A patient who has IBS has been taking dicyclomine and reports ...

[D2AR0N]

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]

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.

[D2AR0N]

Thanks for the timely response, appreciate it

[diana chang]

Great answer, keep it coming