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Terms in this set (45)
What is the function of the colon?
Absorbs water and electrolytes
(1500 mL of fluid enters colon each day and 90% of fluid is absorbed)
What is a cause for constipation?
Diet deficient in fiber and fluid.
What are some drugs that cause constipation?
Antacids (aluminum hydroxide)
What is a laxative effect?
Production of soft, formed stool over a period of 1 or more days.
What is a catharsis?
Prompt, fluid evacuation of the bowel
FAST AND INTENSE
Laxatives are used to?
Ease or stimulate defecation.
Misuse of laxatives comes from?
Misconceptions of what constitutes normal bowel function
Contraindications for laxative use?
Indvs experiencing abdominal pain, nausea, cramps, or other symptoms of appendicitis
Use with caution in PREGNANCY AND LACTATION
Bulk forming laxatives are?
Surfactant laxatives are known as what? Because?
True "stool softeners" because they facilitate penetration of water into feces which softens stools.
Surfactant laxatives are?
*Docusate sodium or
Stimulant laxatives are?
Castor oil (small intestine)
Stimulate peristalsis and increase secretion of water and electrolytes into the intestines.
Osmotic laxatives are?
Magnesium (hydroxide, sulfate and citrate) (Milk of Magnesia [MOM])
What are some misc. laxatives?
Which drug is used for idiopathic constipation in aults and IBS in women > 18 years?
Which laxatives produce an immediate response (Stool in 5-30 min)?
Which laxatives produce a quick response (watery/semifluid stool 2-6 hours)?
Osmotic laxatives (in high doses)
Proper function of bowel is highly dependent on?
Dietary fiber, which absorbs water which softens feces and increases fecal mass.
Which laxative is the preferred treatment for temporary treatment of constipation and diarrhea! (BOGO)
Which drugs are the bulk-forming laxatives again?
Polycabophil (Fibercon, etc.)
What is an adverse effect of bulk-forming laxatives?
What should you teach patients to do with bulk-forming laxatives?
Take with a full glass of water
Surfactant laxatives are the true "stool softeners". What are they the DOC for?
Which drug is for surfactant laxatives again?
Docusate sodium (Colace)
What should you teach pts to do with surfactant laxatives?
Take with a full glass of water.
What are the drugs for stimulant laxatives again?
Bisacodyl (Dulcolax, etc.)
Senna (Ex-lax, etc.)
Are stimulant laxatives for long term use?
Stimulant laxatives are most commonly abused by the general public. What are it's two legitimate uses?
Opioid induced constipation
TX of slow intestinal transit.
What should the nurse instruct his/her patients about stimulant laxatives?
Take no sooner than 1 hr p ingesting milk or antacids
Swallow intact w/o crushing or chewing
Senna (stimulant laxative) can cause urine to have what?
A yellowish-brown or pink color
What are drugs for osmotic laxatives again?
Magnesium salts (Mg hydroxide, -citrate, and -sulfate)
Sodium salt (Na phosphate)
What are some AEs of osmotic laxatives?
Renal decline: Mg toxicity (poorly absorbed, but does)
Na retention (exacerbates heart failure, hypertension, edema, acute renal failure)
What should pts be taught about osmotic laxatives?
Taught to increase fluid intake
What is a property of lactulose?
Poorly absorbed and cannot be digested by intestinal enzymes but colonic enzymes metabolize it into acids which promote a mild osmotic effect.
When is lactulose used?
Only use if pts do not respond to bulk forming laxative.
Unpleasant side efx (flatulence and cramping)
What does lactulose help with in pts with hepatic disease?
Enhance intestinal excretion of ammonia which helps lower blood ammonia levels in pts with hepatic disease
What are some AEs of mineral oil?
Aspiration of oil droplets can cause lipid pneumonia
Excessive dosing can decrease absorption of fat-soluble vitamins
Glycerin supp can cause evacuation in ___ and are used to what?
Used to re-establish normal bowel function following termination of laxative abuse.
Polyethylene glycol (PEG) are known as?
Bowel cleansers (GoLYTELY)
PEG allows for what?
Good visualization of the bowel for colonoscopy.
There are two kinds of bowel cleansers (both equally effective). What are they?
PEG plus electrolytes (ELS)
Why is PEG-ELS safer than sodium phosphate?
No electrolyte imbalance, no dehydration; safer for pts w/ electrolyte imbalances, heart failure, kidney disease, advanced liver disease.
PEG-ELS requires what?
Ingestion of large volume of bad-tasting liquid, but now have others.
What is a cause for laxative abuse?
Bowel replenishment after evacuation can be
2-5 days: often mistaken for constipation (vicious cycle)
What should you teach pts about laxative?
Normal bowel fx
Ingesting high fiber foods
Exercise and establishing regular bowel habits.
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