A nurse is preparing to administer a soapsuds enema to an adult client. Which of the following actions should the nurse take?

Insert the tubing about 15 cm (6 in) into the anus.

Hang the enema container 61 cm (24 in) above the anus.

Assist the client to the left Sims' position.

Put on sterile gloves.

Answer and Explanation

The Correct Answer is C

The left Sims' position (also known as the left lateral position) is the appropriate position for administering a soapsuds enema. This position allows for better visualization and access to the rectum and facilitates the flow of the enema solution.

The other options mentioned are incorrect:

Inserting the tubing about 15 cm (6 in) into the anus: The specific depth of insertion may vary depending on the client, but the general guideline is to insert the tubing about 3 to 4 inches into the rectum for an adult. 15 cm (6 in) would be excessively deep and could cause discomfort or injury.

Hanging the enema container 61 cm (24 in) above the anus: The height at which the enema container is hung should be no more than 18-24 inches (45-60 cm) above the anus. Hanging it too high can cause excessive pressure and discomfort during the administration.

Putting on sterile gloves: Sterile gloves are not typically required for the administration of a soapsuds enema. Clean gloves or non-sterile gloves are generally sufficient for this procedure.

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Correct Answer is A

Explanation

Docusate is a stool softener commonly used to relieve constipation. Opioid pain medications often cause constipation as a side effect by slowing down bowel movements. Docusate helps by increasing the amount of water absorbed by the stool, making it softer and easier to pass.

The other options mentioned are not the primary therapeutic effects of docusate: Relief from nausea: Docusate is not typically prescribed for relief from nausea. Antiemetic medications are used to alleviate nausea and vomiting.

Decreased drowsiness: Docusate does not directly affect drowsiness. Its main action is on the stool consistency, not on alertness or drowsiness.

Decreased cancer pain: Docusate is not prescribed for pain relief. Opioids are generally used to manage cancer pain in this scenario.

Correct Answer is ["1"]

Explanation

The nurse typically auscultates the abdomen for bowel sounds before meals or at least 1-2 hours after meals. This timing allows for the assessment of both the presence and character of bowel sounds. It is important to note that bowel sounds can vary depending on factors such as the client's activity level, diet, and any underlying gastrointestinal conditions. Therefore, a comprehensive assessment of bowel sounds should be conducted at different times to obtain an accurate representation of the client's bowel function.

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A nurse is preparing to administer a soapsuds enema to an adult client. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an older adult client who has cancer and is receiving opioids for pain relief. The client has a new prescription for docusate PO daily. When collecting data from the client, which of the following therapeutic effects of docusate should the nurse expect?

Correct Answer is A

Explanation

A nurse is checking the client's bowel sounds. At which time should the nurse auscultate the client's abdomen?

Correct Answer is ["1"]

Explanation

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