Question

the nurse provides care for an older adult client with a diagnosis of constipation. the nurse understands which factor contributes to the d older adult? (select all that apply.) 1. decreased fluid and fiber intake. 2. slowed peristalsis and decreased muscle tone. 3. decreased use of prescription medication. 4. delayed response to the urge to defecate. 5. decreased physical activity.

Explanation:

• Option 1: Adequate fluid and fiber intake are essential for maintaining normal bowel function. Decreased intake can lead to hard, dry stools, which are difficult to pass, contributing to constipation.
• Option 2: In older adults, the digestive system undergoes physiological changes. Slowed peristalsis (the wave - like muscle contractions that move food through the digestive tract) and decreased muscle tone in the intestines can result in slower movement of feces through the colon, increasing the likelihood of constipation.
• Option 3: Many prescription medications (such as opioids, anticholinergics) can cause constipation as a side effect. Decreased use of prescription medication would not contribute to constipation. In fact, some medications are a known cause of constipation in the elderly.
• Option 4: When the urge to defecate is repeatedly ignored or delayed (a common behavior in some older adults due to various reasons like not wanting to use a public restroom), the rectum can become less sensitive to the stretching (which is the signal for defecation). This can lead to feces remaining in the colon for a longer time, losing more water and becoming harder, causing constipation.
• Option 5: Physical activity helps to stimulate peristalsis. Decreased physical activity in older adults can slow down the digestive process. With less movement, the muscles of the intestines may not contract as effectively, leading to constipation.

Answer:

1. Decreased fluid and fiber intake.
2. Slowed peristalsis and decreased muscle tone.
3. Delayed response to the urge to defecate.
4. Decreased physical activity.