on the opiate receptors in the gut but can
not cross BBB; contraindicated in acute abd process, infectious process; monitor for constipation and
dehydration
lomotil - Answer antidiarrheal drug with diphenoxylate and atropine; may cause respiratory depression
and dependance; combination may discourage recreational opiate use; large doses result in dry mouth,
abd pain, tachycardia, blurred vision anticholinergic effects
travelers diarrhea - Answer E. coli infection
Bismuth subsalicylate (Pepto-Bismol) - Answer antidiarrheal that slows the motility of the gut and
works by helping to slow the growth of bacteria that may be causing the infection
Rifaximin (Xifaxan) - Answer antibiotic to treat e.coli infections causing traveler's diarrhea
(nursing concerns for) antidiarrheals - Answer concerns include through history of bowel patterns,
general state of health, recent history of illness or dietary change and allergy; should rule out acute abd,
infectious process before administering; teach patients to take medication as perscribed and be aware of
fluid intake, dietary and medication changes; assess fluid volume status, I and O, mucous membranes
before, during, after initiation of treatment; monitor for therapeutic effect
Helicobacter pylori - Answer bacterium found in GI tract of 90% of patients with duodenal ulcers, 70%
of gastric ulcers, may not cause problems in some patients; can be detected by serum and antibody
tests, endoscopy, urea breath test; tx is combination of PPI and abx B/M/T + PPI 10-14 days
hydrochloric acid - Answer substance secreted by the parietal cells when stimulated by food, large fatty
meals, excessive amounts of alcohol, emotional stress; helps to break down food; acts as a bactericide;
helps maintain stomach pH
GERD (gastroesophageal reflux disease) - Answer disease where there is a reflux in gastric content into
the esophagus; may experience an increase in abdominal pressure from vomiting, coughing, lifting,
, bending, delayed gastric emptying, hiatal hernia, straining to have BM; reflux can lead to esophagitis
symptoms like heart burn, pain, coughing, esophageal stricture; treated with H2 blockers, PPIs (severe),
and fundoplication
peptic ulcer diease - Answer disease caused by a disruption of the mucosal integrity of the stomach or
duodenum causing a gastric of duodenal ulcer; local excavation due to inflammation; caused by H. pylori
95% of the time and NSAIDs; risk factors include stress, H. pylori, alcohol, smoking
gastric ulcer - Answer cause of peptic ulcer disease; patient may have weight loss, normal or less than
normal Hcl, mucosal permeability increase; pain 1/2 hour to 1 hour after meals, reflux of duodenal bile,
use of aspirin, pain induced by eating
duodenal ulcer - Answer most common ulcer in peptic ulcer disease; patient may be well nourished, h.
pylori infection, inadequate secretion of bicarb in duodenum, pain 2-3 hours after meals, quick gastric
emptying with acid; food may decrease pain; risk of gastric ulcer, cancer; treated with meds; O blood
type more prone
B/M/T + PPI - Answer treatment for H. pylori; take bismuth subsalicylate 2 tabs 4 x day; metronidazole
250 mg 4 x day or 500 mg tid; tetracycline 500 mg 4 x day; PPI of choice twice daily; take medications 10-
14 days
acid controlling medications - Answer drugs that decrease secretion activity, block the action of
secretions, form protective coating; include H2 agonists, PPIs, antacids
Histamine-2 agonists - Answer drugs that selectively block the H2 receptors of parietal cells which
helps to block the release of Hcl in response to gastrin of PNS stimulation
Ranitidine (Zantac) - Answer H2 antagonist drug; removed from shelves due to NMDA which is
classified as a substance than can cause cancer
Famotidine (Pepcid) - Answer H2 antagonist drug that is the most potent of the class, used in acute
care more often due to IV use; caution isn renal/hepatic disease for dose adjustment, decreased B12
absorption, CNS effects including headache and dizziness, urinary retention, cardiac arrhythmias due to
H2 receptors in the heart, hypotension, should be administered with or before meals and HS
