Fecal impaction Quiz: Ace Your Exams
Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!
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An 83-year-old man was admitted to the hospital three days ago from his long-term care facility after he presented to the emergency department with severe fecal impaction and an inability to tolerate an oral diet. His past medical history includes type 2 diabetes, osteoarthritis, constipation, and coronary artery disease. Manual disimpaction was performed in the emergency department and a bowel regimen was initiated, but he has not yet had consistent bowel movements or restarted an oral diet. Serial abdominal X-rays demonstrate a continued significant colonic stool burden. Today on rounds he describes worsening abdominal pain and “feeling feverish.” Vital signs are taken at the bedside and temperature is 38.6°C (101.5°F), blood pressure is 133/87, pulse is 100/min, respiratory rate is 18/min, and oxygen saturation is 95% on room air. On physical exam, the abdomen is full, mildly distended, and tender to deep palpation with no signs of peritonitis. A CBC collected this morning is shown below. What is the best next step in management?
| Laboratory value | Result |
| Leukocyte count | 14,500/mm³ |
| Hemoglobin | 10.4 g/dL |
| Platelet count | 210,000/mm³ |
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