The nurse is caring for a patient who has been unable to have a bowel movement for the last 4 days after taking prescribed narcotic pain medication. Which nursing diagnosis is appropriate for this patient?

Choice A reason: This is an incorrect choice because gently trimming the patient’s toenails after soaking the feet in warm soapy water is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. Trimming the toenails can be risky for the diabetic patient, as it can cause bleeding, infection, or injury to the nail bed or surrounding skin. The nurse should avoid cutting the toenails of the diabetic patient, unless instructed by a podiatrist.

Choice B reason: This is an incorrect choice because using a pumice stone to smooth roughened areas of skin on the patient’s feet is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. A pumice stone is a porous rock that can be used to exfoliate the skin and remove dead cells. However, it can also damage the skin and cause abrasions, irritation, or infection. The nurse should be careful when using a pumice stone on the diabetic patient, and avoid rubbing too hard or too often.

Choice C reason: This is an incorrect choice because liberally applying lotion to the patient's feet especially between the toes is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. Applying lotion to the feet can help to moisturize and soften the skin, but it can also create a moist environment that can promote fungal growth and infection. The nurse should apply lotion sparingly to the feet of the diabetic patient, and avoid applying it between the toes.

Choice D reason: This is the correct choice because obtaining a consultation for a podiatrist to assess the feet and provide nail care is the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. A podiatrist is a specialist who can diagnose and treat foot problems, such as nail disorders, skin conditions, or infections. The podiatrist can safely and effectively trim the toenails of the diabetic patient, and provide education and advice on foot care and prevention of complications. The nurse should refer the diabetic patient to a podiatrist at least once a year, or more often if needed.

Choice A reason: This is an incorrect choice because tying the restraints to the footboard is not a safe or appropriate option when the nurse is applying soft wrist restraints to the patient. The footboard is the part of the bed that supports the foot end of the mattress. Tying the restraints to the footboard can cause the patient to slide down the bed and increase the risk of strangulation, pressure ulcers, or nerve damage.

Choice B reason: This is the correct choice because tying the restraints to the bedframe is the safest and most appropriate option when the nurse is applying soft wrist restraints to the patient. The bedframe is the metal or wooden structure that supports the mattress and the box spring. Tying the restraints to the bedframe can ensure that the restraints are secure and stable, and that the patient has enough room to move without causing injury or discomfort.

Choice C reason: This is an incorrect choice because tying the restraints to the headboard is not a safe or appropriate option when the nurse is applying soft wrist restraints to the patient. The headboard is the part of the bed that supports the head end of the mattress. Tying the restraints to the headboard can cause the patient to slide up the bed and increase the risk of strangulation, pressure ulcers, or nerve damage.

Choice D reason: This is an incorrect choice because tying the restraints to the side rails is not a safe or appropriate option when the nurse is applying soft wrist restraints to the patient. The side rails are the bars that run along the sides of the bed to prevent the patient from falling out. Tying the restraints to the side rails can cause the patient to twist or bend their wrists and increase the risk of circulation impairment, nerve damage, or skin breakdown.