A nurse is checking orders. Which order should the nurse ...

[lbcchick]

A nurse is checking orders. Which order should the nurse question?
 
  a. A normal saline enema to be repeated every 4 hours until stool is produced
  b. A hypertonic solution enema for a patient with fluid volume excess
  c. A Kayexalate enema for a patient with severe hypokalemia
  d. An oil retention enema for a patient with constipation

Question 2

The nurse is managing bowel training for a patient. To which patient is the nurse most likely providing care?
 
  a. A 25-year-old patient with diarrhea
  b. A 30-year-old patient with Clostridium difficile
  c. A 40-year-old patient with an ileostomy
  d. A 70-year-old patient with stool incontinence

[prumorgan]

Answer to Question 1

ANS: C
Kayexalate binds to and helps excrete potassium, so it would be contraindicated in patients who are hypokalemic (have low potassium). Normal saline enemas can be repeated without risk of fluid or electrolyte imbalance. Hypertonic solutions are intended for patients who cannot handle large fluid volume and are contraindicated for dehydrated patients. Oil retention enemas lubricate the feces in the rectum and colon and are used for constipation.

Answer to Question 2

ANS: D
The patient with chronic constipation or fecal incontinence secondary to cognitive impairment may benefit from bowel training, also called habit training. An ileostomy, diarrhea, and C. difficile all relate to uncontrollable bowel movements, for which no method can be used to set up a schedule of elimination.

[lbcchick]

TYSM

[bulacsom]

Gracias!