Case Study: Constipation You are the nurse in the student health...

Case Study: Constipation

You are the nurse in the student health center on the university campus. Sasha

Wilkins, a freshman student, comes into the center 2 weeks into her first

semester complaining of abdominal pain and states "I don't feel good—there is

something wrong with my stomach."

1.Construct a broad opening statement that would encourage more information

regarding her complaint.

2.Sasha tells the nurse, "My stomach is so bloated—I can't even button my jeans." What further questions should you ask Sasha to focus on bowel

functioning?

3.You need to do a focused physical assessment for bowel elimination. Explain to Sasha. How you will proceed. Defer the palpation of the anus and rectum at this time.

The physical assessment reveals that Sasha has a hard, distended abdomen with hypoactive bowel sounds. Percussion and palpation reveal a hard, distended descending colon in the left lower quadrant. She is extremely embarrassed and tells

you, "I haven't gone to the bathroom in 9 days. I have tried but I just can't go. I hate

living in the dorm and sharing a bathroom—I've never had to do that before."

4.A rectal exam reveals that Sasha has a fecal impaction. The primary care provider orders a 90 mL oil-retention enema for Sasha. Discuss the procedure

with Sasha to allay her anxiety and concerns.

5.After an hour, Sasha reports that the enema was not successful. The primary care provider orders digital removal of the stool. How will you implement this

treatment while minimizing Sasha's embarrassment and discomfort?

6.Upon discharge from the center, Sasha needs teaching on how to promote regular defecation. Discuss the key points that need to be taught to Sasha to

ensure a healthy bowel routine

Include - procedural steps to enema that you choose