A client asks if he could use an over-the-counter bulk-type laxative. Which assessment finding would cause the nurse to tell the client not to use this drug? Select all that apply.
1. The client is over age 60.
2. The client takes warfarin every other day.
3. The client has type 2 diabetes.
4. The client has a history of fecal impaction.
5. The client is allergic to penicillin.
Answer: 2,4
Rationale 1: There is no contraindication for use of this laxative class in clients over 60.
Rationale 2: Bulk-type laxatives may decrease the absorption and effects of warfarin.
Rationale 3: Bulk-type laxatives may decrease serum glucose levels in clients with type 2 diabetes. This is not an adverse outcome.
Rationale 4: If there is a chance that the client has a fecal impaction, bulk-type laxative should not be used.
Rationale 5: Allergy to penicillin is not a contraindication for use of bulk-type laxatives.
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