A patient taking magnesium citrate as an osmotic laxative reports abdominal cramping and diarrhea. What should the nurse recommend?
Increase fluid intake
Continue the medication; these are expected side effects
Discontinue the medication and consult a healthcare provider
Switch to a different type of laxative
The Correct Answer is B
A. Increasing fluid intake may not alleviate the cramping and diarrhea, which are common side effects of magnesium citrate.
B. Abdominal cramping and diarrhea are expected side effects of magnesium citrate, and the patient can continue the medication unless symptoms become severe.
C. Discontinuing the medication should not be recommended unless the side effects are intolerable or the patient experiences severe reactions.
D. Switching to a different type of laxative is unnecessary unless the patient has contraindications to magnesium citrate or develops severe side effects.
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Correct Answer is D
Explanation
A. Giving the drug with food may delay absorption but does not affect the extent of the first-pass effect.
B. Administering the drug in small, frequent doses may help maintain therapeutic levels but will not significantly alter the first-pass effect.
C. Limiting protein intake could reduce drug binding to proteins, but this is not a standard approach for managing first-pass metabolism.
D. Administering the drug intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect, thereby increasing the amount of free drug available to body cells.
Correct Answer is B
Explanation
A. A drug that binds tightly to protein is typically released slowly, not quickly, as it remains bound in circulation.
B. Tight binding to proteins usually results in a prolonged duration of action since the drug is released gradually into the bloodstream, leading to sustained therapeutic effects.
C. Drugs that bind tightly to protein are generally not excreted quickly; they remain in circulation longer due to the binding.
D. While toxicity can occur with any drug, tight protein binding does not inherently lead to toxicity; it primarily affects the pharmacokinetics of the drug.