Rh Is A 74-Year-Old Black Woman Who Presents To The Family P ✓ Solved

Rh Is A 74 Year Old Black Woman Who Presents To The Family Practice

R.H. is a 74-year-old black woman who presents to the family practice clinic for a scheduled appointment. She complains of feeling bloated and constipated for the past month, sometimes going an entire week with only one bowel movement. Until this episode, she has been very regular all of her life, having a bowel movement every day or every other day. She reports straining most of the time and it often takes her 10 minutes at a minimum to initiate a bowel movement. Stools have been extremely hard.

She denies pain during straining. A recent colonoscopy was negative for tumors or other lesions. She has not yet taken any medications to provide relief for her constipation. Furthermore, she reports frequent heartburn (3–4 times each week), most often occurring soon after retiring to bed. She uses three pillows to keep herself in a more upright position during sleep.

On a friend’s advice, she purchased a package of over-the-counter aluminum hydroxide tablets to help relieve the heartburn. She has had some improvement since she began taking the medicine. She reports using naproxen as needed for arthritic pain in her hands and knees. She states that her hands and knees are extremely stiff when she rises in the morning. Because her arthritis has been getting worse, she has stopped taking her daily walks and now gets very little exercise.

Case Study 1 Questions: In your own words, define constipation and name the risk factors that might lead to developing constipation. List recommendations you would give to a patient who is suffering from constipation. Include both pharmacological and non-pharmacological. Based on the clinical manifestations in R.H.'s case study, name and explain the signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list in question 3 with other signs and symptoms of constipation not present in the case study. Sometimes anemia can be present as an associated diagnosis and/or a complication for patients with constipation. Would you consider that possibility based on the information provided in the case study? Explain. 500 words, 2 cited sources, APA format.

Paper For Above Instructions

Constipation is typically defined as a condition characterized by infrequent bowel movements or difficulty in passing stools. Specifically, it can be defined as having fewer than three bowel movements per week (Mayo Clinic, 2021). This can lead to discomfort and may be associated with straining during bowel movements, hard and lumpy stools, and the feeling of incomplete evacuation (American Gastroenterological Association, 2020). There are several risk factors that contribute to the development of constipation.

Risk Factors for Constipation

One notable risk factor is age, as the frequency of bowel movements generally decreases with age (Mayo Clinic, 2021). In R.H.'s case, being a 74-year-old woman may contribute to her constipation. Other contributing factors include a sedentary lifestyle, inadequate hydration, poor dietary habits lacking in fiber, and certain medications. R.H. reports reduced physical activity due to worsening arthritis, which could increase her risk of constipation.

Recommendations for Management

For patients suffering from constipation, comprehensive recommendations can be categorized into pharmacological and non-pharmacological strategies. Non-pharmacological interventions include dietary modifications such as increasing fiber intake, consuming more fruits, vegetables, and whole grains, and ensuring adequate hydration by drinking enough fluids throughout the day (American Gastroenterological Association, 2020). Regular physical activity can also facilitate bowel function, so encouraging gentle exercise, such as walking, may benefit R.H.

Pharmacological strategies may involve the use of over-the-counter laxatives, such as fiber supplements (e.g., psyllium) or osmotic agents (e.g., polyethylene glycol), to help soften stools and promote bowel regularity. In R.H.'s case, since she has not yet tried any medications for her constipation, consulting with her healthcare provider about appropriate laxatives could be beneficial.

Signs and Symptoms of Constipation

In R.H.'s case, her clinical manifestations include infrequent bowel movements (once a week), hard stools, and excessive straining, which are typical signs of constipation. Additionally, she experiences feelings of bloating, indicating a buildup of stool in her colon. Stomach discomfort and the sensation of incomplete evacuation are frequently reported symptoms in constipation sufferers, although R.H. has not expressed discomfort directly related to her bowel movements.

Other common symptoms of constipation, which were not noted in R.H.'s case, may include abdominal pain, nausea, and the presence of mucus in the stool. It is also important to monitor for any signs of rectal bleeding or weight loss, as these may suggest more serious underlying conditions requiring medical evaluation.

Potential for Anemia

Considering the possibility of anemia in conjunction with constipation is vital, especially for elderly patients. R.H. reports several months of constipation which may lead to increased pressure in the colon and rectal area. This can sometimes result in small tears (anal fissures) or bleeding during bowel movements, contributing to blood loss. Additionally, severe constipation and straining may lead to rectal bleeding, which can be a source of iron-deficiency anemia (Mayo Clinic, 2021). Although R.H. currently denies pain during straining, her symptomatology should be closely monitored to rule out potential complications, including anemia.

In conclusion, constipation is a multifactorial condition influenced by dietary, lifestyle, and age-related factors. Effective management requires a holistic approach that combines lifestyle interventions and pharmacotherapy tailored to individual patient needs. Health care providers should assess all aspects of a patient's medical history to develop an effective treatment plan.

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