The nurse is caring for a patient who has not had a bowel movement for 2 days. Which is the priority nursing intervention for this patient?
a. Obtain an order to administer a soap suds cleansing enema.
b. Teach the patient how to use the Valsalva maneuver.
c. Discontinue medications that can cause constipation.
d. Assess the patient's usual pattern of bowel movements.
ANS: D
The nurse should assess the patient's usual pattern of bowel movements to determine if it is normal for the patient to have a bowel movement every 2 to 3 days. Elderly patients should be taught not to use the Valsalva maneuver because it can lead to bradycardia or death.
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