Medical Surgical Constipation #3

Question

The nurse is caring for a 5-year-old with encopresis. Which assessment findings would the nurse expect?

Answers

  1. Social withdrawal from friends and family
    • Rationale:

      This answer is correct because encopresis causes shame and guilt in children. This may be due to soiling their clothing or the fecal odor. This can result in social withdrawal from friends and family out of embarrassment.

  2. Passage of frequent small, hard stools
    • Rationale:

      This answer is not correct because encopresis causes large stools (not small and frequent) that clog up the toilet due to the increased time between bowel movements. The constipation causes bowel movements to become less frequent.

  3. Hyperactive bowel sounds
    • Rationale:

      This answer is not correct because hypoactive bowel sounds will be heard due to the slow or no motility. Encopresis is usually caused by constipation.

  4. Spending a long time on the toilet.
    • Rationale:

      This answer is not correct because encopresis is associated with ignoring the urge to defecate, which results in chronic constipation. Changing the retention habit by having the child sit on the toilet after meals is a positive intervention.

Overview

Encopresis, also known as fecal incontinence, is the involuntary passage of stool usually due to constipation. Build up of stool inside the colon from constipation results in soiling or leakage of stool past the age of 4.

Explanation

Learning Outcomes

Encopresis, also known as fecal incontinence, is the involuntary passage of stool usually due to constipation. Build up of stool inside the colon from constipation results in soiling or leakage of stool. This makes it more difficult for the anal sphincter to hold it inside. As a result, softer stool leaks out and around the retained fecal matter, soiling the underwear. Encopresis may be the result of a neurological disorder, but usually the cause is a result of fecal impaction. Interventions include dietary changes, stool softeners or laxatives, and encouraging the child to sit on the toilet after meals to overcome withholding.

Test Taking Tip

Encopresis is usually the result of constipation; therefore, expect assessment findings of constipation.

Video Rationale