# A client with chronic constipation receives lubiprostone but now has abdominal distention, vomiting, and no passage of stool or flatus. Which action is best?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522584&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client with chronic constipation receives lubiprostone but now has abdominal distention, vomiting, and no passage of stool or flatus. Which action is best?

## Option

1. Give the first dose with a large meal and reassess bowel sounds at the next routine visit.
2. Hold lubiprostone and obtain prompt evaluation for possible mechanical gastrointestinal obstruction. **✔ Correct answer**
3. Crush the capsule into clear liquid so it can pass through the suspected obstruction.
4. Add another laxative and restrict diagnostic testing until the constipation resolves.

**Correct answer: 2**

## Explanation

Abdominal distention, vomiting, and obstipation suggest mechanical obstruction, a contraindication that must be evaluated before lubiprostone exposure.

## In-depth explanation

Quick answer
Screen for mechanical obstruction before activating intestinal secretion.

Why this is correct
Lubiprostone should not be started when obstruction is known or suspected. Additional laxative exposure does not replace urgent diagnostic assessment.

Easy analogy or mental picture
Use a closed medication-safety loop: identify the exposure, connect the new findings, interrupt further harm, support physiology, and verify the response over time.

Memory hook
Exposure, interaction, toxicity pattern, immediate action, serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving monitoring and escalation.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic process active.References
1DailyMed: Lubiprostone CapsulesContraindication in mechanical gastrointestinal obstruction and evaluation before treatment

## Clinical scenario

Medication safety review
Verify the indication, route, interacting medicines, current respiratory and gastrointestinal findings, authorized action, and measurable follow-up.

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