The nurse is caring for a 19-year-old male client with a ...

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The nurse is caring for a 19-year-old male client with a fractured left femur whose leg was pinned 36 hours ago and is now in traction. Which of the following stressors is mostly likely the cause of this client's difficulty related to constipation?
 
  1. Pain related to the fracture and its repair
  2. Anxiety regarding the serious nature of the injury
  3. The need to defecate in an unfamiliar, awkward position
  4. Poor fluid intake after the accident and ensuing surgery

Question 2

A client is caring for her daughter, who recently suffered multiple fractures in an automobile ac-cident. The client tells the home care nurse that she has been really down since all this hap-pened.
 
  She adds that she has been constipated and not really interested in eating. Which of the follow-ing statements by the nurse focuses on the most likely cause of the gastrointestinal problem?
  1. Actually, how long have you been constipated?
  2. Are you eating fiber-rich foods like fruit and whole grains?
  3. You may be depressed; emotional depression can cause constipation.
  4. I suggest you get some over-the-counter mild laxative and see if that helps.

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Answer to Question 1

ANS: 3
For the client immobilized in bed, defecation is often difficult. In a supine position it is impossi-ble to contract the muscles used during defecation. If the client's condition permits, raise the head of the bed; this assists the client to a more normal sitting position on a bedpan, enhancing the ability to defecate. Although the other options may have some effect, the primary cause is most likely the emotional stress of not being able to assume the usual position for defecation.

Answer to Question 2

ANS: 3
If a person becomes depressed, the autonomic nervous system slows impulses, and peristalsis de-creases, resulting in constipation. Although the other options are not incorrect, they are not the most likely cause for this particular client.

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TYSM

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