The nurse is assisting an older adult client who has problems with constipation and reports fear of defecation because of painful hemorrhoids, to establish a regular bowel pattern. Which action should the nurse take?

Suggest using a stool softener.

Recommend a daily laxative.

Obtain a stool specimen.

Discuss oral analgesic options.

Answer and Explanation

The Correct Answer is A

A. Suggesting a stool softener is appropriate as it helps to ease bowel movements and reduce straining, which can alleviate pain associated with hemorrhoids and help establish a regular bowel pattern.
B. Recommending a daily laxative may not be appropriate for long-term use and could potentially exacerbate the issue if overused. It is generally better to start with less invasive measures like stool softeners.
C. Obtaining a stool specimen may be necessary for diagnostic purposes but does not directly address the immediate concern of painful defecation due to hemorrhoids.
D. Discussing oral analgesic options might help with pain management, but it does not address the underlying issue of constipation and the need for a regular bowel pattern. Stool softeners are more directly related to resolving the constipation problem.

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Correct Answer is B

Explanation

A. While applying a barrier ointment is important for preventing further skin breakdown, it does not address the immediate need to assess the severity of existing damage.
B. Determining the size and depth of skin breakdown is crucial for assessing the severity of the pressure injury and planning appropriate treatment. Accurate assessment helps in selecting the right interventions and monitoring the progression of the wound.
C. Completing a functional assessment of the client's self-care abilities is important for overall care planning but should follow the initial assessment of the skin breakdown to ensure immediate needs are addressed.
D. Establishing a toileting schedule is a preventive measure for future incontinence but does not address the current skin breakdown that needs immediate assessment and treatment.

A. Dizziness can occur during cleansing. B. Foreskin should not be retracted. C. An erection may occur while providing care. D. Pubic area should be kept shaved.

Correct Answer is C

Explanation

A. Dizziness is not typically associated with routine perineal care, so it is not a common concern for the caregiver to monitor during cleansing. Normal care does not usually affect blood pressure or circulation enough to cause dizziness.

B. The foreskin should be gently retracted in male clients who are uncircumcised to clean beneath it, as failing to do so can lead to buildup of secretions and increase the risk of infection. Proper retraction is important for hygiene and to prevent conditions like balanitis.

C. An erection may occur as a reflex response during perineal care, especially in males with intact neurologic function. Caregivers should be aware of this possibility and continue care calmly and professionally without assuming it is sexual in nature.

D. The pubic area does not need to be shaved for routine hygiene, and shaving can cause microabrasions that increase the risk of infection. Proper cleansing with soap and water is sufficient to maintain perineal hygiene.

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The nurse is assisting an older adult client who has problems with constipation and reports fear of defecation because of painful hemorrhoids, to establish a regular bowel pattern. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

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