QUESTION: "A pregnant client tells the nurse that she has been having discomfort from her hemorrhoids. After giving instruction about strategies to decrease the discomfort, which of the following client statements would alert the nurse to the need for additional instruction?"
CHOICES
( X ) a.) "I'll avoid straining to have a bowel movement."
( X ) b.) "I'll be sure to change positions frequently during the day."
( O ) c.) "I'll stop using my prescribed iron supplements."
( X ) d.) "I'll use warm sitz baths frequently during the day."
RATIONALE: The client needs further instruction when she says that discontinuing iron supplements will alleviate hemorrhoids. Although iron does cause constipation that could lead to straining, iron supplementation during pregnancy is important and should not be discontinued unless the physician tells the client to do so. The client should avoid straining, which increases pressure and subsequently increases engorgement of the hemorrhoids. Changing positions frequently during the day and avoiding prolonged standing and sitting positions minimizes pressure on the rectal veins, thus helping to minimizing discomfort. Warm sitz baths are helpful in providing soothing relief from the discomfort of hemorrhoids. NURSING PROCESS STEP: Evaluation CLIENT NEEDS CATEGORY: Health promotion and maintenance CLIENT NEEDS SUBCATEGORY: None
