A nurse is admitting a patient to the hospital who reports having ...

[jman1234]

A nurse is admitting a patient to the hospital who reports having recurrent, crampy abdominal pain followed by diarrhea.
 
  The patient tells the nurse that the diarrhea usually relieves the pain and that these symptoms have occurred daily for the past 6 months. The patient undergoes a colonoscopy, for which the findings are normal. The nurse will plan to teach this patient to:
  a. use antispasmodic medications.
  b. avoid food containing lactose and gluten.
  c. keep a food, stress, and symptom diary.
  d. use antidiarrheal drugs to manage symptoms.

Question 2

A patient is taking bismuth subsalicylate (Pepto-Bismol) to prevent diarrhea. The nurse performing an assessment notes that the patient's tongue is black. What will the nurse do?
 
  a. Assess further for signs of gastrointestinal (GI) bleeding.
  b. Reassure the patient that this is an expected side effect of this drug.
  c. Request an order for liver function tests to evaluate for hepatotoxicity.
  d. Withhold the drug, because this is a sign of bismuth overdose.

[IAPPLET]

Answer to Question 1

ANS: C
This patient shows signs of irritable bowel syndrome (IBS), which can be managed with drug and nondrug therapies. Patients should be taught to keep a log to identify foods and stressors that trigger symptoms. Antispasmodic medications frequently are used, but there is no clear evidence of their benefit. Patients with malabsorption disorders may need to avoid lactose or gluten but only if indicated. Antidiarrheal drugs do not have clear benefits, even though they are commonly used.

Answer to Question 2

ANS: B
Bismuth subsalicylate can cause blackening of the tongue and stools, an expected side effect. This finding does not indicate GI bleeding, hepatotoxicity, or drug overdose.

[jman1234]

TYSM

[frankwu0507]

Excellent