Question

The nurse is assisting in the care of a patient who is 2 days postoperative from a hemorroidectomy. The nurse would be correct in instructing the patient to: A. Avoid a high-fiber diet because this can hasten the healing time B. Continue to use ice packs until discharge and then when at home C. Take \(200 \mathrm{mg}\) of Colace bid to prevent constipation D. Use a sitz bath after each bowel movement to promote cleanliness and comfort

Short answer

a. Avoid a high-fiber diet b. Continue using ice packs until discharge and at home c. Take 200 mg of Colace bid d. Use a sitz bath after each bowel movement Answer: c. Take 200 mg of Colace bid

Step-by-step solution

Identify the goal of postoperative care for a hemorroidectomy patient

In order to choose the correct instruction, it is crucial to understand the key goals of postoperative care for a patient who has had a hemorroidectomy. The primary goals are to prevent infection, promote healing, and manage pain.

Evaluate option A

A high-fiber diet is typically recommended for patients recovering from a hemorroidectomy because it can prevent constipation and strain on the surgical area. Therefore, option A is incorrect, as it advocates avoiding a high-fiber diet.

Evaluate option B

Ice packs can help to reduce inflammation and pain in the initial postoperative period. However, their use should be limited to the first 24-48 hours after surgery. Therefore, option B is incorrect, as it suggests to continue using ice packs until discharge and at home.

Evaluate option C

Colace is a stool softener that works by drawing water into the stool, making it easier to pass. Taking 200 mg of Colace bid (twice daily) can help to prevent constipation and reduce strain on the surgical area. This aligns with the goal of postoperative care for a hemorroidectomy patient. Option C is correct.

Evaluate option D

Using a sitz bath after each bowel movement can help to promote cleanliness and comfort. However, it is not the most effective measure for preventing constipation and promoting healing. While using a sitz bath is beneficial, it is not the best choice among the given options. Option D is incorrect.

Conclusion

Based on the analysis of each option, the nurse would be correct in instructing the patient to take \(200 \mathrm{mg}\) of Colace bid (option C) to prevent constipation and promote proper postoperative care after a hemorroidectomy.

Key concepts

NCLEX-PN Exam Preparation

Preparing for the NCLEX-PN exam requires a meticulous study plan and a deep understanding of nursing concepts. A crucial topic within the exam is the management and care of patients post-surgery, such as those recovering from a hemorrhoidectomy.

To effectively prepare, students should focus on the principles of postoperative nursing care, including pain management, infection control, and promotion of healing. Understanding medications like stool softeners (e.g., Colace) and their role in postoperative care is also vital. Integrating practice questions on postoperative care into your study regime can enhance your readiness to answer similar questions on the exam.

Patient Recovery Guidelines

Post-hemorrhoidectomy care is pivotal for a patient's recovery. Key guidelines include the prevention of constipation and straining during defecation, which can disrupt the surgical site and impair healing. Nurses should instruct patients to:

• Eat a high-fiber diet to ensure soft stools
• Hydrate adequately
• Avoid prolonged sitting and engage in light activity to stimulate bowel movements
• Use pain management techniques, like ice packs, within the first 48 hours post-surgery
• Take prescribed stool softeners like Colace to ease bowel movements without straining

Providing these guidelines emphasizes the importance of postoperative care in reducing complications and ensuring a smooth recovery.

Post-Surgical Constipation Prevention

Constipation can be a significant problem after a hemorrhoidectomy due to pain and the use of narcotic pain medications. To prevent this:

• Advise patients to consume a diet rich in fiber from fruits, vegetables, and whole grains.
• Encourage the intake of fluids to help facilitate stool passage.
• Recommend regular use of stool softeners as prescribed to maintain stool softness.
• Stress the importance of mobility, as limited movement post-surgery can contribute to constipation.

These interventions play an essential role in reducing the risk of constipation and thus minimizing discomfort and complications during the recovery period.