Author Question: A patient who has IBS has been taking dicyclomine and reports decreased pain and diarrhea but is now ... (Read 24 times)

D2AR0N · **on:** Jul 24, 2018

A patient who has IBS has been taking dicyclomine and reports decreased pain and diarrhea but is now having occasional constipation. The primary care NP should recommend:

a. beginning treatment with an SSRI.
b. beginning therapy with a TCA.
c. over-the-counter (OTC) laxatives as needed when constipated.
d. increasing the amounts of raw fruits and vegetables in the diet.

Question 2

A patient who has diabetes is taking metformin 1000 mg daily. At a clinic visit, the patient reports having abdominal pain and nausea. The primary care NP notes a heart rate of 92 beats per minute. The NP should:

a. obtain LFTs.
b. decrease the dose of metformin.
c. change metformin to glyburide.
d. order electrolytes, ketones, and serum glucose.

diesoon · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

C
Patients who experience constipation may use OTC laxatives as needed. Antidepressants, such as SSRIs or TCAs, are used long-term to help with pain. Raw fruits and vegetables can increase the likelihood of bloating.

Answer to Question 2

D
Symptoms of lactic acidosis include nausea, abdominal pain, and tachycardia. Tests should include electrolytes, ketones, and serum glucose.