A nurse manager is planning to assist with resolving conflict within a group of nurses. Which of the following actions should the nurse manager take?

Choice A reason: Decreasing fluid intake to firm stools is incorrect, as adequate hydration (2-3 L/day) is essential to prevent constipation, especially with opioids like oxycodone, which slow intestinal motility. Low fluid intake hardens stools, exacerbating constipation risk by reducing water content in the colon, indicating a misunderstanding of prevention strategies.
Choice B reason: Increasing dietary fiber intake (25-35 g/day) adds bulk to stools, stimulating peristalsis and counteracting opioid-induced slowed motility. Soluble and insoluble fiber, found in fruits, vegetables, and whole grains, promotes regular bowel movements. This statement reflects correct understanding of dietary measures to prevent constipation during opioid therapy.
Choice C reason: Taking a laxative only when constipated is reactive, not preventive. Opioids like oxycodone commonly cause constipation by reducing peristalsis via mu-opioid receptors in the gut. Prophylactic use of stool softeners or laxatives is recommended to maintain regular bowel movements, making this statement incorrect as it lacks a preventive approach.
Choice D reason: Exercising less to conserve energy worsens constipation, as physical activity stimulates intestinal motility, countering opioid-induced slowing. Regular movement, like walking, promotes bowel function by enhancing peristalsis and blood flow to the gut. This statement indicates a misunderstanding, as reduced activity increases constipation risk.

Choice A reason: Preparing for a paracentesis is inappropriate, as abdominal distention post-laparoscopic cholecystectomy is typically due to retained carbon dioxide from insufflation, not ascites. Paracentesis is invasive and unnecessary, risking complications without addressing the cause, making it an incorrect intervention for this scenario.
Choice B reason: Assisting the client to ambulate promotes the expulsion of residual gas used during laparoscopic cholecystectomy, relieving abdominal distention. Early mobility enhances circulation, reduces bloating, and prevents complications like ileus, aligning with postoperative care guidelines, making it the most effective and appropriate action.
Choice C reason: Inserting a rectal suppository is not indicated, as distention is likely from gas, not constipation, immediately post-cholecystectomy. Suppositories may cause discomfort without resolving gas-related bloating. This intervention is premature and misaligned with the cause, making it inappropriate.
Choice D reason: Placing the client in the prone position may worsen discomfort from abdominal distention by compressing the abdomen, trapping gas. Upright or walking positions facilitate gas movement and relief. This position is counterproductive, making it an incorrect choice for managing post-surgical distention.