A client has a history of atrial fibrillation and is taking an oral anticoagulant. The client has been newly diagnosed with hypothyroidism and placed on levothyroxine.
What assessment should the nurse prioritize?

This is because a nutritious diet provides adequate fiber and nutrients for the GI tract, avoiding alcohol prevents dehydration and irritation of the GI mucosa, and cautious use of laxatives prevents dependency and electrolyte imbalance.

Choice A is wrong because caffeine can stimulate the GI motility and cause diarrhea or cramps.

Choice C is wrong because some prescription medications can affect the GI function, such as antibiotics, opioids, or antacids.

Increased fluid intake is good, but not enough to promote optimal GI function.

Vigorous exercise can also cause GI distress or dehydration.

Choice D is wrong because adequate fluid intake is essential for preventing constipation and maintaining hydration.

Exercise can also help with bowel movements and overall health.

Normal ranges for GI function vary depending on the individual, but generally, a person should have at least one bowel movement every 3 days and no more than 3 bowel movements per day.

The stool should be soft, formed, and easy to pass.

The correct answer is c. The importance of consuming adequate amounts of water.

Rationale for Choice A:

• Statement:The need to monitor for systemic side effects.
• Rationale:It's not accurate to prioritize monitoring for systemic side effects when teaching a patient about psyllium (Metamucil).Psyllium is a bulk-forming laxative that primarily acts within the gastrointestinal tract,and systemic side effects are rare.While it's essential to be aware of potential side effects,focusing on them during initial teaching might cause unnecessary anxiety.

Rationale for Choice B:

• Statement:The need to use the dry form of Metamucil to prevent cramping.
• Rationale:This statement is incorrect.It's generally recommended to mix psyllium with water or another liquid before ingestion.Consuming the dry form can increase the risk of choking and might not adequately hydrate stool.

Rationale for Choice C:

• Statement:The importance of consuming adequate amounts of water.
• Rationale:This is the most crucial information to emphasize when teaching about psyllium.Psyllium works by absorbing water and forming a bulky gel that softens stool and promotes bowel movements.Without sufficient water intake,psyllium can cause constipation to worsen or lead to intestinal obstruction.

Rationale for Choice D:

• Statement:The onset of action of 30 to 60 minutes after administration.
• Rationale:This statement is inaccurate.Psyllium is not a fast-acting laxative.It typically takes 12-72 hours to produce a bowel movement.Informing patients about the expected time frame for results is essential to manage expectations and prevent unnecessary medication overuse.