Foundations Chapter 47 Bowel Elimination Practice Questions and Complete Solutions

A registered nurse is educating nursing students about the required interventions while administering an enema. Which statements if made by a student nurse indicate effective understanding? Select all that apply. 1 "I'll place a waterproof pad under the patient's hips and buttocks." 2 "I'll assist the patient into the supine position with the right knee flexed." 3 "I'll stand on the left side of the patient's bed and raise the side rail on the opposite side." 4 "I'll cover the patient with a bath blanket, exposing only the rectal area, and clearly visualizing the anus." 5 "If the patient has poor sphincter control, I'll position the patient on a bedpan in a comfortable dorsal recumbent position."1, 4, 5 The nurse should place a waterproof pad under the patient's hips and buttocks when administering an enema. The nurse should also cover the patient with a bath blanket, exposing only the rectal area, and clearly visualizing the anus. If the patient has poor sphincter control, the nurse should position the patient on a bedpan in a comfortable dorsal recumbent position. While preparing a patient for an enema, the nurse should assist the patient into the Sims' position with the right knee flexed and the nurse should stand on the right side of the patient's bed and raise side rail on the opposite side. While assessing a patient before administering an enema, the nurse inspects the patient's abdomen for distention. What is the purpose of this nursing intervention? 1 It allows the nurse to plan for appropriate teaching measures. 2 It helps determine the number and type of enemas to be given. 3 It helps determine conditions that contraindicate the use of enemas. 4 It provides a baseline for determining the effectiveness of the enema.4 Before administering an enema, the nurse should inspect the patient's abdomen for distention. This provides a baseline for determining the effectiveness of the enema. To plan for appropriate teaching measures, the nurse should determine the patient's level of understanding of the purpose of the enema. The nurse should review the health care provider's order for the type of enema and the amount to be given. Before administering an enema, the nurse should review the patient's medical record for increased intracranial pressure, glaucoma, or recent abdominal, rectal, or prostate surgery because these conditions contraindicate the use of enemas. A nurse is assessing a patient with diarrhea. Which question will help determine the presence of other symptoms? 1 "Do you feel bloated after eating?" 2 "Do you have to strain to have a bowel movement?" 3 "Have you had fever, chills, weight loss, or abdominal pain recently?" 4 "Do you have abdominal or rectal pain when you have a bowel movement?"3 Diarrhea may be associated with fever, chills, weight loss, or abdominal pain; therefore, the nurse should ask the patient about the presence of these symptoms. A bloated feeling after eating may be present in patients with indigestion. Patients with constipation may have to strain to have a bowel movement and may have abdominal or rectal pain when they have a bowel movement. A nurse is discussing common bowel elimination problems. Which statement indicates effective understanding of the difference between fecal impaction and fecal incontinence? 1 Fecal impaction may occur due to antibiotic therapy, whereas fecal incontinence may occur due to opiate therapy. 2 Fecal impaction is the accumulation of gas in the lumen of the intestines, whereas fecal incontinence is the inability to control the passage of feces and gas from the anus. 3 Fecal impaction is common in debilitated, confused, or unconscious patients, whereas fecal incontinence is common in patients with impaired cognitive function. 4 Fecal impaction is characterized by loss of appetite, nausea and/or vomiting, and rectal pain, whereas fecal incontinence is characterized by abdominal distention and severe, sharp abdominal pain.3