The nurse is caring for a 19-year-old male client with a fractured lef

The nurse is caring for a 19-year-old male client with a fractured left femur whose leg was pinned 36 hours ago and is now in traction. Which of the following stressors is mostly likely the cause of this client’s difficulty related to constipation?

1. Pain related to the fracture and its repair
2. Anxiety regarding the serious nature of the injury
3. The need to defecate in an unfamiliar, awkward position
4. Poor fluid intake after the accident and ensuing surgery

ANSWER

ANS: 3
For the client immobilized in bed, defecation is often difficult. In a supine position it is impossi-ble to contract the muscles used during defecation. If the client’s condition permits, raise the head of the bed; this assists the client to a more normal sitting position on a bedpan, enhancing the ability to defecate. Although the other options may have some effect, the primary cause is most likely the emotional stress of not being able to assume the usual position for defecation.