A nurse is providing teaching to a client who has constipation. What information should the nurse include? (Select all that apply.)

Constipation is a functional or structural impairment of defecation characterized by infrequent bowel movements or hard stools. Management strategies focus on increasing colonic motility and improving the consistency of the fecal bolus. Lifestyle modifications are the primary line of defense to restore regularity and prevent complications like fecal impaction or hemorrhoids. A. Include probiotic foods such as yogurt in the daily diet.: Probiotics containing Lactobacillus or Bifidobacterium help normalize the gut microbiome, which can improve intestinal transit time. These beneficial bacteria facilitate the fermentation of fiber and support healthy peristalsis. They are an effective adjunct to dietary fiber. B. Exercise daily.: Physical activity, especially walking, stimulates the enteric nervous system and promotes the movement of chyme through the colon. Sedentary lifestyles are a major risk factor for decreased bowel motility. Regular movement helps maintain the muscle tone necessary for effective defecation. C. Increase intake of low fiber foods.: Low-fiber foods like white rice, cheese, and processed meats contribute to the formation of small, hard stools that are difficult to pass. The client should decrease these items and increase high-fiber choices like whole grains and legumes. Residue is essential for fecal bulk. D. Avoid drinking warm liquids.: Warm liquids, such as water or tea, can actually stimulate the gastrocolic reflex, which initiates peristalsis and helps trigger a bowel movement. Cold liquids do not have the same stimulatory effect. Avoiding them would be counterproductive to relieving constipation. E. Increase fluid intake to at least 1500 mL daily.: Fiber requires adequate water to soften the stool and move it effectively through the intestinal tract. Without sufficient hydration, increased fiber intake can actually worsen constipation by creating a hard, dry mass. Fluid is a critical lubricant for the bowel.