Gastrointestinal System Disorders Q 132

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A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine which of the following is the most likely cause of the client’s constipation?

  

    A. The client has not been including enough fiber in his diet.

    B. The client needs to increase his daily exercise.

    C. The client is experiencing a side effect of the aluminum hydroxide.

    D. The client has developed a gastrointestinal obstruction.

    

    

Correct Answer: C. The client is experiencing a side effect of the aluminum hydroxide.

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It is most likely that the client is experiencing a side effect of the antacid. Antacids with aluminum salt products, such as aluminum hydroxide, form insoluble salts in the body. These precipitate and accumulate in the intestines, causing constipation. Disturbances of gut motility occur frequently under a high-dose antacid regimen. Typical symptoms are diarrhea and constipation. They are due to the cations of the antacids. Aluminum causes constipation, magnesium induces diarrhea, and calcium has no definite motor effect.

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Option A: Increasing dietary fiber intake may be a beneficial lifestyle change for the client but is not likely to relieve constipation caused by the aluminum hydroxide. Fiber adds bulk to the stool and makes defecation easier because it passes through the intestine essentially unchanged.

Option B: Urge the patient for some physical activity and exercise. Consider isometric abdominal and gluteal exercises. Movement promotes peristalsis. Abdominal exercises strengthen abdominal muscles that facilitate defecation.

Option D: Constipation, in isolation from other symptoms, is not a sign of bowel obstruction. Encourage the patient to take in fluid 2000 to 3000 mL/day, if not contraindicated medically. Sufficient fluid is needed to keep the fecal mass soft. But take note of some patients or older patients having cardiovascular limitations requiring less fluid intake.

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