An older adult who recently had surgery complains of pain at the level of 3 out of 10 and constipation during the postoperative primary care visit. Which intervention should the nurse implement to first facilitate elimination?
a. Encourage the use of a laxative. c. Promote fiber in the diet.
b. Review the medica-tion list. d. Suggest added fluid intake.
B
The nurse begins by reviewing the medication list to find substances that are likely to cause con-stipation such as opioid analgesics and antidepressants, among others. If the patient is taking an opioid analgesic and because the patient rates the pain as 3 out of 10, then a change in pain me-dication can help relieve constipation. The use of a laxative can be contraindicated and is the therapy of last resort for constipation caused by factors other than opioid analgesics. Promoting fiber in the diet is a reasonable intervention but can be made unnecessary by omitting the opioid analgesic. Increasing fluid intake is a reasonable nursing intervention for older adults with and without constipation, but it can be unnecessary for this older adult.
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