Medical Surgical Constipation #2

Question

Which client is at most risk for constipation?

Answers

  1. A gravida 2, para 1 near 12-weeks gestation taking iron supplements
    • Rationale:

      This answer is not correct because the client has one factor that contributes to constipation; taking iron supplements. Constipation usually does not occur until the second trimester.

  2. A post-op ORIF of the femur client taking opioid pain relief
    • Rationale:

      This answer is correct because this client has multiple risks associated with constipation. Limited mobility and opioid use. Limited mobility decreases peristalsis and opioids inhibit gastric emptying, thus causing constipation.

  3. A 55-year-old client taking oxybutynin for urinary incontinence
    • Rationale:

      This answer is not correct because although oxybutynin does cause constipation, it is not the best answer listed. Oxybutynin blocks acetylcholine, which helps the muscles move, thus slowing down peristalsis.

  4. A client with an ileostomy with a pouch full of liquid stool
    • Rationale:

      This answer is not correct because the client with an ileostomy has a bowel diversion and will not have constipation. An ileostomy is where the small intestine is diverted through an opening in the abdomen. Stool from an ileostomy is liquid since water is not being absorbed into the body.

Overview

Constipation is infrequent bowel movements with hard to pass stool. Stool is usually hard and dry. Risk factors include medication use, inactivity, inadequate fluid intake, low fiber diet, and neurogenic disorders.

Explanation

Learning Outcomes

Constipation is infrequent bowel movements with hard to pass stool. Stool is usually hard and dry. Inadequate fluid intake will cause the stool to become dry and hard and difficult to pass. Encouraging daily fluid intake to 2-3 L daily is recommended unless contraindicated medically. A client with limited mobility is at risk for constipation since activity promotes movement of the bowels to help defecate. Certain medications cause constipation: opioids, anticholinergics, and iron supplements are just a few. These drugs slow peristalsis.

Test Taking Tip

Know the risk factors of constipation and understand which types of medications cause constipation and why. NSAIDs, antihistamines, tricyclic antidepressants, iron supplements, urinary incontinence meds, opioids, calcium channel blockers, beta blockers, and nausea medications cause constipation.

Video Rationale