A nurse is teaching a client who has constipation.
Which of the following statements should the nurse include?
Reduce your daily activity.
Try to defecate at different times of the day.
Increase your daily fluid intake.
Consume a low-fiber diet.
The Correct Answer is C
Choice A rationale
Reducing daily activity is not advised for clients with constipation. Physical activity helps stimulate bowel movements and can relieve constipation.
Choice B rationale
Trying to defecate at different times of the day is not recommended. Establishing a regular bowel routine helps promote consistent bowel movements and can prevent constipation.
Choice C rationale
Increasing daily fluid intake is beneficial for constipation. Fluids help soften stool, making it easier to pass and promoting regular bowel movements.
Choice D rationale
Consuming a low-fiber diet is not advisable for clients with constipation. A high-fiber diet helps bulk up and soften stool, making it easier to pass through the intestines.
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Correct Answer is D
Explanation
Choice A rationale
Blood in the urine (hematuria) is not a typical finding in urinary retention. It may indicate other conditions such as infection, stones, or malignancy.
Choice B rationale
Cloudy urine is often a sign of infection, not typically associated with urinary retention. It can be caused by the presence of bacteria, white blood cells, or crystals.
Choice C rationale
Dark-colored urine can result from dehydration or certain foods and medications. It is not a specific finding of urinary retention.
Choice D rationale
Leakage of urine, also known as overflow incontinence, can occur in urinary retention. This happens when the bladder becomes overly full, and small amounts of urine leak out due to the pressure.
Correct Answer is D
Explanation
Choice A rationale
Clients should be instructed to hold their breath for about 10 seconds after inhalation, not 2 seconds. This allows the medication to reach deeper into the lungs.
Choice B rationale
The MDI canister should not be washed after each use. Instead, it should be cleaned regularly to ensure proper functioning and avoid medication buildup.
Choice C rationale
Clients should be instructed to inhale the medication slowly and deeply over a few seconds, rather than quickly for 1 second. This ensures proper delivery of the medication to the lungs.
Choice D rationale
Shaking the MDI prior to administration is essential. This action mixes the medication evenly, ensuring that the correct dose is delivered with each puff.