A client with a small bowel obstruction should have senna withheld based on understanding of which reason?

A client with a small bowel obstruction should have senna withheld based on understanding of which reason?

• A. Laxatives are contraindicated in clients who have small bowel obstructions
• B. Bulk-forming laxatives such as psyllium should be substituted for this client
• C. Prescribed medication should be administered via NG route rather than the oral route for this client
• D. Osmotic laxative, such as magnesium citrate, should be substituted in this client

Answer: (A)

In a small bowel obstruction, the bowel is blocked so contents can’t advance. Giving laxatives to stimulate movement in this setting can worsen the blockage by increasing intraluminal pressure proximal to the obstruction, which raises the risk of ischemia or perforation. Senna, a stimulant laxative, would accelerate contractions and propulsion when that propulsion is not possible, making the situation more dangerous. The usual approach is bowel rest (NPO), IV fluids, and nasogastric decompression to relieve pressure and allow the bowel to recover, with surgical evaluation if needed. Other laxatives such as bulk-forming agents can swell and add bulk to a blocked lumen, osmotic laxatives draw water into the bowel and worsen distention, and medication routes are not the reason to withhold senna; the fundamental issue is that laxatives are contraindicated in a mechanical obstruction due to the risk of worsening the obstruction and causing complications.

In a small bowel obstruction, the bowel is blocked so contents can’t advance. Giving laxatives to stimulate movement in this setting can worsen the blockage by increasing intraluminal pressure proximal to the obstruction, which raises the risk of ischemia or perforation. Senna, a stimulant laxative, would accelerate contractions and propulsion when that propulsion is not possible, making the situation more dangerous. The usual approach is bowel rest (NPO), IV fluids, and nasogastric decompression to relieve pressure and allow the bowel to recover, with surgical evaluation if needed. Other laxatives such as bulk-forming agents can swell and add bulk to a blocked lumen, osmotic laxatives draw water into the bowel and worsen distention, and medication routes are not the reason to withhold senna; the fundamental issue is that laxatives are contraindicated in a mechanical obstruction due to the risk of worsening the obstruction and causing complications.