The nurse performs digital removal of feces for a patient. Which patient diagnosis cues the nurse to assess the patient more frequently than usual during the procedure?

Question

a. Abdominal pain
b. Atrial fibrillation
c. Urinary infection
d. Diabetes mellitus

Answer 1

B
The nurse assesses the patient who has atrial fibrillation more frequently during digital removal of a fecal impaction because the patient has a serious cardiac arrhythmia. Al-though most patients with atrial fibrillation have ventricular response rates greater than 100 beats/min, most also have heart disease. The nurse scrutinizes the patient keenly during the procedure, taking frequent blood pressure and heart rate measurements, because impaction removal can cause a vasovagal response and slow the heart rate. The patient with heart disease is more likely to be unable to compensate for the changing heart rate. The fecal impaction is a likely cause of the abdominal pain; however, a patient with abdominal pain is assessed thoroughly before the procedure is per-formed to ensure that the patient's condition is suitable for impaction removal. Urinary infection should not contraindicate impaction removal or cause difficulty during the procedure. The patient with diabetes mellitus is assessed before the procedure to avoid a glycemic crisis during removal of the impaction.