A patient at a long-term care facility makes the following statements regarding management of his constipation. Which statement would require follow-up teaching by the nurse?

I try to walk in the hallway each day with assistance.

I need to increase fiber in my diet and drink more water.

I take my laxative every morning and an enema every night.

The pain medication I take tends to make my constipation worse.

Answer and Explanation

The Correct Answer is C

Choice A reason: I try to walk in the hallway each day with assistance is a correct statement. Walking is a form of physical activity that can stimulate bowel movements and prevent constipation. Walking also has other benefits such as improving circulation, muscle strength, and mood. The patient should be encouraged to walk as much as possible with assistance to prevent falls and injuries.

Choice B reason: I need to increase fiber in my diet and drink more water is a correct statement. Fiber is a type of carbohydrate that is not digested by the body and helps to form soft and bulky stools. Fiber can be found in foods such as fruits, vegetables, whole grains, nuts, and seeds. Water is essential for hydration and helps to soften the stools and ease their passage. The patient should be advised to consume at least 25 grams of fiber and 8 glasses of water per day to prevent constipation.

Choice C reason: I take my laxative every morning and an enema every night is an incorrect statement that requires follow-up teaching by the nurse. Laxatives and enemas are medications that are used to treat constipation by stimulating or lubricating the bowel. However, they should not be used routinely or excessively, as they can cause side effects such as dehydration, electrolyte imbalance, abdominal cramps, diarrhea, or dependence. The patient should be instructed to use laxatives and enemas only as prescribed by the doctor and for a short period of time. The patient should also be informed of the potential risks and complications of overusing laxatives and enemas.

Choice D reason: The pain medication I take tends to make my constipation worse is a correct statement. Pain medications, especially opioids, can slow down the movement of the bowel and cause constipation. This is a common and expected side effect of pain medications. The patient should be educated on how to manage constipation caused by pain medications, such as increasing fiber and water intake, exercising regularly, and using stool softeners or laxatives as needed. The patient should also be reassured that constipation does not mean that the pain medication is not working or that they are addicted to it.

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Correct Answer is D

Explanation

Choice A reason: Using soap to clean the client's skin is not a recommended action, as it can dry out and irritate the skin, increasing the risk of skin breakdown and infection.

Choice B reason: Applying friction when drying the client's skin is not a recommended action, as it can damage and abrade the skin, causing pain and inflammation.

Choice C reason: Using hot water to clean the client's skin is not a recommended action, as it can increase the blood flow and inflammation to the skin, as well as remove the natural oils that protect the skin.

Choice D reason: Applying a barrier cream to the client's skin is a recommended action, as it can moisturize and protect the skin from the effects of urine, such as acidity, bacteria, and enzymes.

A. William, who exercises three times a week B. Samantha, who has a family history of osteoporosis C. Juanita, who smokes two packs of cigarettes a day D. Tori, who is postmenopausal at age 40

Correct Answer is C

Explanation

Choice A reason: William, who exercises three times a week, does not have a modifiable risk factor for osteoporosis. Exercise is actually beneficial for bone health, as it stimulates bone formation and reduces bone loss. Exercise also improves muscle strength, balance, and coordination, which can prevent falls and fractures.

Choice B reason: Samantha, who has a family history of osteoporosis, does not have a modifiable risk factor for osteoporosis. Family history is a genetic factor that cannot be changed or controlled. Having a parent or sibling with osteoporosis increases the risk of developing the condition, especially if they have had a fracture.

Choice C reason: Juanita, who smokes two packs of cigarettes a day, has a modifiable risk factor for osteoporosis. Smoking is a lifestyle factor that can be changed or controlled. Smoking increases the risk of osteoporosis by reducing the blood supply to the bones, decreasing the absorption of calcium, and lowering the levels of estrogen, which protects the bones.

Choice D reason: Tori, who is postmenopausal at age 40, does not have a modifiable risk factor for osteoporosis. Menopause is a natural process that occurs when the ovaries stop producing estrogen, which leads to bone loss and increased risk of fractures. Menopause cannot be prevented or reversed, but its effects on bone health can be managed with hormone therapy, calcium, and vitamin D supplements.

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A patient at a long-term care facility makes the following statements regarding management of his constipation. Which statement would require follow-up teaching by the nurse?

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