A nurse is instructing a newly licensed nurse on how to obtain a fecal occult blood test from a patient.
What information should the nurse include?

Choice A rationale:

Taking the patient to the bathroom every 2 hours while the patient is awake is not the most effective strategy for a bowel training program. This approach does not take into account the natural rhythms of the body and the patient’s personal comfort. It may lead to unnecessary trips to the bathroom, which can be physically and emotionally draining for the patient.

Choice B rationale:

This is the correct answer. A bowel training program aims to help the patient regain control over their bowel movements. Taking the patient to the bathroom when they have the urge to defecate aligns with this goal. It allows the patient to respond to their body’s signals, which can help improve their confidence and independence over time.

Choice C rationale:

Taking the patient to the bathroom immediately before meals is not the most effective strategy for a bowel training program. While it’s true that eating can stimulate bowel movements due to the gastrocolic reflex, this approach does not consider the patient’s comfort or individual needs. It may also disrupt the patient’s enjoyment of their meals.

Choice D rationale:

Waiting until the patient feels abdominal cramping is not the most effective strategy for a bowel training program. Abdominal cramping can be a sign of constipation or other digestive issues. It’s important to address these issues separately and not rely on them as indicators for when to take the patient to the bathroom.

Choice A rationale:

The statement “I do my wheelchair exercises sitting in my chair” is correct. Wheelchair exercises are designed to be performed while seated in a wheelchair. They help to maintain muscle strength and flexibility, which is crucial for individuals with paralysis.

Choice B rationale:

The statement “I use a suppository every night to have a bowel movement” is also correct. Individuals with paralysis often have difficulty with bowel movements due to lack of muscle control. Using a suppository can stimulate the rectum and induce a bowel movement. Choice C rationale:

The statement “I need to catheterize myself twice a day” indicates a need for further teaching. Individuals with paralysis from the waist down following a spinal cord injury typically need to perform intermittent self-catheterization every 4-6 hours, not just twice a day. This helps to prevent urinary tract infections and bladder overdistension.

Choice D rationale:

The statement “I carry a water bottle with me because I drink a lot of water” is correct. Drinking plenty of water is important for overall health and can help to prevent urinary tract infections, which are common in individuals who self-catheterize.