Author Question: A patient has been taking psyllium Metamucil two to three times daily for several days. The patient ... (Read 143 times)

Mr. Wonderful · **on:** Jul 23, 2018

A patient has been taking psyllium Metamucil two to three 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 Dulco-lax suppository.
d. Palpate the patient's abdomen and aus-cultate for bowel sounds.

Question 2

An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities. The physician orders hydrochlorothiazide HydroDIURIL.

Before ad-ministering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern? a. Elevated creatinine clearance
b. Elevated serum potassium level
c. Normal blood glucose level
d. Low levels of low-density lipoprotein (LDL) cholesterol

Expo · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

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

A
Hydrochlorothiazide should not be given to patients with severe renal impairment; therefore, an elevated creatinine clearance would cause the most concern. Thiazide diuretics are potas-sium-wasting drugs and thus may actually improve the patient's potassium level. Thiazides may elevate the serum glucose level in diabetic patients. Thiazides increase LDL cholesterol; however, this patient's levels are low, so this is not a risk.