QuestionSBA
QuestionChoice
This is inappropriate as the patient will be left in pain. After disimpaction with an enema, regular laxatives should be prescribed along with opiates to prevent this from happening again.
10028260
e
Stop codeine
QuestionChoice
Oral vancomycin is an appropriate option for managing C.difficile-induced diarrhoea. The most likely diagnosis given the clinical scenario given is overflow diarrhoea.
10028259
d
Oral vancomycin
QuestionChoice
While this may seem like a sensible option given the patient has diarrhoea, it is important to recognise that this is likely overflow due to severe constipation. Loperamide will make the situation worse.
10028257
b
Loperamide
QuestionChoice
Bulk forming laxatives should not be used in opiate-induced constipation or faecal impaction, as they can draw further water out of the stools, exacerbating the issue. Disimpaction is required.
10028258
c
Ispaghula husk
QuestionChoice
The history is suggestive of overflow diarrhoea, caused by constipation (and likely faecal impaction) due to poor mobility and opiate use. An enema will relieve the obstructing stool, hopefully providing the patient with some relief.
10028256
a
Phosphate enema
QuestionComment
Would need history of constipation. Unrealistic that pt complains of abdo pain and it doesn't cross anyone's mind to ask if she's opened her bowels
43568
User
subscriber
Ale
QuestionComment
Abdo pain suggests constipation plus the recent diarrhoea gives clues for overflow diarrhoea (bc of constipation). Hope this helps

43750
User
subscriber
Taa The Best
QuestionComment
Get this crack head off the codeine and on to good old paracetamol I say! 
53599
QuestionComment
i mean she literally broke her tibia idk if that would do much 
61634
User
subscriber
Defibrillator Dominant
User
subscriber
Dr. Moe Lester
QuestionComment
would you not say that the cause of the constipation is the codeine so whats most likely to relieve her discomfort is stopping the codeine? even if you give enema is there not a chance she'll get constipated agan?
60385
User
subscriber
Schistosomiasis
QuestionComment
oh slay learning point tbf 
62186
User
subscriber
Britney Spears
Concept
Chapter
2693
6046
Constipation
Topic
191
Geriatrics
18049
A phosphate enema can be used to relieve opioid-induced constipation by stimulating bowel movements and helping to soften stool, providing effective, rapid relief when other laxatives are insufficient.
A 63-year-old woman is admitted to hospital after fracturing her tibia. She has developed progressive abdominal pain and has recently experienced a few episodes of watery diarrhoea. She has a poor appetite and is upset that her abdominal discomfort is interfering with her rehabilitation. She has been using multiple doses of PRN codeine to help with her pain.

Which intervention is most likely to relieve her discomfort?
a