Question

Mrs. Sally Shark is a 90-year-old resident in a long-term care facility. Mrs. Shark has a history of severe osteoarthritis, and has no teeth but is otherwise fairly healthy. She normally has a bowel movement every other day but has occasional constipation, which she takes care of herself by requesting a dose of Milk of Magnesia. Today when the nurse brings Mrs. Shark’s medications to her, she says, “I think I need a second dose of that Milk of Magnesia. My bowels haven’t moved in 3 days.” The nurse looks at the medication administration record and finds as needed (prn) orders for Milk of Magnesia (magnesium hydroxide mixture), psyllium (Metamucil), senna (Senokot), or a tap water enema.

1. What should the nurse do before administering more medication?

2. What factors most likely led to Mrs. Shark’s constipation?

3. What will happen if Mrs. Shark’s bowels do not move today?

4. What nondrug interventions will help Mrs. Sharks move her bowels?

5. After Mrs. Shark’s bowels have moved, what measures can be instituted to prevent

    constipation next time?

Answer 1

The goals of treatment of osteoarthritis is to relieve pain and promote joint function. Opiates relieve pain by inhibiting pain receptors in the brain but also block muscle cells in the digestive tract and can cause constipation.

After giving milk of magnesia wait for few hours before giving other medications.Frequent usage of laxatives will create dependence its better to avoid it.

The non drug interventions are

• Add fibre supplements in diet
• Diet with more fibre content grains, fruits and vegetables.
• Drink plenty of water
• Regular exercises helps to be more active.
• These measures helps in bowel movements next time.

Constipation happens when colon absorbs more water and hardens stool. If its left untreated it may cause complications like hemorrhoids or rectal prolapse.