Chapter 30 Promoting Bowel Elimination 273 Wurse: \"Tell me about your usual die

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Chapter 30 Promoting Bowel Elimination 273 Wurse: "Tell me about your usual diet and fuid intake. Do you eat enough tber?" Ms. D: "I have cereal and fruit juice for breakfast during the week. For lunch I eat yogurt, an apple, and some crackers. I have a couple of low-fat, fruit-6illed cookies for dessert. For dinner we eat salad every night as well as some fresh fruit as an appetizer. I fix a casserole with pasta or we have chicken or stir fry. We eat a piece of meat on the weekends. Once in a while we will have a grilled pork chop during the week. We have bread with dinner. Our portions are very moderate. I have a piece of hard candy for dessert later in the evening and light ice cream or frozen yogurt once or twice a week. I drink decaf for breakfast and mid-morning, lots of water during the day and a diet coke mid-afternoon. We eat some peanuts or and I drink tonic with lime-once in a while with a capful of gin in it. I have wine with dinner about three times a week. No more than one or two glasses though." at cocktail time Nurse: Ms. D.: "Oh, I use raw vegetables in the salad every night. My husband doesn't like cooked vegetables "It seems like you are eating pretty well. You could use more vegetables though." other than potatoes very much. We do eat potato several times a week and I eat the skin." Nurse: "That sounds pretty good. What about your bowel movements?" Ms. D "I have small, harder stools, sometimes three or four a day, sometimes every other day. The pattern isn't consistent." Nurse: "Do you ever have alternating constipation and diarrhea? Ms. D "Not really. I'll have a loose stool sometimes if I eat really spicy food or drink a lot of wine. Nurse:"What about pencil-thin stool?" Ms. D.: "Occasionally after a severe episode of bloating. I will have soft, pencil-like stool. It quickly returns to normal." "Have you ever noticed blood in your stool? "No, I have only ever had blood if I had a hemorrhoid flare-up. I developed one hemorrhoid during the last week of pregnancy Ms. D.: Nurse: "What about abdominal cramping?" Ms. D: "I do have intermittent cramping, especially in the middle of the night. It is diffuse but seems Nurse: "About how often does this happen?" Ms. D.: "It varies; it may occur several nights in one week and then not again for two or three weeks." to start somewhere around my belly button." "OK, Ms. Dumas. The doctor will examine you and then will probably order some tests. We can probably find some medication that can help you with this problem." Nurse 2B. Using the example above, write a dialogue evaluating an older patient who lives alone and has been ex- periencing constipation. Make dietary recommendations. Copyright O 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Explanation / Answer

Dialogue of older patient:

Diet recommention for constipation:

Home remedies:

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