Question

You are the nurse taking care of Mr. Case, a 75-year-old patient newly diagnosed with colon cancer. Mr. Case’s pain has been severe, and has been taking narcotics for pain management. He feels weak and tired, has no energy or appetite, and is unable to keep his weight up. Mr. Case has had great difficulty moving his bowels; when he does, it is very painful. He is oozing a small amount of stool from his rectum.

Mr. Case is admitted to the hospital for fecal impaction. He tells you, “Nobody told me I would get constipated. It’s been almost a week and it hurts so bad. In the future, I am going to just deal with the pain rather than take the pain meds.”

Identify three factors affecting Mr. Case’s bowel elimination.

Identify three strategies you can recommend to Mr. Case to treat his constipation and prevent it from occurring again.

Answer 1

Answer: When we eat food, it breaks down in stomach then passes through intestines and this process is known as digestion, but sometimes the waste material gets accumulated in colon, giving rise to fecal impaction.

For the pain management in the colon cancer narcotics sometimes is helpful to decrease the intensity of the pain, but it also cause constipation if taken in large amount or most frequently. The reasons of the Mr. Case's bowel elimination difficulty are:

• Age of the Mr. Case
• Poor diet i.e. low weight
• Taking the narcotics
• Less fluid intake

The constipation can be treated through by giving an oral laxative as this can help stimulate clearing of the colon. The other option could be the medicated suppository, which is a medication that’s placed into the rectum. The other method can be indulged as manual method of clearing the faeces when these laxatives are not effective. There could be an introduction of enema which is a small, fluid-filled bottle with a nozzle attached. The nozzle inserts into the rectum.

Constipation can be prevented from reoccurring as by eating foods that are high in fiber, such as whole wheat, pears, oats, and vegetables and Reduction intake of foods that are high in sugar, which can cause constipation along with drinking more water.