McKenna's Pharmacology for Nursing, 2e

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P A R T 1 1  Drugs acting on the gastrointestinal system

Paul, S. P., Dewdney, C. & Lam, C. (2012). Managing children with constipation in the community. Nurse Prescribing, 10(6) , 274–284. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Prynn, P. (2011). Managing adult constipation. Practice Nurse, 41(17) , 23–28. Sarre, R. (2005). Bowel preparation. Australian Prescriber, 28 , 16–17.

Selby, W. (2010). Managing constipation in adults. Australian Prescriber, 33 , 116–119. Shah, S. B. & Hanauer, S. B. (2007). Treatment of diarrhea in patients with inflammatory bowel disease: concepts and cautions. Reviews in Gastroenterology Disorders, 7 (Suppl 3), S3–S10. Tobias, N., Mason, D., Lutkenhoff, M., Stoops, M. & Ferguson, D. (2008). Management and principles of organic causes of childhood constipation. Journal of Pediatric Health Care, 22(1) , 12–23. Wang, M., Szucs, T. D. & Steffen, R. (2008). Economic aspects of traveler’s diarrhea. Journal of Travel Medicine, 15(2) , 110B.

C H E C K Y O U R U N D E R S T A N D I N G

MULTIPLE RESPONSE Select all that apply. 1. A nurse or midwife is preparing a teaching plan for a person who has been prescribed a laxative. The teaching plan should include which of the following? a. the importance of proper diet and fluid intake b. the need to take the drug for several weeks to get the full effect c. the importance of exercise d. the need to take advantage of natural reflexes by providing privacy and time to allow them to work e. the need to limit fluids f. the importance of limiting the duration of laxative use 2. A nurse or midwife might expect an order for liquid paraffin for which person? a. a debilitated person low on nutrients b. a person with haemorrhoids c. a person with recent rectal surgery d. a child with encopresis e. a postpartum woman f. a person with Crohn’s disease 3. When explaining the actions of laxatives to a person, the nurse or midwife would state that they can work by: a. acting as chemical stimulants. b. acting as lubricants of the intestinal bolus. c. acting to increase bulk of the intestinal bolus and stimulate movement. d. stimulating CNS centres in the medulla to cause GI movement. e. blocking the parasympathetic nervous system. f. causing central nervous system depression.

Answers to the questions in this chapter can be found in Appendix A at the back of this book.

MULTIPLE CHOICE Select the best response to the following. 1. Laxatives are drugs that are used to:

a. increase the quantity of wastes excreted. b. speed the passage of the intestinal contents through the GI tract. c. increase digestion of intestinal contents. d. increase the water content of the intestinal contents. 2. The laxative of choice when mild stimulation is needed to prevent straining is: a. senna. b. castor oil. c. bisacodyl. d. magnesium sulphate. 3. Cathartic dependence can occur when: a. people do not use laxatives routinely and experience severe bouts of constipation. b. chronic laxative use leads to a reliance on the intense stimulation of laxatives. c. people maintain a nutritious high-fibre diet. d. people start an exercise program to promote bowel elimination. 4. Drugs that stimulate parasympathetic activity are used to increase GI activity and secretions. For which of the following would this group be most likely used? a. duodenal ulcers b. gastric ulcers c. gastro-oesophageal reflux disease d. poisoning, to induce nausea and vomiting 5. The drug of choice for treating traveller’s diarrhoea is: a. loperamide. b. opium. c. bisacodyl. d. peppermint oil.