A nurse is receiving report on a group of clients. Using the ABCDE priority framework which f the following clients should the nurse see first?

A) Place the client on a low-fiber diet:
A low-fiber diet is not recommended for patients experiencing constipation. Fiber plays a key role in bowel regularity by absorbing water and adding bulk to stool, which promotes movement through the intestines. In fact, a high-fiber diet (from fruits, vegetables, whole grains, and legumes) is usually recommended for clients with constipation. Reducing fiber intake can worsen constipation and should be avoided unless otherwise directed by a healthcare provider for specific conditions (e.g., during acute exacerbations of inflammatory bowel disease).

B) Request a prescription for a mineral oil for the client:
Mineral oil is a laxative that is sometimes used to relieve constipation, but it is typically used only for short-term relief and under specific circumstances. Long-term use of mineral oil can interfere with the absorption of fat-soluble vitamins (A, D, E, and K) and can also lead to a lipid pneumonia if aspirated. It is not the first-line intervention for a patient on bed rest with constipation and should not be used indiscriminately without a provider's recommendation.

C) Encourage the client to drink cold fluids:
While fluid intake is essential for managing constipation, it is not specifically the temperature of the fluid that makes a difference. Both cold and room temperature fluids are effective, but encouraging the client to increase fluid intake overall is the most important action. Water is particularly helpful, as it helps soften stool and aids in the movement through the colon.

D) Increase the client's fluid intake:
Increasing fluid intake is the most effective intervention for constipation, especially for a client on bed rest. Adequate hydration helps to soften stool and can promote more regular bowel movements. Inactive individuals, such as those on bed rest, are more prone to constipation because of decreased physical activity and potentially insufficient fluid intake.

A) Use hot water so rinse hand sanitizer off:
Using hot water is not recommended when performing hand hygiene with alcohol-based hand sanitizer. Alcohol-based sanitizers do not require rinsing off, as they are designed to evaporate quickly, killing germs as they dry. Rinsing with water, especially hot water, can dilute the sanitizer, reducing its effectiveness. Hands should be left to dry naturally after applying the sanitizer.

B) Dry hands with a reusable towel:
While towels can be used for drying hands after washing with soap and water, they should not be used after alcohol-based hand sanitizers. Alcohol hand sanitizers should be allowed to air dry on the hands. Using a towel could reintroduce contaminants and diminish the effectiveness of the sanitizer. Ideally, hands should be rubbed together until they are dry without the need for any towel.

C) Rub hands together for 20 seconds:
Alcohol-based hand sanitizers are effective in killing germs in a short amount of time—usually within 20 seconds or less. However, the correct technique for using alcohol-based hand sanitizers involves rubbing hands together until they are completely dry, not for a full 20 seconds as one might with handwashing. The important factor is ensuring the sanitizer has covered all surfaces of the hands, including between fingers and around nails, before allowing it to air dry.

D) Rub hand sanitizer around rings on fingers:
Rubbing the hand sanitizer around rings is a necessary step. Jewelry, such as rings, can harbor bacteria or other pathogens, making it essential to ensure the sanitizer comes into contact with areas that are often missed during hand hygiene, like around rings. The nurse should rub the hand sanitizer thoroughly over all surfaces of the hands, including around jewelry, to ensure effective hand hygiene.