Nurse Abby is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the plan of care to reduce ICP?
a- Encourage coughing and deep breathing
b- Position with head turned toward side of brain tumor
c- Administer stool softeners
d- Provide sensory stimulation
Answer C.
Stool softeners reduce the risk of straining during a bowel movement, which can increase ICP by raising intrathoracic pressure and interfering with venous return. Coughing also increases ICP. Keeping the head in midline and avoiding extreme neck flexion prevents obstruction of venous outflow from the brain. Both sensory stimulation and noxious stimuli can increase ICP.
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Stool softeners:
For what conditions or diseases is this medication prescribed?
Stool softeners are used in the short term to relieve constipation symptoms in those people who should avoid exerting much effort during bowel movements, as they suffer from heart disease, hemorrhoids and other problems. They work by softening the stool, which facilitates its evacuation.
How should this medicine be used?
Stool softeners come in the form of capsules, pills, liquid solution and syrup to take by mouth. Stool softeners are usually taken at bedtime. Follow the instructions on the medication label carefully and ask your doctor or pharmacist anything you do not understand. Use the medication exactly as directed. Do not use more or less than the indicated dose or more often than prescribed by your doctor.
Swallow docusate capsules whole; Do not divide, chew, or crush.
Take the capsules and pills with a large glass of water. The liquid solution comes with a specially marked dropper to measure the dose. If you have any problems using it, ask your pharmacist to show you how to use it. Mix the liquid solution (not the syrup) with 4 ounces of milk, fruit juice or breast milk or formula to hide its bitter taste.
It takes between one and three days of regular use for this medication to take effect. Do not take stool softeners for more than 1 week unless your doctor tells you. If sudden changes in the intestines last more than 2 weeks or if your stools are still hard after you have taken the medicine for a week, call your doctor.
What other uses does this medication have?
This medication may be prescribed for other uses; Ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before you start taking stool softeners:
- tell your doctor and pharmacist if you are allergic to any stool softener, any other medications, or any of the ingredients in stool softeners. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention mineral oil. Your doctor may need to change the dose of your medications or monitor you carefully for any side effects.
- tell your doctor if you are pregnant, have plans to get pregnant or if you are breastfeeding. If you become pregnant while taking this medication, call your doctor immediately.
What do I have to do if I forget to take a dose?
This medicine is taken as needed. If your doctor has told you to take stool softeners regularly, take the missed dose as soon as you remember, however, if it is time for the next one, skip the one you did not take and continue with the regular dosage. Do not take a double dose to make up for the one you forgot.
What are the side effects that this medicine could cause?
Although the side effects of stool softeners are not common, they may occur. Tell your doctor if any of these symptoms become severe or if it does not go away:
- cramps
- Stomach ache
- throat irritation (caused by oral liquid solution).
Some Side Effects Can Be Serious. If you experience any of the following symptoms, call your doctor immediately:
- rash
- hives
- difficulty breathing or swallowing
- fever
- vomiting
- stomach ache
a- Encourage coughing and deep breathing
b- Position with head turned toward side of brain tumor
c- Administer stool softeners
d- Provide sensory stimulation
Answer C.
Stool softeners reduce the risk of straining during a bowel movement, which can increase ICP by raising intrathoracic pressure and interfering with venous return. Coughing also increases ICP. Keeping the head in midline and avoiding extreme neck flexion prevents obstruction of venous outflow from the brain. Both sensory stimulation and noxious stimuli can increase ICP.
--------------------------
Stool softeners:
For what conditions or diseases is this medication prescribed?
Stool softeners are used in the short term to relieve constipation symptoms in those people who should avoid exerting much effort during bowel movements, as they suffer from heart disease, hemorrhoids and other problems. They work by softening the stool, which facilitates its evacuation.
How should this medicine be used?
