After months of receiving opioids for chronic pain, a male client is admitted with abdominal distension and pain, reporting that he has not had a bowel movement in two weeks. Which should the nurse do first?

Rationale: A. Provide fiber-rich dietary supplements: Increasing dietary fiber can help promote bowel regularity, but it is not effective or safe if the client already has a suspected obstruction or impaction. Introducing fiber without addressing the blockage can worsen distension and discomfort. B. Assess for a fecal impaction: Long-term opioid use often causes severe constipation due to slowed gastrointestinal motility. With two weeks of no bowel movement, abdominal pain, and distension, fecal impaction must be ruled out first to guide safe interventions. C. Encourage regular ambulation: Activity supports bowel motility and is part of a long-term management plan. However, in the presence of acute symptoms and prolonged constipation, ambulation will not resolve the immediate concern of a possible impaction. D. Discuss taking less pain medication: Adjusting opioid use may reduce constipation over time, but pain management decisions require provider involvement. The priority is identifying and addressing a possible impaction before modifying the pain regimen.