Question

Harry, an 8-month old infant, is seen by the pediatric nurse practitioner for his well-child visit. Harry’s mother states that he usually has one hard stool every 4 or 5 days, which causes discomfort when the stool is passed. He has also had one episode of diarrhea and two episodes of ribbon-like stools. Abdominal distention and vomiting have not accompanied the constipations, and Harry’s growth has been normal. Currently, his diet consists of cow’s milk-based formula only. Harry’s mother reports that the infrequent passage of hard stool began approximately 6 weeks ago when she stopped breastfeeding. Which interventions should the nurse practitioner include in the initial management of Harry’s problem?

1. What interventions should the nurse practitioner implement at this time?

2. Does the evidence support these interventions?

Answer 1

The interventions should the nurse practitioner include in the initial management of harry's problem include:

a.Provide high fluid intake to promote bowel elimination.

b. Offer undiluted apple or prune juices

c. Offer cereals with vegetables,iron,fruits and lentils.

The intervention should the nurse practitioner implement is :

a. Do an abdominal assessment

b. Perform rectal check and administer suppository  if stool present.

c. Order diagnostic tests like abdominal x ray to rule out other problems.

Yes ,these evidence support the interventions   because mother stated that constipation developed after the transition of breast milk to cow's milk .The protein in the cow milk can cause constipation.So change in diet can relieve constpation to some extent and thus the evidence support the interventions .There is no other discomfort like abdominal distention or vomiting associated with constipation to suspect any other conditions intially.