A nurse is contributing to the plan of care for a client who is starting bowel training for the management of fecal incontinence. Which of the following interventions should the nurse recommend?

Limit the client's physical activity until bowel continence is achieved.

Limit the client's fluid intake to 1500 mL/day.

Instruct the client to limit their intake of high-fiber foods.

Assist the client to the restroom 30 minutes after meals.

Answer and Explanation

The Correct Answer is D

Choice A Reason:
Limiting the client's physical activity is not generally recommended as part of bowel training for fecal incontinence. Regular physical activity can actually help with bowel movements by increasing muscle activity in the intestines. It is important for clients to maintain as much normal activity as possible.

Choice B Reason:
Limiting the client's fluid intake to 1500 mL/day is not advisable unless specifically recommended by a healthcare provider for another medical reason. Adequate hydration is essential for normal bowel function, and restricting fluids could exacerbate constipation, which can complicate fecal incontinence.

Choice C Reason:
Instructing the client to limit their intake of high-fiber foods would be counterproductive in managing fecal incontinence. A diet high in fiber can help form bulkier, softer stools, which can be easier to control. Fiber helps to regulate bowel movements, which is beneficial in bowel training programs.

Choice D Reason:
Assisting the client to the restroom 30 minutes after meals takes advantage of the gastrocolic reflex, which is a normal response where the act of eating stimulates movement in the gastrointestinal tract. This can help the client establish a regular pattern of bowel movements, which is a key goal in bowel training for fecal incontinence.

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Correct Answer is C

Explanation

Choice A reason:
The statement that having a total cholesterol level below 200 mg/dL increases the risk for a stroke is incorrect. In fact, maintaining a total cholesterol level below 200 mg/dL is generally considered desirable and can help reduce the risk of stroke and heart disease. High cholesterol levels can lead to atherosclerosis, which is the buildup of plaques in the arteries, increasing the risk of a stroke.

Choice B reason:
The use of glucocorticoids is not typically associated with decreasing the risk of a stroke. Glucocorticoids are a type of corticosteroid hormone that is often prescribed for their anti-inflammatory and immunosuppressive effects. However, long-term use of glucocorticoids can actually increase the risk of developing conditions that may lead to a stroke, such as high blood pressure and diabetes.

Choice C reason:
Losing excess weight is a recognized way to decrease the risk of a stroke for individuals with diabetes mellitus. Excess weight, especially around the abdomen, can increase the likelihood of high blood pressure, high cholesterol, and type 2 diabetes, all of which are risk factors for stroke. Weight loss can improve these risk factors and thus lower the risk of stroke.

Choice D reason:
An HbA1c level of 6 percent or less is typically a goal in diabetes management to indicate good blood sugar control. Lower HbA1c levels are associated with a reduced risk of complications from diabetes, including stroke. Therefore, an HbA1c level of 6 percent or less does not increase the risk of stroke; rather, it suggests that the diabetes is well-managed.

A. You should increase your oxygen to 5 liters per minute if you have shortness of breath. B. You should discontinue your prednisone when your symptoms improve. C. You should decrease your caloric intake by 200 calories per day. D. You should consume small, frequent meals each day.

Correct Answer is D

Explanation

Choice A reason:
Increasing oxygen to 5 liters per minute if experiencing shortness of breath is not a standard recommendation for all COPD patients. Oxygen therapy must be tailored to each individual's needs, and excessive oxygen can be harmful, leading to CO2 retention and respiratory depression. The goal is to maintain oxygen saturation at 88-92%.

Choice B reason:
Discontinuing prednisone abruptly can lead to adrenal insufficiency, as the body needs time to resume natural cortisol production. Prednisone should be tapered off under medical supervision, especially for COPD patients who may be on long-term corticosteroids for their condition.

Choice C reason:
Decreasing caloric intake is not generally advised for COPD patients without considering their nutritional status. COPD patients often require more calories due to the increased effort of breathing and the body's higher energy demands during respiratory distress.

Choice D reason:
Consuming small, frequent meals is beneficial for COPD patients. It can help avoid the discomfort of fullness, which can impede the diaphragm's movement and make breathing more difficult. Smaller meals can also ensure better nutrient absorption and maintain energy levels throughout the day.

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A nurse is contributing to the plan of care for a client who is starting bowel training for the management of fecal incontinence. Which of the following interventions should the nurse recommend?

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