The nurse is interviewing a client who is experiencing constipation. During the interview, the client states, "I don't understand what is going on. I feel the urge to go to the bathroom but, once I am in there and I begin pushing with my abdominal muscles, nothing happens." Which of the following represents the nurse's best response to the client?
A)"Try taking an over-the-counter medication containing bismuth salts, such as Kaopectate or Pepto-Bismol. If your symptoms don't subside in 2 days, come back to the office."
B)"Stop taking all medications until you have reestablished a normal elimination routine. Medication usage often leads to constipation."
C)"Make sure that you are taking proper care of the skin in the anal area. Skin breakdown can result in hesitancy when defecating."
D)"Try to avoid straining with the abdominal muscles during defecation. Doing so may actually close the anal sphincter, preventing feces from passing through."

Question

Quizplus · Accepted Answer

A)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.
B)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.
C)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.
D)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.

The Nurse Is Interviewing a Client Who Is Experiencing Constipation