14.5/15 good job see comments

Case Study 15.4
Simone Walker
Lakeview College of Nursing
Nursing of the Gerontological Client
February 11, 2012

Case Study 15.4
1. How is constipation defined?
    The definition of constipation is a condition in which bowel movements are infrequent or incomplete (Stedman, 2012).
2. What is the most probable cause of George’s constipation?  
	a. a normal process of aging
	b. BPH
	c. dehydration and cognitive impairment
	d. access to health care services
    The answer is C.
3. What are additional causes of constipation?
    The other causes of constipation are a lack of fiber intake, low levels of physical activity or limited exercise and mobility, lack of fluid intake, poor oral health problems, changes in appetite, and limited ingestion of fresh fruits and vegetables (Mauk, 2010).
4. List examples of medication classes known to cause constipation.
    The medication classes that are known to cause constipation are antacids, anticholinergics, antidiarrheals, cholinergic blockers and opioid analgesics (Skidmore-Roth, 2012).
5. What are complications of chronic constipation?
    The complications of chronic constipation are fecal impaction, incontinence, delirium, leading to severe curtailment in ADLs and in some cases hospitalization (Mauk, 2010).

6. What are treatments for constipation?
    Some treatments for constipation are laxatives, enemas, stool softeners, bulk fiber (Metamucil), suppositories, and oil retention enemas or chemical irritants, like castor oil, milk of magnesia (Gulanick & Myers, 2003).
 Treatments for constipation can be dietary approaches, behavioral changes, medication
reviews for causative factors, and enemas and/or laxatives

7. What types of nonmedicinal recommendations can the nurse encourage for this patient?
    The types of nonmedicinal recommendations to treat constipation is adequate fluid intake, regular meals, a balanced diet that has adequate fiber like fresh fruits and vegetables and grains, regular exercise or activity, and consume prunes or prune juice (Gulanick & Myers, 2003).
8. What nursing recommendations should Geneva, RN, make to the family for the management
    of George’s constipation with MOM? 
    The recommendations the nurse should give to the family is:
•	Notify health care professional if constipation, rectal bleeding, or symptoms of electrolyte imbalance occur. 
•	Shake the suspension well.
•	Do not take this medication within 2 hours of taking other medications (Skidmore-Roth, 2012).
 Recommendations for further management of George’s constipation with MOM should include the following:
• take the medication with 8 oz of water • establish a clear plan for fluid and dietary intake • make sure his MOM is taken at the same time every other day, results usually occur within 3–6 hours, so stools can be predictable after initial dosing • make sure this medication is not taken within 2 hours of other medications unless recommended by his nurse practitioner, because it can interfere with absorption of other medications

References
Gulanick, M., & Myers, J. L. (2003). Nursing care plans: Nursing diagnosis and intervention 
	(5th ed.). Philadelphia, PA: Mosby.
Mauk, K. L. (2010). Gerontological nursing: Competencies for care (2nd ed.). Sudbury, MA:
	Jones & Bartlett.
Sidmore-Roth, L. S. (2012). Mosby’s 2012 nursing drug reference (25th ed.). St. Louis, MO: 	Elsevier. 
Stedman, T.  (2012). Stedman’s medical dictionary for the health professions and nursing (7th 	ed.). Philadelphia, PA: Lippincott Williams and Wilkins.