A patient has been admitted for surgery for a colostomy. The patient states, "I can't believe this has happened to me." What is the nurse's best response?

A) Dysrhythmias:
Straining while defecating can trigger the Valsalva maneuver, which involves taking a deep breath and bearing down. This can lead to increased intrathoracic pressure, decreased venous return to the heart, and subsequently a sudden drop in blood pressure when the strain is released. These changes can cause cardiac dysrhythmias, particularly in older adults or those with underlying heart conditions.

B) Dilated pupils:
Dilated pupils are not a known consequence of straining while defecating. Pupillary dilation is typically associated with responses to low light, certain medications, or neurological conditions, rather than gastrointestinal strain.

C) Gastric ulcer:
Gastric ulcers are caused by factors such as Helicobacter pylori infection, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), or excessive stomach acid. Straining during defecation does not contribute to the development of gastric ulcers.

D) Diarrhea:
Straining while defecating is more likely to be associated with constipation rather than diarrhea. Diarrhea involves frequent, loose, or watery stools, whereas straining typically occurs due to hard stools and difficulty passing them.

Answer: A, C, D, E

Rationale:

A) Yoga: Yoga is an effective nonpharmacological therapy that combines physical postures, breathing exercises, and meditation, which can help reduce stress, improve flexibility, and enhance mental focus.

B) Electromagnetic therapy: Electromagnetic therapy is typically used for pain management or to promote wound healing rather than stress reduction. It is not commonly included in stress management techniques.

C) Meditation: Meditation focuses on mindful breathing and awareness, which can significantly reduce stress by calming the mind and improving emotional resilience. It’s widely used to help manage stress and anxiety.

D) Acupuncture: Acupuncture involves the insertion of needles at specific body points and is believed to release endorphins and balance energy flow, which can reduce stress and promote relaxation.

E) Biofeedback: Biofeedback teaches clients to control physiological responses like heart rate and muscle tension, helping them manage stress and anxiety effectively through self-regulation techniques.