A nurse is planning care for a client who has a prescription for a bowel-training program following a spinal cord injury.
Which of the following actions should the nurse include in the plan of care?
A.
Encourage a maximum fluid intake of 1,500 mL per day.
B.
Increase the amount of refined grains in the client’s diet.
C.
Provide the client with a cold drink prior to defecation.
D.
Administer a cathartic suppository 30 min prior to scheduled defecation times.
The correct answer and Explanation is :
The correct answer is D. Administer a cathartic suppository 30 minutes prior to scheduled defecation times.
Explanation:
A bowel-training program is essential for clients with spinal cord injuries to establish a regular bowel routine and prevent constipation. Proper bowel management helps improve quality of life and can prevent complications related to bowel dysfunction, such as fecal incontinence or impaction.
Option A: Encourage a maximum fluid intake of 1,500 mL per day. This recommendation is inadequate for a bowel-training program. Typically, a higher fluid intake (at least 2,000-3,000 mL per day) is encouraged to help soften the stool and promote regular bowel movements. Adequate hydration is crucial for preventing constipation and ensuring the effectiveness of the bowel-training program.
Option B: Increase the amount of refined grains in the client’s diet. Refined grains are low in fiber and can contribute to constipation. A diet high in fiber, including whole grains, fruits, and vegetables, is preferable for promoting bowel regularity. Increasing fiber intake helps form well-formed stools and stimulates bowel movements.
Option C: Provide the client with a cold drink prior to defecation. While some clients may find certain temperature-related stimuli (like warm drinks) helpful, this approach is not a standardized or effective method for bowel training. The primary goal of bowel training is to establish a routine rather than using temperature as a stimulus.
Option D: Administer a cathartic suppository 30 minutes prior to scheduled defecation times. This approach is effective and commonly used in bowel-training programs. Cathartic suppositories stimulate bowel movements by irritating the rectal mucosa, which promotes evacuation. Administering a suppository 30 minutes before a scheduled defecation time helps in establishing a regular bowel routine and ensures that the client can have a bowel movement at the planned time.
In summary, administering a cathartic suppository 30 minutes prior to scheduled defecation times is a practical strategy to help clients with spinal cord injuries establish a consistent and manageable bowel routine.