The nurse provides education and supportive assistance for the family of a preschool-age client diagnosed with encopresis. Which statement would indicate parental understanding of appropriate care?
Select all that apply.
A) "We will establish a limited schedule of activities that has many breaks to provide opportunities to use the toilet regularly."
B) "We will schedule an appointment with a play therapist to help our older child adjust to our new baby."
C) "We won't change our child's diet because we were afraid it will be stress provoking."
D) "We will work on regular elimination after morning and evening meals."
E) "We will continue to punish our child for having accidents as the behavior is learned and attention seeking."
Answer: A, B, D
The underlying constipation that leads to encopresis may be caused by the stress of a full schedule of activities or other environmental changes (e.g., birth of a sibling). Dietary changes including incorporating high-fiber foods and limiting refined and highly processed foods and dairy products may be helpful. It takes several months for the bowel to be retrained to respond to sphincter stimulation. It is inappropriate to punish the child for having the accidents because they cannot be helped due to the underlying constipation.
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