QUESTION: "During a visit to the clinic, a pregnant 25-year-old who began prenatal care at 10 weeks' gestation and is now in her third trimester reports frequent constipation. Which of the following suggestions by the nurse would be most helpful initially?"
CHOICES
( X ) a.) Using glycerin suppositories as needed.
( O ) b.) Eating at least four pieces of fruit daily.
( X ) c.) Avoiding highly seasoned foods.
( X ) d.) Using milk of magnesia, as needed.
RATIONALE: Dietary measures such as increasing dietary intake of bulk and roughage (for example, eating at least four pieces of fruit each day) help to relieve constipation and should be suggested initially. Other nonpharmacologic measures include drinking a glass of hot fluid in the morning, increasing fluid intake, and exercising regularly. It is best not to suggest laxatives or suppositories because a client may become dependent on them. Additionally, the client should avoid taking any medication unless directed to do so by the physician. If the constipation is unrelieved by other nonpharmacologic measures, the physician may order glycerin suppositories. Avoiding highly seasoned foods would have no effect on constipation. However, if the client was experiencing heartburn, this might be an appropriate suggestion. Laxatives, even mild over-the-counter ones such as milk of magnesia, should be used only when diet, fluid intake, and exercise do not relieve the problem and after consultation with the nurse or physician. NURSING PROCESS STEP: Implementation CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Basic care and comfort
