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A client with chronic fecal incontinence is crying because of being embarrassed for not getting to the bathroom in time to avoid soiling the bed and clothing. When establishing a bowel training regimen, which intervention should the nurse implement?

A.

Insert a rectal tube at specified intervals.

B.

Assist to a bedside commode 30 minutes after meals.

C.

Encourage the use of incontinence briefs.

D.

Administer a glycerin suppository 15 minutes after meals.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Inserting a rectal tube at specified intervals is not a standard practice for bowel training regimens. This intervention is typically reserved for specific medical conditions and is not recommended for routine management of chronic fecal incontinence.

 

Choice B rationale

 

Assisting the client to a bedside commode 30 minutes after meals leverages the natural gastrocolic reflex, which stimulates bowel movements after eating. This intervention helps establish a regular bowel routine and is a key component of bowel retraining programs.

 

Choice C rationale

 

Encouraging the use of incontinence briefs does not address the underlying issue of bowel incontinence and may not help in establishing a regular bowel routine. This intervention is more focused on managing the symptoms rather than treating the condition.

 

Choice D rationale

 

Administering a glycerin suppository 15 minutes after meals can stimulate bowel movements, but it is not the first-line intervention for establishing a bowel training regimen. This approach may be used as an adjunct to other bowel retraining techniques.


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Beginning with questions that are less sensitive in nature helps build rapport and makes the client more comfortable. This approach gradually leads to more sensitive topics, reducing anxiety and promoting honest responses.

Choice B rationale

Getting the most difficult questions over with first can increase the client’s anxiety and discomfort, leading to less honest or incomplete answers. It is not an effective strategy for sensitive topics.

Choice C rationale

Sharing personal values to put the client at ease can introduce bias and affect the client’s responses. It is important to remain neutral and nonjudgmental.

Choice D rationale

Asking questions in a vague, non-specific format can lead to misunderstandings and incomplete information. Clear, direct questions are more effective for gathering accurate information.

Correct Answer is D

Explanation

Choice A rationale

Risk for infection is a concern for clients with neuropathy, as they may have reduced sensation and be unaware of injuries that can become infected. However, the primary concern in promoting foot care is preventing the occurrence of wounds or skin breakdown in the first place.

Choice B rationale

Self-care deficit is relevant for clients with neuropathy who may have difficulty performing foot care independently. However, the priority is to prevent skin breakdown and wounds, which can lead to more severe complications.

Choice C rationale

Impaired physical mobility is a common issue for clients with neuropathy, but it is not the primary concern for foot care. The focus should be on preventing skin breakdown and ensuring proper foot care to avoid complications.

Choice D rationale

Risk for impaired skin integrity is the priority for promoting foot care in clients with neuropathy. Neuropathy can compromise the ability to detect injuries or wounds on the feet, leading to unnoticed wounds that can become infected and cause serious complications.
Preventing skin breakdown and maintaining skin integrity is crucial in this scenario.

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