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 A
Explanation
A. Try not to swallow while the pill dissolves is correct because sublingual medications are designed to be absorbed directly into the bloodstream through the mucous membranes under the tongue, and swallowing may hinder this absorption.
B. Take a big drink of water and swallow the pill is incorrect because sublingual medications should not be swallowed with water as they need to dissolve under the tongue.
C. Swallow frequently to get the best benefit is incorrect, as this can interfere with the absorption of the medication.
D. Chew the pill so it will dissolve faster is incorrect since chewing may destroy the sublingual formulation, preventing it from working as intended.
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.