A nurse is planning care for a client who has a prescription for a bowel-training program following a spinal cord injury. Which of the following actions should the nurse include in the plan of care?

Administer a cathartic suppository 30 min prior to scheduled defecation times.

Increase the amount of refined grains in the client's diet.

Provide the client with a cold drink prior to defecation.

Encourage a maximum fluid intake of 1,500 mL per day.

Answer and Explanation

The Correct Answer is A

A.   Administering a cathartic suppository 30 minutes prior to scheduled defecation times can help stimulate bowel movements in clients with spinal cord injuries, aiding in bowel training.
B.   Refined grains can lead to constipation, and increasing fiber intake is typically preferred over refined grains in a bowel training program.
C.   A cold drink is not a standard or recommended method to stimulate bowel movements in clients with spinal cord injuries.
D.   Fluid intake should generally be higher than 1,500 mL per day, as adequate hydration is important to prevent constipation and support healthy bowel function.

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Correct Answer is ["A","B","C","D","E","F","G"]

Explanation

Rationale

Findings Indicating Improvement Laboratory Results:

Hemoglobin 12 g/dL (Normal range: 14 to 18 g/dL)

Although the hemoglobin level is still slightly below the normal range (it was 9.1 g/dL prior to the transfusion), it has increased from 9.1 g/dL to 12 g/dL, showing improvement after the blood transfusion. This indicates that the transfusion has helped to raise the hemoglobin level, improving oxygen-carrying capacity.

Hematocrit 36% (Normal range: 40% to 52%)

The hematocrit level has also increased from 27% to 36%. While still below normal, this is an improvement, suggesting the transfusion is starting to correct the client’s anemia and restore normal blood volume.

Vital Signs:

Blood Pressure 112/74 mm Hg

The blood pressure has improved significantly from 76/45 mm Hg (at 1200) and 78/49 mm Hg (at 1230). An increase in blood pressure to 112/74 mm Hg indicates the client is now hemodynamically stable, and the transfusion has helped to address the hypotension. The blood pressure is now in a normal range (typically around 120/80 mm Hg), and it is no longer dangerously low.

Heart Rate 95/min

The heart rate has decreased from 118/min and 121/min (at earlier times) to 95/min. This drop

indicates that the client’s heart is not having to work as hard to compensate for the low blood volume,

suggesting improvement in circulatory status.

Oxygen Saturation 100% via 2 L/min nasal cannula

Oxygen saturation is now normal at 100%. This is an improvement compared to the previous status of 98% on room air, which indicates that the client is now receiving adequate oxygenation, and the supplemental oxygen may be effectively maintaining oxygen levels.

Physical Exam:

General: No distress

The client is no longer in apparent distress, which is an important sign of improvement. Prior to the transfusion, the client was described as diaphoretic and uncomfortable, but now the client is stable and not in distress.

HEENT: Oropharynx clear, mucous membranes moist and pink

The mucous membranes are now moist and pink, which suggests adequate hydration and oxygenation. This is an improvement, as the previous finding indicated the client’s mucous membranes were pale (which can be a sign of anemia or dehydration).

A. Attach the restraint to the bed's side rails. B. Document the client's condition every 15 min. C. Request a PRN restraint prescription for clients who are aggressive. D. Remove the client's restraint every 4 hr.

Correct Answer is B

Explanation

A. Restraints should never be attached to the side rails, as this can increase the risk of injury.
B. The client's condition should be documented every 15 minutes to ensure their safety and comfort while in restraints.
C. A PRN prescription for restraints is not appropriate; restraints should be used only as a last resort and with a physician's order.
D. The restraint should be removed at least every 2 hours to assess for skin integrity and allow for range- of-motion exercises.

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A nurse is planning care for a client who has a prescription for a bowel-training program following a spinal cord injury. Which of the following actions should the nurse include in the plan of care?

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