# A postoperative client on opioid pain medication is started on docusate sodium 100 mg PO BID. Which client statement reflects an accurate understanding of this medication?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391816&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A postoperative client on opioid pain medication is started on docusate sodium 100 mg PO BID. Which client statement reflects an accurate understanding of this medication?

## Option

1. "This medication is used to slow diarrhea."
2. "This medication softens stool so it's easier to pass, but it does not directly stimulate the bowel; I should also drink plenty of fluids and increase fiber." **✔ Correct answer**
3. "This medication treats opioid overdose."
4. "This medication will produce a bowel movement within 30 minutes."

**Correct answer: 2**

## Explanation

Correct (2): Docusate is a stool softener (surfactant) — lowers surface tension, allows water/fat to penetrate stool. Does not stimulate motility, often combined with senna in opioid-induced constipation. Effect over 1-3 days. (1) Not rapid. (3) Antidiarrheal class confusion. (4) Naloxone reverses opioid OD.

## In-depth explanation

Memory Tip Docusate = "Softens, does not push." For opioid-induced constipation: combine with senna or use OIC-specific agents (methylnaltrexone, naloxegol).

## Clinical scenario

Scenario 45-year-old male post-op day 1 on opioids for pain; docusate 100 mg PO BID ordered for constipation prevention.

## Key concepts

- **Stool softener** — Docusate; surfactant that softens stool; not a stimulant.
- **Opioid-induced constipation** — Common opioid side effect; prophylactic stool softener + stimulant or PAMORA.
- **PAMORA** — Peripherally acting mu-opioid receptor antagonists (methylnaltrexone, naloxegol) for OIC.

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