A patient reports taking an oral bisacodyl laxative (Dulcolax) ...

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A patient reports taking an oral bisacodyl laxative (Dulcolax) for several years. The provider has suggested discontinuing the laxative, but the patient is unsure how to do this. The nurse will tell the patient to:
 
  a. stop taking the oral laxative and use a suppository until normal motility resumes.
  b. stop taking the laxative immediately and expect no stool for several days.
  c. switch to a bulk-forming laxative, such as methylcellulose (Metamucil).
  d. withdraw from the laxative slowly to avoid a rebound constipation effect.

Question 2

The nurse is caring for an older adult patient after a right hip open reduction internal fixation (ORIF). The patient is taking an opioid every 6 hours as needed for pain. The nurse discusses obtaining an order from the prescriber for which medication?
 
  a. Docusate sodium (Colace)
  b. GoLYTELY
  c. Lactulose
  d. Polyethylene glycol (MiraLax)

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Answer to Question 1

ANS: B
The first step in breaking the laxative habit is abrupt cessation of laxative use. Bowel movements will be absent for several days after laxative withdrawal. Using a suppository, a bulk-forming laxative, or tapering the laxative only prolongs the habit and prevents normal function from returning.

Answer to Question 2

ANS: A
Oxycodone can be constipating. The patient needs something prophylactically, such as docusate sodium, that can be taken daily to prevent constipation. In addition, the patient's mobility is limited, which can further increase the risk of constipation. GoLYTELY is not indicated for constipation; it is used for cleansing the bowel before diagnostic procedures. Lactulose is not indicated; it typically is used for reducing ammonia levels in hepatic encephalopathy. Polyethylene glycol is indicated for occasional constipation; no information suggests that the patient is constipated.

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Excellent

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