A patient who is constipated has just received a mineral oil-retention enema. The nurse encourages this patient to hold this enema for a minimum of how long?

Bright red stool can be a sign of gastrointestinal bleeding, and it is essential to take this symptom seriously and investigate its cause. Requesting a stool sample can help identify the presence of blood and determine the possible source of bleeding. Additionally, notifying the Charge RN ensures that the appropriate healthcare professionals are informed, and further evaluation and treatment can be initiated promptly. The nurse should not dismiss or downplay the concern, as it real. Suggesting that severe stress can cause bright red stool may not be accurate and could potentially dismiss the patient's concern without proper investigation.

Option A, "Sometimes severe stress can make the stool bright red," is not an appropriate response. While stress can affect bowel movements, it is important not to dismiss the presence of bright red stool without further investigation.

Option B, "This is probably nothing. Just let me know if it happens again," is not an appropriate. The nurse should not downplay the symptom without further assessment and investigation.

Option D, "You should schedule a colonoscopy as soon as possible," is not an appropriate response. While bright red stool should be investigated, scheduling a colonoscopy would be a more extensive procedure and should be considered based on the findings of the initial assessment and stool sample analysis.

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.