A nurse cares for a client who is prescribed mesalamine (Asacol) ...

[nelaaney]

A nurse cares for a client who is prescribed mesalamine (Asacol) for ulcerative colitis. The client states, I am having trouble swallowing this pill. Which action should the nurse take?
 
  a. Contact the clinical pharmacist and request the medication in suspension form.
  b. Empty the contents of the capsule into applesauce or pudding for administration.
  c. Ask the health care provider to prescribe the medication as an enema instead.
  d. Crush the pill carefully and administer it in applesauce or pudding.

Question 2

A nurse assesses a client with Crohn's disease and colonic strictures. Which clinical manifestation should alert the nurse to urgently contact the health care provider?
 
  a. Distended abdomen
  b. Temperature of 100.0  F (37.8  C)
  c. Loose and bloody stool
  d. Lower abdominal cramps

[janeli]

Answer to Question 1

ANS: C
Asacol is the oral formula for mesalamine and is produced as an enteric-coated pill that should not be crushed, chewed, or broken. Asacol is not available as a suspension or elixir. If the client is unable to swallow the Asacol pill, a mesalamine enema (Rowasa) may be administered instead, with a provider's order.

Answer to Question 2

ANS: A
The presence of strictures predisposes the client to intestinal obstruction. Abdominal distention may indicate that the client has developed an obstruction of the large bowel, and the client's provider should be notified right away. Low-grade fever, bloody diarrhea, and abdominal cramps are common symptoms of Crohn's disease.