A nurse in a long-term facility is caring for an older adult client who has dementia and begins to have frequent episodes of urinary incontinence. After the provider determines no medical cause for the client’s incontinence, which of the following interventions should the nurse initiate to manage this behavior?

Choice A reason: Irrigating an NG tube requires sterile technique and assessment of patency, which are beyond the UAP’s scope. This task involves clinical judgment to avoid complications like aspiration, making it inappropriate for delegation.

Choice B reason: Assisting a client to the bathroom post-enema is within the UAP’s scope, involving mobility support and safety. This task does not require clinical judgment beyond ensuring the client’s stability, making it appropriate for delegation.

Choice C reason: Digital removal of stool is an invasive procedure requiring assessment for complications like vagal stimulation or rectal trauma. It is outside the UAP’s scope, as it demands nursing judgment and skill.

Choice D reason: Checking tube feeding aspirate pH and auscultating bowel sounds involve clinical assessment to confirm tube placement and gastrointestinal function. These tasks require nursing expertise and cannot be delegated to a UAP.

Choice A reason: Offering the bedpan every 2 hours does not directly stimulate peristalsis. While regular toileting may prevent constipation, it lacks the mechanical or physiological stimulus needed to enhance bowel motility, especially in postoperative patients at risk for paralytic ileus.

Choice B reason: Ambulation promotes peristalsis by stimulating abdominal muscles and increasing intra-abdominal pressure, which encourages bowel motility. Early mobilization post-surgery enhances blood flow to the gastrointestinal tract, reducing the risk of paralytic ileus by counteracting slowed motility from anesthesia or immobility.

Choice C reason: Increasing protein intake supports tissue repair but does not directly stimulate peristalsis. Protein metabolism may increase stool bulk over time, but it lacks the immediate mechanical or neural stimulation needed to prevent or treat paralytic ileus in the postoperative period.

Choice D reason: Decreasing fluid intake can worsen bowel motility by reducing stool hydration, leading to harder stools and increased risk of constipation. Adequate hydration is essential for maintaining soft stool and supporting peristalsis, making this intervention counterproductive.