Which of the following clients is at greatest risk for serious complications when using the Valsalva maneuver to expel feces?
1. 25-year-old pregnant client
2. 66-year-old male with hypertrophied prostate disease
3. 44-year-old male client with glaucoma
4. 53-year-old female with stomach cancer
ANS: 3
Clients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk, such as cardiac irregularities and elevated blood pressure, with this maneuver and need to avoid straining to pass the stool. Although the Valsalva maneuver may contribute to hemorrhoids, this is not as serious as increasing the intraocular pressure of a client with glaucoma. The Valsalva maneuver is not contraindicated in a client with hypertrophied prostate disease or in a client with stomach cancer.
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