Exhibits Review H and P, nurse's notes, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the bisacodyl administered, a non- therapeutic side effect, or an unrelated finding. Each row must have one option selected.
Explanation & Rationale
• Non-blanchable red area: This finding indicates early skin breakdown or a stage 1 pressure injury due to immobility and pressure from Buck’s traction. It is unrelated to bisacodyl, which affects bowel function but does not impact skin integrity directly. • Blood pressure 135/81 mm Hg: This blood pressure reading is slightly elevated but still within an acceptable range for this patient. It is unrelated to bisacodyl administration as the medication does not directly influence blood pressure. • Burning sensation: The burning sensation near the anus is a non-therapeutic side effect likely caused by irritation from the bisacodyl suppository or frequent bowel movements. This local irritation can cause discomfort during defecation. • Semifluid stool: The presence of semifluid stool is a therapeutic result of bisacodyl’s stimulant laxative effect, promoting bowel motility and softening stool to relieve constipation. • Itching in legs: Itching is likely related to immobility, dry skin, or healing abrasions and is not connected to bisacodyl use, making it an unrelated finding. • Pain rating 2 on pain scale of 0 to 10: A reduced pain rating suggests effective pain management with prescribed analgesics. While bisacodyl does not directly reduce pain, alleviating constipation can contribute to overall comfort, marking this as a therapeutic result. • Sinus tachycardia: This increased heart rate is likely due to pain, anxiety, or physiological stress related to trauma. It is not caused by bisacodyl.