Think back to meeting Justin Jones from Module 5. He was admitted after a motorcycle accident. He had surgery for fracture reduction on his legs and now has casts on both legs and one arm. For the past three days, he has been receiving narcotic analgesics for severe pain.
Today, he has a new priority problem: constipation. The nurse enters the diagnosis into an electronic care plan. In addition to a list of suggested assessments, the computer database generates the following list of suggested interventions:
- Institute a program to establish a regular pattern of bowel movements
- Administer laxative or stool softener, as prescribed
- Administer enema
- Remove stool manually
- Encourage increased fluid intake, including warm liquids; instruct on and encourage a high-fiber diet
- Encourage a regular program of activity and exercise
- Perform manual reduction of rectal prolapse
Instructions
Write 200250 words using the discussion prompts to guide the content for your initial post. Then, respond to at least two of your peers posts.
Discussion Prompts
- As a nurse, which interventions would you choose and why?
- Identify one resource to support your answer. Be sure to cite your resource using APA (7th ed.) format.
Reply to peers—–
My response:
The constipation experienced by Justin Jones is most probably connected with opioid consumption, lack of mobility, and decreased post-operative fluid consumption. As a nurse, I would first opt to use noninvasive interventions and then subsequently proceed to more aggressive interventions. Some of my priority interventions would involve the promotion of increased fluid intake, high-fiber diet as tolerated, and the establishment of a regular bowel routine. These strategies promote normal bowel movements and they also prevent additional complications without causing unnecessary discomfort.
Since Justin is taking narcotic analgesics, I would also prescribe a stool softener or stool laxative as a second drug, because opioids greatly decelerate gastrointestinal motility (Horrigan et al., 2023). his intervention is a direct response to the cause of his constipation and is regarded as a common preventive treatment of opioid-induced constipation. Moreover, I would encourage activities and exercises within his restrictions, including repositioning in bed and upper-body range-of-motion activities, as immobility exacerbates constipation.
More invasive interventions like the use of enemas or manual stool removal would be used as the last-line therapies in case of failure of the conservative treatment, since they may be uncomfortable and can cause harm particularly in older adults. In general, my practice is aimed at prevention, comfort, and solving the root causes of constipation as well as preserving patient dignity and safety.
References
Horrigan, J., Bhumi, S., Miller, D., Jafri, M., & Tadros, M. (2023). Management of Opioid-induced Constipation in Older Adults. Journal of Clinical Gastroenterology, 57(1), 39-47.
peer#1:As a nurse, I would prioritize diet and lifestyle interventions first. Encouraging Justin to increase his fluid intake, eat high-fiber foods as tolerated, and establish a regular bowel routine aligns with the first-line recommendations outlined by the Mayo Clinic. Implementing mobility activities within his abilities, such as assisted repositioning and physical therapy exercises, also supports bowel motility. These interventions target the underlying causes of constipation without immediately resorting to invasive procedures. In addition to lifestyle changes, administering prescribed stool softeners or mild laxatives would be appropriate to help soften stool and promote bowel movements. More invasive measures like enemas or manual stool removal should be reserved for when less invasive approaches have failed or if fecal impaction develops, due to the discomfort and risks associated with these methods. According to Mayo Clinic, constipation typically occurs when stool moves too slowly through the large intestine, leading to infrequent, hard, or difficult bowel movements. Lifestyle factors such as inadequate fluid intake, low dietary fiber, and lack of physical activity are major contributors to slow stool movement and constipation symptoms. Opioid pain relievers which Justin has been receiving for three days are also specifically mentioned as a medication-related cause of constipation because they slow gastrointestinal transit.
Resources:
Mayo Clinic Staff. (2025, April 15). Constipation: Symptoms & causes. Mayo Clinic.
Peer#2:Constipation is a common side effect of surgery due to the anesthesia administered and pain medication. The nursing interventions that I would choose for Mr. Jones are.
Institute a program to establish a regular pattern of bowel movements. It is essential to educate Mr. Jones to schedule a time each day to sit on the toilet for about 15 minutes to attempt to have a bowel movement. It is crucial to. Be patient and consistent with this exercise, as it can take a few days to establish a pattern. This and increasing fluids and high fiber duet should be our first intervention, and if it is not helping, we could incorporate laxative administration.
Administer laxative or stool softener, as prescribed. These require patience as they usually take from 1 to 3 days to work in the system. This will help stimulate bowel movements. These can be taken with the pain medication.
Encourage increased fluid intake, including warm liquids; instruct on and encourage a high fiber diet. Increasing your fiber intake helps in creating bowel movements. These foods include whole grains, fruits, and vegetables. Secondly, fluids will allow your stools to soften. Additionally, warm liquids will help in creating bowel movements, thought they will be watery.
References
Bowel Retraining Program. (n.d.).
Relieving Constipation After Surgery. (2025, August 18). Franciscan Health; Franciscan Health Alliance.
Requirements: 150 words minimum for each