A client with heart failure informs the nurse he has not had a bowel movement in 2 days. Why would it be important for the nurse to obtain an order for a stool softener?
A) Straining causes the Valsalva maneuver, which can cause dangerous effects.
B) The client should not develop hemorrhoids.
C) The client can develop a rectal fissure, which will increase pain levels.
D) The client should have a bowel movement every day to avoid development of an intestinal obstruction.
A
Feedback:
Avoid activities that engage the Valsalva maneuver, such as straining with bowel elimination or using the arms to pull and reposition oneself. The Valsalva maneuver increases intrathoracic pressure, reduces right atrial filling, triggers tachycardia, and increases blood pressure. The client's discomfort would be increased if hemorrhoids or a rectal fissure developed but would not engage the Valsalva maneuver. It is not necessary for the client to have a bowel movement on a daily basis.
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