Stool softeners come in the form of capsules, pills, liquid solution and syrup to take by mouth. Stool softeners are usually taken at bedtime. Follow the instructions on the medication label carefully and ask your doctor or pharmacist anything you do not understand. Use the medication exactly as directed. Do not use more or less than the indicated dose or more often than prescribed by your doctor.
Swallow docusate capsules whole; Do not divide, chew, or crush.
Take the capsules and pills with a large glass of water. The liquid solution comes with a specially marked dropper to measure the dose. If you have any problems using it, ask your pharmacist to show you how to use it. Mix the liquid solution (not the syrup) with 4 ounces of milk, fruit juice or breast milk or formula to hide its bitter taste.
It takes between one and three days of regular use for this medication to take effect. Do not take stool softeners for more than 1 week unless your doctor tells you. If sudden changes in the intestines last more than 2 weeks or if your stools are still hard after you have taken the medicine for a week, call your doctor.
What other uses does this medication have?
This medication may be prescribed for other uses; Ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before you start taking stool softeners:
- tell your doctor and pharmacist if you are allergic to any stool softener, any other medications, or any of the ingredients in stool softeners. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention mineral oil. Your doctor may need to change the dose of your medications or monitor you carefully for any side effects.
- tell your doctor if you are pregnant, have plans to get pregnant or if you are breastfeeding. If you become pregnant while taking this medication, call your doctor immediately.
What do I have to do if I forget to take a dose?
This medicine is taken as needed. If your doctor has told you to take stool softeners regularly, take the missed dose as soon as you remember, however, if it is time for the next one, skip the one you did not take and continue with the regular dosage. Do not take a double dose to make up for the one you forgot.
What are the side effects that this medicine could cause?
Although the side effects of stool softeners are not common, they may occur. Tell your doctor if any of these symptoms become severe or if it does not go away:
- cramps
- Stomach ache
- throat irritation (caused by oral liquid solution).
Some Side Effects Can Be Serious. If you experience any of the following symptoms, call your doctor immediately:
- rash
- hives
- difficulty breathing or swallowing
- fever
- vomiting
- stomach ache
How should I store or dispose of this medicine?
Keep this medicine in its container, tightly closed and out of the reach of children. Store it at room temperature and away from excessive heat and humidity (not in the bathroom).
It is important that you keep all medications out of the sight and reach of children, because many containers (such as weekly pill boxes, and those containing ophthalmic drops, creams, patches and inhalers) are not proof of small children, who can easily open them. In order to protect them from intoxication, always wear safety covers and immediately place medications in a safe place, one that is up and away from your sight and reach.
Medications that are no longer needed should be disposed of in an appropriate manner to ensure that pets, children and others cannot consume them. However, you should not discard these medications by the toilet. Instead, the best way to get rid of your medications is through a medication return program. Talk to your pharmacist or contact your local trash / recycling department to learn about your community's drug return programs. See the Food and Drug Administration (FDA) website for more information on how to safely dispose of medications if you do not have access to the medication return program.
What other important information should I know?
Ask the pharmacist any questions you have about how to take this medicine.
It is important that you keep a written list of all the medications you are taking, including those you received with a prescription and those you bought without a prescription, including vitamins and diet supplements. You should have the list every time you visit your doctor or when you are admitted to a hospital. It is also important information in emergencies.
Trademarks:
- Colace®
- Correctol Soft Gels®
- Diocto®
- Ex-Lax Stool Softener®
- Fleet Sof-Lax®
- Phillips' Liqui-Gels®
- Surfak®
Combined product trademarks:
- Correctol 50 Plus® (contains docusate, sennosides)
- Ex-Lax Gentle Strength® (contains docusate, sennosides)
- Gentlax S® (contains docusate, sennosides)
- Peri-Colace® (contains docusate, sennosides)
- Senokot S® (contains docusate, sennosides)
Other names:
- dioctyl calcium sulfosuccinate
- dioctyl sodium sulfosuccinate
- docusate calcium
- docusate sodium
- DOSS
- DSS.
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Psychosocial Integrity