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 D
Explanation
Choice D rationale
Easily bruised is a common sign of Cushing's syndrome due to increased cortisol levels, which weaken blood vessel walls, leading to capillary fragility and easy bruising.
Choice A rationale
Jaundice is not a typical finding in Cushing's syndrome. It is usually associated with liver conditions where bilirubin levels increase.
Choice B rationale
Muscle rigidity is not a common symptom of Cushing's syndrome. It is more associated with neurological or muscular disorders.
Choice C rationale
Weight loss is contrary to what is seen in Cushing's syndrome, where weight gain, particularly in the abdomen and face (moon face), is more typical.
Correct Answer is B
Explanation
Choice A rationale
Instilling a warm enema solution is not appropriate for treating malignant hyperthermia. The focus should be on cooling measures and medications.
Choice B rationale
Applying a cooling blanket is an appropriate action to help reduce the client's body temperature during malignant hyperthermia.
Choice C rationale
Administering meperidine IM is not indicated for malignant hyperthermia. The appropriate medications include dantrolene, cooling measures, and supportive care.
Choice D rationale
Ventilating the client with 100% oxygen, not 50%, is the appropriate action to ensure adequate oxygenation during malignant hyperthermia.
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