A client asks the RN why it is more difficult to use a bedpan for defecating than sitting on the toilet. Which of the following is the best response?
1. The sitting position decreases the contractions of the muscles of the pelvic floor.
2. The sitting position increases the downward pressure on the rectum, making it easier to pass stool.
3. The sitting position increases the pressure within the abdomen.
4. The sitting position inhibits the urge to urinate, allowing one to defecate.
Correct Answer: 2
Rationale 1: Expulsion of the feces is assisted by contraction of the abdominal muscles and the diaphragm, which increases abdominal pressure, and by contraction of the muscles of the pelvic floor, which moves the feces through the anal canal.
Rationale 2: Normal defecation is facilitated by thigh flexion, which increases the pressure within the abdomen, and a sitting position, which increases the downward pressure on the rectum.
Rationale 3: Thigh flexion increases the pressure within the abdomen.
Rationale 4: The sitting position increases the downward pressure on the rectum.
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