The nurse is providing discharge instructions to a patient who is ...

[imowrer]

The nurse is providing discharge instructions to a patient who is recovering from anal-rectal surgery for repair of an anal fissure. What should be included in these instructions?
 
  Select all that apply.
  1. Do not remove the dressing.
  2. Change the dressing if it becomes soiled with urine or feces.
  3. Use the sitz bath.
  4. Use the antibiotic until all drainage stops.
  5. Avoid bowel movements.

Question 2

The nurse is providing medications to a patient with diverticular disease. Which medication should the nurse question for this patient?
 
  1. docusate (Colace)
  2. metronidazole (Flagyl)
  3. trimethoprim-sulfamethoxazole (Bactrim)
  4. bisacodyl (Dulcolax) suppository

[Anonymous]

Answer to Question 1

Correct Answer: 2, 3
Teach the importance of maintaining a high-fiber diet and liberal fluid intake to increase stool bulk and softness and thereby decrease discomfort with defecation. Stress the importance of responding to the urge to defecate to prevent constipation. Teach the patient to keep the perianal region clean and dry. If a dressing is in place, instruct to avoid soiling it with urine or feces during elimination. Following removal of the dressing, teach to clean the area gently with soap and water following a bowel movement. Discuss the use of sitz baths for cleaning and comfort. If an antibiotic has been prescribed, provide written and verbal instructions about its use, its desired effects, and possible adverse effects and their management.

Answer to Question 2

Correct Answer: 4
Although a stool softener such as docusate (Colace) may be prescribed, it is important to note that laxatives can further increase intraluminal pressure in the colon and should be avoided for the patient with diverticular disease. Systemic broad-spectrum antibiotics effective against usual bowel flora are prescribed to treat acute diverticulitis. Oral antibiotics such as metronidazole (Flagyl) or trimethoprim-sulfamethoxazole (Septra, Bactrim) may be prescribed if manifestations are mild.