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Chapter 35 Drugs Used to Treat Constipation and DiarrheaLearning ObjectivesState the underlying causes of constipationExplain the meaning of “normal” bowel habitsCite nine causes of diarrheaDescribe medical conditions in which laxatives should not be usedLearning Objectives (cont’d)Identify electrolytes that should be monitored whenever prolonged or severe diarrhea is presentDescribe nursing assessments needed to evaluate the patient’s state of hydration when suffering from either constipation or dehydrationConstipationInfrequent, incomplete or painful elimination of feces“Normal” bowel habits varyDaily bowel movement not necessaryAs long as patient’s health is good and stool not hardened or impacted, this is acceptableConstipation (cont’d)CausesImproper dietToo little fluid intakeLack of exercise—sedentary habitsFailure to respond to normal defecation impulsesMuscular weakness of the colonDiseases such as anemia and hypothyroidismFrequent use of constipating medicines Tumors of the bowel or pressure from tumorsDiseases of the rectumDiarrheaAn increase in the frequency of fluid content of bowel movementsDiarrhea (cont’d)CausesIntestinal infectionsSpicy or fatty foodsEnzyme deficienciesExcessive use of laxativesDrug therapyEmotional stressHyperthyroidismInflammatory bowel diseaseSurgical bypass of the intestineTreatment of Altered EliminationConstipationHigh-fiber diet, adequate hydration, exerciseUse of laxatives should be avoidedTreatment of Altered Elimination (cont’d)Diarrhea: treatment depends on specific cause of diarrhea, which may be:Chronic, mild or severeIndication of disease of stomach, small or large intestinePsychogenicSymptom of cancer of the colon or rectumTreatment of Altered Elimination (cont’d)Nursing processAssessment: obtain history, medications, activity and exercise, elimination patterns, nutritional history, basic assessment, vital signs; review lab reportsMonitor electrolytes in prolonged diarrheaMonitor hydrationLearning ObjectivesIdentify the indications for use, method of action, and onset of action for stimulant laxatives, saline laxatives, lubricant or emollient laxatives, bulk-forming laxatives, and fecal softenersState the differences between locally acting and systemically acting antidiarrheal agentsLearning Objectives (cont’d)Cite conditions that generally respond favorably to antidiarrheal agentsReview medications studied to date and prepare a list of those that may cause diarrheaLaxativesStimulant laxativesAct directly on intestines; promote peristalsis and evacuationUsed to relieve acute constipation and routine elimination of gas and feces before radiologic examination of kidneys, colon, intestine, or gallbladderLaxatives (cont’d)Saline laxatives Hypertonic compounds draw water into the intestines from surrounding tissues, distending bowel and causing peristalsisLaxatives (cont’d)Fecal softeners: draw water into bowel to soften stools; do not cause peristalsisUsed routinely for prophylactic purposesBulk-forming laxatives Drug of choice for those who use laxatives routinely; they absorb irritating substances and soften stoolsTable 35-1 pg 565Laxatives (cont’d)Lubricant laxatives Lubricate intestinal wall, allowing for smooth passage of fecal contentsUsed as prophylactic for patients who should not strain during defecationLaxatives (cont’d)Antidiarrheal AgentsLocally acting agentsAbsorb excess water to cause a formed stool and absorb irritants or bacteria causing diarrheaSystemic agentsAct through autonomic nervous system to reduce peristalsis and motility of the GI tract, allowing the mucosal lining to absorb nutrients, water, and electrolytes, leaving a formed stoolAntidiarrheal Agents (cont’d)Help control inflammatory bowel diseasePostgastrointestinal surgery patients may require agents to help absorb electrolytes and fluidsMany cases are self-limiting but may be prescribed by health care professionalsAntidiarrheal Agents (cont’d)Medications That May Cause DiarrheaAntibioticsAntacids containing magnesium ................
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