A patient has been taking psyllium (Metamucil) 2 to 3 times daily ...

[vHAUNG6011]

A patient has been taking psyllium (Metamucil) 2 to 3 times daily for several days. The patient complains of stomach pain but has not had a stool. What will the nurse do?
 
  a. Ask the patient to drink a full glass of water.
  b. Give another dose of the psyllium.
  c. Request an order for a bisacodyl (Dulcolax) suppository.
  d. Palpate the patient's abdomen and auscultate for bowel sounds.

Question 2

A patient is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notes that the patient's abdomen is distended and firm, and hypoactive bowel sounds are present.
 
  The patient has not had a stool for 3 days. The nurse will contact the provider, who will:
  a. order a bulk-forming laxative.
  b. order extra fluids and fiber.
  c. perform diagnostic tests.
  d. prescribe a cathartic laxative.

[alexanderhamilton]

Answer to Question 1

ANS: D
Psyllium is a bulk-forming laxative and can cause a fecal impaction or obstruction. Abdominal pain can be a sign of impaction or obstruction, so the nurse should assess the patient for this complication. Giving fluids by mouth, administering more laxative, or giving a suppository are all contraindicated if an obstruction has developed and should not be done until this condition is ruled out.

Answer to Question 2

ANS: C
Laxatives are contraindicated for patients with abdominal pain, nausea, cramps, or other symptoms of abdominal disease or an acute surgical abdomen. Laxatives should not be used in patients with obstruction or impaction. This patient shows signs of abdominal obstruction, and laxatives could cause a bowel perforation secondary to increased peristalsis. A bulk-forming laxative is contraindicated. Patients with acute abdomens should be kept NPO pending diagnosis. A cathartic laxative is contraindicated.

[vHAUNG6011]

TYSM

[Dominic]

Excellent