Health Promotion and Maintenance Q 109
An older patient asks a nurse to recommend strategies to prevent constipation. Which of the following suggestions would be helpful? Note: More than one answer may be correct. Select all that apply.
A. Get moderate exercise for at least 30 minutes each day.
B. Drink 6-8 glasses of water each day.
C. Eat a diet high in fiber.
D. Take a mild laxative if you don't have a bowel movement every day.
E. Eat a protein-rich diet.
Correct Answers: A, B, & C
A daily bowel movement is not necessary if the patient is comfortable and the bowels move regularly. Moderate exercise, such as walking, encourages bowel health, as does generous water intake. A diet high in fiber is also helpful. Check on the usual pattern of elimination, including frequency and consistency of stool. It is very crucial to carefully know what is “normal” for each patient. The normal frequency of stool passage ranges from twice daily to once every third or fourth day. Dry and hard feces are common characteristics of constipation.
Option A: Urge patient for some physical activity and exercise. Consider isometric abdominal and glute exercises. Movement promotes peristalsis. Abdominal exercises strengthen abdominal muscles that facilitate defecation.
Option B: Encourage the patient to take in fluid 2000 to 3000 mL/day, if not contraindicated medically. Sufficient fluid is needed to keep the fecal mass soft. But take note of some patients or older patients having cardiovascular limitations requiring less fluid intake.
Option C: Assist the patient to take at least 20 g of dietary fiber (e.g. raw fruits, fresh vegetable, whole grains) per day. Fiber adds bulk to the stool and makes defecation easier because it passes through the intestine essentially unchanged.
Option D: Laxatives should be used as a last resort and should not be taken regularly. Over time, laxatives can desensitize the bowel and worsen constipation. The use of laxatives or enemas is indicated for short-term management of constipation.
Option E: Protein-rich foods could cause constipation. A balanced diet that comprises adequate fiber, fresh fruits, vegetables, and grains. Twenty grams of fiber per day is suggested. A regular period for elimination and an adequate time for defection. Successful bowel training relies on routine. Facilitating regular time prevents the bowel from emptying sporadically.