Question

PN 200 Fundamentals of Nursing II Pharmacology Case Study - Vomiting/Diarrhea prochorperazine Cassy Smith, a 34 year-old woman, has been vomiting for 48 hours. In the Smith has had nausea and diarrhea. Prochorperazine (Compazine) 10 mg was ad intramuscularly. miting/Diarrhea prochorperazine (Compazine) nan, has been vomiting for 48 hours. In the last 12 hours Ms. Prochorperazine (Compazine) 10 mg was administered 1. What nonpharmacological measures should the nurse suggest when al measures should the nurse suggest when vomiting occurs? 2. Why was Ms. Smith given prochorperazine given intramuscularly rather than orally or rectally? Prochorperazine should be given deep intramuscularly. Why? 3. What electrolyte imbalances may occur as a result of vomiting and diarrhea? Explain how these electrolytes can be replaced. 4. What are the side effects of prochorperazine? Could these occur with Ms. Smith? Explain your answer. 5. Could a serotonin antagonist be given to Ms. Smith instead of prochorperazine? Explain your answer. Ms. Smith was prescribed dipenoxylate with atropine (Lomotil) 2.5 mg three times a day. 6. Is the dipenoxylate with atropine (Lomotil) within the normal prescribed range? Explain your answer. 7. What clinical conditions are contraindicated for the use of Lomotil? 8. What are some combination drugs that may be prescribed to control diarrhea? List the advantages and disadvantages of the drugs you have listed. 9. Explain the similarities of two over-the-counter antidiarrheals. Explain how frequently they should be used. 10. Do you think that Ms. Smith should receive an absorbent? Explain your answer 11. Explain the similarities and differences between ipecac and charcoal. Revised 1/20 Wednsday

Answer 1

1. Encourage Ms Smith to have soft, easily digestable food.

maintain hydration and ask her to rinse mouth after eating.

encourage to have dry foods. suck ice chips and non caffeinated drinks.

2. Ms smith is having diarrhea and vomiting. so oral and rectal route may not be effective. that is the reason why given intra muscularly. Prochorperazine should be given as deep IM to avoid local irritation.

3. Mostly sodium and pottasium is lost along with other electrolytes. If she can tolerate oral fluids encourage her to take oral fluids especially ORS, clear fluids, juices, avoid caffiene.0.9% normal saline can be given intra venously if the client cannot tolerate oral fluids.

4. dizziness, dry mouth, drowsiness, agitation, restlesness. It may occur with Ms Smith. she is having diarrhea and vomiting for 48 hours. electrolyte imbalance can occur.

5. she is having diarrehea and vomiting so it is better to use prochorperazine.

6. Dose is inadequate. adult needs 2 tab 4 times a day initially. when the severity is reduced the dose can be decreased.

7.After correction of electrolyte imbalance lomotil should be given. otherwise decreased peristalsis in the stomach cause fluid retention and aggrevate dehydration and electrolyte imbalance. lomotil is to be used cautiously in clients with CNS disorder, hepatic and gastrointestinal problems

8. loperamide, bismuth subsalicylate

bismuth subsalicylate - disadvantage- change the colour of the tongue to dark colour, constipation, dark coloured stools

loperamide- used to treat diarrehea. disadvantage- constipation, loss of appetite

9.used to treat diarrhea.drugs like lopermide and dicyclomine slows intestinal motility and controls diarrhea.

10. she is having severe diarrhea and vomiting. absorbents helps to make diarreal stools less watery.

11. activated charcoal is more effective in drug absorption than ipecac. so it is better to give activated charcoal after emesis than ipecac.