A 36-year-old male client is about to be discharged from the hospital after 5 days due to surgery. Which intervention should be included in the home health care nurse’s instructions about measures to prevent constipation?
A. Discouraging the client from eating large amounts of roughage-containing foods in the diet.
B. Encouraging the client to use laxatives routinely to ensure adequate bowel elimination.
C. Instructing the client to establish a bowel evacuation schedule that changes every day.
D. Instructing the client to fill a 2-L bottle with water every night and drink it the next day.
Correct Answer: D. Instructing the client to fill a 2-L bottle with water every night and drink it the next day.
Adequate fluids and fiber in the diet are key to preventing constipation. Having the client fill a 2-L bottle with water every night and drink it the next day is one method for ensuring the client receives at least 2,000 ml of water daily. The client also should be instructed to drink any other fluids throughout the day.
Option A: High fiber or roughage foods are encouraged. Assist the patient to take at least 20 g of dietary fiber (e.g., raw fruits, fresh vegetables, whole grains) per day. Fiber adds bulk to the stool and makes defecation easier because it passes through the intestine essentially unchanged.
Option B: Laxatives should not be used routinely for bowel elimination. They should be used only as a last resort, because clients may become dependent on them. The use of laxatives or enemas is indicated for the short-term management of constipation.
Option C: A regular bowel evacuation schedule should be established. Encourage a regular period for elimination. Most people defecate following the first daily meal or coffee, as a result of the gastrocolic reflex.
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