Question

A client comes to the clinic today to get an Rx refill for her birth control patches. While talking to the nurse practitioner, she comments that she has a rather embarrassing problem she would like to discuss. On further questioning, she tells you that she has difficulty expelling bowel movements because they are so large and hard, and she is only able to go about every 4-5 days. On questioning, you learn that her diet is erratic: meals from a fast food restaurant eaten on the run. She walks 3 miles a day each way to school 5 times a week. She intentionally restricts fluids during the day because of her tight schedule, which prevents regular toilet breaks. For the last two weeks, the only way she has been able to have a BM is after taking Ex-lax. When she does have a bowel movement, it is hard, dry, requires straining, and is coated with a film of bright red blood. She often experiences rectum soreness after one of these bowel movements. Your physical exam reveals a well nourished, trim young woman in apparent good health. BP is 118/75; P 82; R 18l and T 98.6 When you palpate the abdomen, a large mass is felt in the lower quadrant of the abdomen.

Nursing Diagnosis?

Answer 1