A patient is having trouble defecating into a bed pan while lying in bed. Which action by the nurse would assist the patient in having a successful bowel movement?

Administering laxatives to the patient

Preparing to administer a cleansing enema

Withholding narcotic pain medication for at least 2 hours until the patient had a bowel movement successfully.

Raising the head of the bed to a semi or high Fowlers position

Answer and Explanation

The Correct Answer is D

Raising the head of the bed to a semi or high Fowler's position (sitting up at a 30-45-degree angle) can assist the patient in having a successful bowel movement while using a bedpan. This position helps to facilitate gravity, making it easier for the patient to bear down and evacuate their bowels.

Administering laxatives to the patient in (option A) is incorrect because laxatives are medications that help promote bowel movements. While they may be used in some cases of constipation, they might not be the immediate solution for a patient having difficulty using a bedpan.

Preparing to administer a cleansing enema in (option B) is incorrect because Enemas involve introducing liquid into the rectum to stimulate bowel movements. They are typically used for more severe cases of constipation or as part of a bowel preparation before certain medical procedures. For a patient who is simply having trouble using a bedpan while lying in bed, an enema may not be necessary or appropriate at this time.

Withholding narcotic pain medication for at least 2 hours until the patient had a bowel movement successfully in (option C) is incorrect because, while some pain medications, particularly opioids, can cause constipation as a side effect, withholding pain medication solely for this purpose may not be appropriate or safe. Pain management is essential for patient comfort and recovery, and the nurse should find other interventions to assist with bowel movements while maintaining appropriate pain control.

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Correct Answer is A

Explanation

Stool softeners, also known as emollient laxatives, work by helping to moisten and soften the stool, making it easier to pass. They are typically taken orally and act by promoting water absorption into the stool, thereby making it softer and easier to pass. This option is often recommended as a first-line treatment for constipation, especially for patients with a history of constipation.

Soap suds enema (option B) is not recommendable as the best option to try first because it involves introducing a solution of soap and water into the rectum to stimulate bowel movement. It is usually used for immediate relief of constipation and is not recommended as the first option.

Suppositories (option C) is not recommendable as the best option to try first because they are medications that are inserted into the rectum to stimulate bowel movement. They work by irritating the lining of the rectum and promoting peristalsis. Suppositories are generally considered to be more invasive than stool softeners and are typically used if other methods have not been successful.

Mineral oil enema (option D) is not recommendable as the best option to try first because it involves introducing mineral oil into the rectum to lubricate the stool and facilitate its passage. This option is also considered more aggressive and is usually used when other methods have failed.

A. An oil retention enema for a patient using mineral oil laxatives B. A normal saline enema to be repeated every 4 hours until stool is produced C. A hypertonic solution enema with a patient with fluid volume excess D. A Kayexalate enema for a patient with hypokalemia

Correct Answer is D

Explanation

A. An oil retention enema for a patient using mineral oil laxatives: This is generally appropriate as oil retention enemas help lubricate and soften the stool, making it easier to pass, especially if the patient is already using mineral oil laxatives.

B. A normal saline enema to be repeated every 4 hours until stool is produced: This is typically safe because normal saline is isotonic and less likely to cause fluid or electrolyte imbalances compared to hypertonic solutions. However, repeated administration should be monitored to avoid dehydration or electrolyte imbalances.

C. A hypertonic solution enema for a patient with fluid volume excess: This order is questionable but can still be used cautiously. Hypertonic enemas draw fluid into the colon, which could potentially worsen fluid volume excess. The patient's overall condition should be carefully monitored.

D. A Kayexalate enema for a patient with hypokalemia: Kayexalate (sodium polystyrene sulfonate) is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the colon, leading to a decrease in potassium levels. Administering this to a patient with hypokalemia (low potassium) could dangerously lower potassium levels further, leading to severe complications like arrhythmias. This order should definitely be questioned.

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A patient is having trouble defecating into a bed pan while lying in bed. Which action by the nurse would assist the patient in having a successful bowel movement?

Nursing Test Bank

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Correct Answer is A

Explanation

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A patient is having trouble defecating into a bed pan while lying in bed. Which action by the nurse would assist the patient in having a successful bowel movement?