A patient reports taking an oral bisacodyl laxative Dulcolax for ...

[CQXA]

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

A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders thioridazine. The patient asks the nurse why the provider hasn't ordered olanzapine Zyprexa, which the patient has seen advertised on television.
 
  Which response by the nurse is the most im-portant reason that this patient is not receiving olanzapine? a. Olanzapine is more expensive than thi-oridazine.
  b. Olanzapine causes more metabolic side effects than thioridazine.
  c. Thioridazine has fewer side effects than olanzapine.
  d. Thioridazine has a faster onset of action than olanzapine.

[lkoler]

Answer to Question 1

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 re-turning.

Answer to Question 2

B
Olanzapine is an SGA and, although it has fewer extrapyramidal side effects than the FGA the provider has ordered, it has an increased risk of metabolic side effects, which is contraindicated in patients with diabetes. It is more expensive, but this is not the most important reason for not prescribing it. Thioridazine has more side effects than olanzapine, but the side effects caused by olanzapine are more critical for this patient. Thioridazine does not have a faster onset of action.

[CQXA]

Thank you!

[lkoler]

Always glad to help...