A nurse is reinforcing teaching about management of constipation during pregnancy with a group of pregnant clients who are pregnant. Which of the following statements should the nurse include in the teaching?

A. Provide a diet high in protein.

During the oliguric phase of acute kidney injury (AKI), there is a risk of electrolyte imbalances, including elevated levels of blood urea nitrogen (BUN) and creatinine. Restricting protein intake is often recommended during this phase to manage azotemia and prevent the accumulation of waste products that the kidneys may struggle to excrete.

B. Provide ibuprofen for retroperitoneal discomfort.

Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in AKI. They can further compromise renal function and may contribute to acute tubular necrosis. NSAIDs can also affect renal blood flow, leading to worsening kidney function.

C. Monitor intake and output hourly.

Monitoring intake and output (I&O) is a critical nursing intervention during the oliguric phase of AKI. Hourly monitoring helps assess renal function, fluid balance, and the effectiveness of interventions. It allows for early detection of changes that may require prompt intervention.

D. Encourage the client to consume at least 2 L of fluid daily.

In the oliguric phase of AKI, fluid intake is often restricted to prevent fluid overload. Encouraging excessive fluid intake may contribute to fluid retention and worsen the oliguria. Fluid management is carefully regulated based on the individual client's needs and renal function.

Correct answer: D

A. "Use mineral oil to relieve constipation.": Mineral oil is not recommended during pregnancy because it can interfere with the absorption of fat-soluble vitamins (A, D, E, K).

B. "Drink 1 liter of water daily to decrease constipation.": While hydration is important, 1 liter of water is insufficient. Pregnant clients are advised to drink more, typically around 2-3 liters daily, to help with digestion and prevent constipation.

C. "Use an enema when constipation occurs.": Enemas are generally not recommended during pregnancy without consulting a healthcare provider, as they may stimulate uterine contractions.

D. “Eat an apple to help with constipation.”Apples are high in fiber, which helps to promote bowel regularity and prevent constipation, making them a healthy option for managing constipation during pregnancy.