A client reports daily use of senna for 6 months for chronic… | MyMerci
Medical EmergenciesPA
Question
A client reports daily use of senna for 6 months for chronic constipation and now must take increasing doses for the same effect. Which is the nurse's best counseling?
1"Add another stimulant laxative for additive effect."
2"Continue increasing the dose indefinitely."
3"Switch to senna only when severe constipation occurs."
4"Chronic stimulant laxative use causes tolerance and laxative dependence. Discuss tapering with osmotic laxatives (polyethylene glycol), fiber, and adequate fluids."✓ Correct answer
Explanation
Correct (2): Long-term stimulant laxative use (senna, bisacodyl) causes tolerance and laxative dependence (colon hypotonia). Switch to osmotic laxatives (PEG, lactulose), add bulk-forming (psyllium) with adequate fluids, and ensure exercise. (1,3,4) Worsen the cycle.