Case Conversation • Nurse : Good morning mrs luluk • Mrs Luluk : Good morning nurse. • Nurse : How are you mrs.luluk? you look uncomfortable today. • Mrs Luluk : You are right nurse, I feel bad , really bad (unhealthy). • Nurse : What’s the problem? • Mrs Luluk : I haven’t bowels open properly for day. • Nurse : When did you last have your bowels open (defaecate)? • Mrs Luluk : Emmmm,,,maybe last Wednesday. • Nurse :So that’s 3 days ago. Is it true? • Mrs Luluk :Yes, nurse. I want to say earlier, but I was afraid to go to the toilet because my broken leg still hurts and can’t be moved.(fractured) • Nurse : How often do you usually bowels open? (defaecate) • Mrs Luluk : Every day without being missed. • Nurse : That might happen because you are not as active as before, but to have bowels open and pass water you can use a chamber pot. • Mrs Luluk : Yes right, I can’t do much with traction in the legs. • Mrs Luluk’s daughter : Sorry nurse, I am mrs.luluk’s daughter. • Nurse : Yes, can I help you? • Mrs Luluk’s daughter : Not with me. but, I want to ask about my mother’s condition. • Nurse : Yes, please. • Mrs Luluk’s daughter : What my mother can’t bowels open has to do with the food eaten? • Nurse : Yes it’s also another contributing factor, in addition to decreased activity due to broken legs. • Mrs Luluk’s daughter : My mother for few days is hard to eat vegetables. Is that also the reason? • Nurse : Yes, it can too. To make sure I will check your mother. • Mrs Luluk’s daughter : Yes, please. • Nurse : How do you feel now mrs luluk? • Mrs Luluk : I feel my stomach is full of wind (flatulence). Look at my stomach, this is very big. I can’t eat anything even though my daughter brings my favorite food. • Nurse : Yes, your stomach is a little distanded. Is this sick? (pressing on the stomach) • Mrs Luluk : Yes, there feels a little pain when pressed. • Nurse : How do you have bowels open before these three days? • Mrs Luluk : Just a little harder and I have to try hard to get it out. • Nurse : How about before being sick? • Mrs Luluk : Normal, soft and doesn’t need to push. I usually diarrhea after eating spicy food. so that I can bowels open even though I have tried eating spicy food here, but I can’t. • Nurse : What are you feel on your anus is pain or uncomfortable when you cleanse yourself? • Mrs Luluk : Without pain, but feel my anus full but can’t get out. • Nurse : What are you doing to remove it? • Mr Luluk : Yes, but still can’t get out. • Nurse : I will report to dr.mark. so that you can prescribe medication for immediate bowel movemets (laxative) and I will propose that dr.mark collaborate with physiotherapy to train you. So that your activity increases. • Mrs Luluk : Ok nurse, How is the form of bowels open medicine? • Nurse : The medicine is in the form of a soft capsule and will be inseted into the anus. • Mrs luluk’s husband :Sorry nurse, I am mrs luluk’s husband. • Nurse : Yes sir, any question? • Mrs luluk’s husband : Can’t you just take the medicine? • Nurse : You can’t, because your wife’s stool collected at the bottom. so it can’t be done with just a medication that functions at the top. • Mrs luluk’s husband :Doesn’t it hurt? • Nurse : No, doesn’t. instead the drug given through the anus will react faster. • Mrs luluk’s husband : Ok nurse, give it to my wife. • Nurse : Yes sir I will report to the dr.mark first. • Mrs luluk’s husband : Thank you nurse. So that my wife feels better. • Nurse : You are welcome sir, I will report it so mrs luluk can immediately bowels open. • Mrs Luluk : I am very grateful, because this is very uncomfortable. • Nurse : please to help you to have bowels open other than with medicine you can drink lots of water and eat high fiber foods. • Mrs Luluk : What are the foods high fiber other than vegetables? • Nurse : There are many hight fiber foods for more details I call our nutritionist. You can ask a lot about foods that are safe for you. Wait a minute I will call.(out of the patient’s room) • Mrs Luluk : Yes, nurse. • Nurse : Excuse me nutritionists, there is patient who want to consult about foods that are safe for her and can help bowels open. • Nutritionists : Yes nurse, which patient? • Nurse : please, I will deliver to her room. • Nutritionists : Ok thanks. • Nurse : Excuse me mrs luluk, she is our nutritionist. You can consult about foods. • Nutritionists : Nice to meet you mrs luluk. I am nutritionist in here. My nama miss tri. • Mrs Luluk : Nice to meet you too miss tri. My name mrs luluk • Nurse : Ok mrs luluk. I leave you with her, because I have to report your condition to dr.mark. .(out of the patient’s room)