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?

Option A is the most appropriate choice. Applying a skin protective lotion after cleaning the backside can help moisturize and nourish the dry and thin perineal skin. It creates a barrier that helps protect the skin from further irritation and excoriation. It is important to choose a skin protective lotion specifically formulated for perineal care and suitable for older adults.

Let's go over the other options:

Option B is incorrect because taping an occlusive moisture barrier pad to the skin may not be necessary for mild excoriation and can potentially further irritate the skin. It is not the most appropriate intervention in this situation

Massage the skin with deep kneading pressure in (option C) is incorrect because deep kneading pressure may cause further irritation to the already dry and thin perineal skin, potentially worsening the excoriation. Gentle and cautious care should be taken to avoid excessive pressure or friction

Thoroughly scrub the skin with a washcloth and hypoallergenic soap in (option D) is incorrect because thoroughly scrubbing the skin with a washcloth and hypoallergenic soap can be too harsh for the already compromised perineal skin. It may cause further dryness, irritation, and damage to the skin. Gentle cleansing using mild, non-irritating soap and soft cloths or disposable wipes is more appropriate.

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.