RStudentRN

I am trying to work up my careplan and need some help. My patient has constipation. He is 4 days postop but I contributing his constipation to all the medication that he is on and not because of the surgical anasthesia. 6 of his 13 medications main side effect is constipation. He said he has not had a BM in 5 days, and now has been ordered a fleets enema. My question is he has some abdomen distension above his umbilicus. Would this be a subjective sign of constipation or could this be something else. I was not sure with constipation where the abdomen distension should be. Thanks R

I always make the questions out to be complicated : ) My teacher said that we were not very good critical thinkers at this point. Hopefully after I graduate and have some years of practice behind me I will look back and laugh at all these questions that I had as a student. Thanks for your help :)

o.k here was another question that I got stumped on... Your patient has End Stage Renal Disease, with a 30 year HX of Type 1 DM. She has a 2-cm dry, ulcerated circular area on the lateral outer aspect of her right great toe and an AV fistula in the right forearm. You have adminisered her AM NPH insulin at 0730 and you are waiting for her dialysis treatment. At 1130 you do a fingerstick and the results are 236, According to the Sliding Scale you administered 10 units of Regular insulin. Which of these Nursing Diagnosis is a priority at this time. Risk for infection Altered patterns of elimination Fatique Excess fluid volume Deficient Fluid Volume Imbalance Nutrition:Less than body requirements I choose Fluid volume excess, because she is now hyperglycemic. Wouldn't there be a fluid shift from intracellular to intravascular because of the high concentration of glucose in the vascular system. F&E confuses me...Anyone have any ideas. Thanks