Factors Affecting Bowel Elimination

Every question here, with the answer

1. A client started on oral morphine after surgery asks why the nurse is recommending a stool softener. What is the best explanation?

   1. Opioids slow bowel motility and reduce intestinal secretions, which can cause constipation.
   2. Opioids cause esophageal irritation.
   3. Opioids speed bowel motility and cause diarrhea.
   4. Opioids cause stools to turn black.

   Answer: Opioids slow bowel motility and reduce intestinal secretions, which can cause constipation.

   Opioids bind to receptors in the GI tract, slowing motility and reducing secretions, which leads to opioid-induced constipation; stool softeners or laxatives are a mitigation strategy. Black stools are linked to iron, and esophageal irritation to bisphosphonates.

2. A client starting ferrous sulfate for iron-deficiency anemia calls the clinic worried that their stools are black. What should the nurse explain?

   1. Black stools mean the iron is not being absorbed.
   2. Black stools are expected with iron.
   3. The client should stop the iron immediately.
   4. Black stools mean the dose is too low.

   Answer: Black stools are expected with iron.

   Iron can cause stools to be black and can also cause constipation, nausea, and abdominal discomfort. The section does not link black stools to a low dose or poor absorption, and stopping therapy is not indicated by this finding.

3. A client taking furosemide reports constipation and muscle weakness. Which assessment should the nurse prioritize?

   1. Amount of caffeine intake
   2. Hours of sleep
   3. Stool color
   4. Serum potassium level

   Answer: Serum potassium level

   Diuretics can deplete potassium, and low potassium can cause muscle weakness and intestinal dysmotility, leading to constipation; electrolyte levels should be monitored. Stool color, sleep, and caffeine do not explain this combination of findings.

4. An older adult reports that bowel movements have become less frequent over the past few years. Which age-related change should the nurse consider?

   1. Pelvic floor muscles strengthen with age.
   2. Peristalsis typically slows with aging.
   3. Older adults produce more meconium-like stool.
   4. Aging increases bowel motility.

   Answer: Peristalsis typically slows with aging.

   Peristalsis typically slows with aging, and constipation, fecal incontinence, and diverticulosis may become more prevalent. Meconium is a newborn's first stool, and aging does not increase motility or strengthen the pelvic floor.

5. A client reports frequent constipation. Which teaching points support regular bowel elimination? Select all that apply.

   1. Keep a consistent toilet routine.
   2. Drink an adequate amount of water throughout the day.
   3. Eat a diet rich in fruits, vegetables, whole grains, and legumes.
   4. Get regular physical activity such as walking.
   5. Delay bowel movements until a convenient time.

   Answer: Keep a consistent toilet routine., Drink an adequate amount of water throughout the day., Eat a diet rich in fruits, vegetables, whole grains, and legumes., Get regular physical activity such as walking.

   Fiber, adequate fluids, regular exercise, and a consistent toilet routine all promote regular bowel movements. Ignoring the urge or delaying bowel movements disrupts normal function and can lead to constipation or fecal impaction.

6. The parent of a 4-month-old breastfed infant who recently started pureed foods reports harder, less frequent stools. Which suggestions by the nurse are appropriate? Select all that apply.

   1. Move the infant's legs in a bicycle motion.
   2. Gently massage the infant's tummy.
   3. Offer more breast milk if the infant seems thirsty.
   4. Continue pureed fruits and vegetables for their fiber.
   5. Stop all solid foods permanently.

   Answer: Move the infant's legs in a bicycle motion., Gently massage the infant's tummy., Offer more breast milk if the infant seems thirsty., Continue pureed fruits and vegetables for their fiber.

   The nurse suggests extra breast milk for hydration, continuing fiber-containing purees, tummy massage, and bicycle leg movements, and calling if symptoms persist. Changes in stool are normal during the transition to solids, so stopping solids permanently is not recommended.