The nurse has an order for 325 mg acetaminophen p.r. q4h prn for pain

The nurse has an order for 325 mg acetaminophen p.r. q4h prn for pain for a 7-year-old client who has had surgery. In preparing the client for insertion of the suppository, the client states that she feels the need to have a bowel movement.

The nurse’s best response is to:
1. Insert the suppository, knowing that it will dissolve quickly
2. Allow the client to defecate first to clear the rectum of stool
3. Explain to the client that it is normal to feel the urge to defecate when a supposi-tory is inserted into the rectum, but the urge will pass
4. Hold the medication and contact the physician for a p.o. order

ANSWER

ANS: 2
By allowing the client to defecate before the suppository being inserted, the nurse knows that absorption will be facilitated. Placing the suppository into a mass of fecal material will not allow it to be absorbed by the rectal mucosa. The suppository may be expelled before it has a chance to be absorbed if the client has the urge to defecate before the suppository is inserted. There is no indication that the client cannot tolerate the suppository.