A nurse is contributing to the plan of care for a client who is starting bowel training for the management of fecal incontinence.Which of the following interventions should the nurse recommend?
Limit the client's fluid intake to 1500 m/day.
Assist the client to the restroom 30 min after meals.
Limit the client's physical activity until bowel continence is achieved.
Instruct the client to limit their intake of high-fiber foods.
The Correct Answer is B
Choice A rationale
Limiting fluid intake to 1500 mL/day is not recommended for bowel training. Adequate fluid intake is important for maintaining regular bowel movements and preventing constipation. Limiting fluids can worsen constipation and interfere with bowel training.
Choice B rationale
Assisting the client to the restroom 30 minutes after meals takes advantage of the gastrocolic reflex, which stimulates bowel movements following food intake. This helps establish a regular bowel routine and manage fecal incontinence.
Choice C rationale
Limiting physical activity is not advised for bowel continence. Regular physical activity promotes gastrointestinal motility and overall bowel health. Physical inactivity can lead to constipation and negatively impact bowel training efforts.
Choice D rationale
High-fiber foods are important for bowel health as they add bulk to stool and promote regular bowel movements. Limiting intake of high-fiber foods can lead to constipation and is counterproductive to bowel training.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Condition: Sepsis.
2 actions:
Administer a broad-spectrum antibiotic,
Perform a swab culture of the AVF site.
2 parameters:
White blood cell count,
Blood cultures.
Rationale for correct condition: Sepsis is indicated by the client's fever, elevated heart rate, and respiratory rate, combined with signs of infection at the AVF site. Chronic conditions like diabetes and renal disease increase sepsis risk. The symptoms and history align with systemic infection spreading from the AVF site. Sepsis requires immediate intervention to prevent severe complications. Elevated temperature and infection signs suggest systemic involvement.
Rationale for actions: Administering antibiotics is crucial to control the infection. Swab culture identifies the causative organism. Indwelling catheter is unnecessary here. Aspirin does not treat infection. Bed rest alone is insufficient. Monitoring WBC count tracks infection response. Blood cultures confirm sepsis diagnosis. Creatinine is less urgent for immediate management. Blood glucose is relevant but not immediate. AVF site circumference monitors local rather than systemic infection.
Rationale for parameters: WBC count indicates immune response. Blood cultures identify bacteria, confirming sepsis. Creatinine is routine but not urgent. Blood glucose tracks diabetes control, less immediate. AVF circumference monitors local inflammation. Cellulitis is localized, not systemic. AVF thrombosis lacks systemic signs like fever. Endocarditis requires specific cardiac symptoms.
Rationale for incorrect conditions: Cellulitis does not explain systemic symptoms. AVF thrombosis lacks systemic infection signs. Endocarditis has distinct cardiac symptoms absent here.
Correct Answer is B
Explanation
Choice A rationale
NSAIDs for pain relief are not directly linked to an increased risk of osteoporosis.
Choice B rationale
Smoking cigarettes is a known risk factor for developing osteoporosis as it affects bone density and health.
Choice C rationale
Age 45 is not considered a high-risk factor for osteoporosis without other contributing factors.
Choice D rationale
Regular aerobic exercise helps maintain bone health and is not a risk factor for osteoporosis.
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