Question

Mr. Jones is now three days postoperative. His pain is being managed with scheduled doses of ibuprofen (800 mg every 8 hours by mouth) and prn doses of acetaminophen with hydrocodone. Mr. Jones has not had a bowel movement since surgery. Which nursing action is appropriate based on the current data?

A. Notify the healthcare provider immediately.
B. Administer the prn dose of docusate sodium.
C. Assist the patient in a guided imagery exercise.
D. Place the patient on a bedpan and provide privacy.

Answer 1

The appropriate nursing action for Mr. Jones, who has not had a bowel movement postoperatively and is on ibuprofen and hydrocodone, is to administer the prn dose of docusate sodium (option B) to alleviate potential opioid-induced constipation.

Step-by-step explanation:

Considering Mr. Jones has not had a bowel movement for three days postoperative and is being managed on ibuprofen (an NSAID) and acetaminophen with hydrocodone (a combination of an analgesic and narcotic), the appropriate nursing action would be B. Administer the prn dose of docusate sodium. The use of opioids like hydrocodone can lead to constipation due to their slowing effect on bowel motility. Docusate sodium is a stool softener that would be prescribed on a prn (as needed) basis to alleviate constipation, a common postoperative issue, especially in patients taking opioids for pain management.

There is no immediate need to notify the healthcare provider unless the patient presents with additional symptoms or complications that would signify a more serious condition, such as abdominal distension, vomiting, or absence of bowel sounds. Assisting the patient with guided imagery exercises may help with overall comfort but won't address the issue of constipation, and placing the patient on a bedpan with privacy assumes they are ready to defecate, which might not be the case if they haven't had a bowel movement due to opioid-induced constipation.