Questions and Answers
What part of the GI system makes the difference between having diarrhea, a normal stool, and constipation?
What is your best response when a patient reports that his bowel movements are not normal?
What antiemetic would you expect to administer to a chemotherapy patient complaining about nausea/vomiting?
What antihistamine would you expect to be prescribed for a patient with motion sickness?
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Which antiemetic drug should be avoided in a patient with a history of depression?
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If a patient taking promethazine (Phenergan) reports uncontrolled movements of the tongue, what is your best response?
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What is a serious adverse effect of promethazine (Phenergan)?
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Study Notes
Gastrointestinal Disorders and Stool Consistency
- The large bowel significantly influences stool consistency based on water absorption; too much absorption results in constipation, while less leads to diarrhea.
- The alimentary canal encompasses the entire GI system; nutrient absorption occurs primarily in the small bowel.
- Stool is stored in the rectum before expulsion.
Assessing Bowel Movements
- Normal bowel habits vary greatly among individuals, with a range from multiple times daily to several times weekly.
- The consistency of stool is crucial for assessing bowel health; it should be soft yet not liquid.
- Further evaluation is necessary to identify causes of abnormal bowel movements, which may involve dietary adjustments or medication reviews.
Antiemetic for Chemotherapy-Induced Nausea
- Ondansetron (Zofran) is a preferred antiemetic for nausea/vomiting due to chemotherapy.
- Administered 30 minutes before chemotherapy, ondansetron specifically targets 5HT3 receptors to mitigate nausea.
- Alternatives like promethazine, metoclopramide, and cyclizine are less effective for chemotherapy-related symptoms.
Antihistamine for Motion Sickness
- Meclizine (Dramamine) is the recommended antihistamine for treating motion sickness and vertigo.
- It alleviates nausea, vomiting, and dizziness associated with motion or inner ear disorders.
- Other options like granisetron, prochlorperazine, and trimethobenzamide are not specifically suited for motion sickness.
Considerations for Antiemetic Use in Depression
- Metoclopramide (Reglan), a dopamine antagonist, should be avoided in patients with a history of depression due to its potential to exacerbate symptoms.
- Scopolamine, promethazine, and meclizine do not have known adverse effects on mood.
Adverse Effects of Promethazine
- Tardive dyskinesia is a serious potential side effect of promethazine, presenting as involuntary movements of the mouth, face, or limbs.
- Symptoms may include lip smacking, facial grimacing, and tongue movements and can occur after prolonged use.
- Immediate discontinuation of the medication is vital if tardive dyskinesia symptoms appear to prevent irreversible damage.
Serious Risks with Promethazine Administration
- Promethazine can cause tissue necrosis if administered undiluted via intravenous route.
- Clinicians should monitor for signs of adverse reactions to ensure prompt intervention.
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Description
Test your knowledge on drug therapy for gastrointestinal disorders with flashcards from Chapter 22. Explore key concepts that differentiate between diarrhea, normal stools, and constipation in the GI system. Ideal for nursing students preparing for exams.
