مريض يأخذ مورفين منتظماً للألم بعد العملية منذ ٤ أيام، ولم يتبرز. ما التدخل الأنسب؟

A client on regular post-operative morphine for 4 days has not opened his bowels. What is most appropriate?

1. Stop morphine entirely without any pain alternative
2. Restrict fluids to reduce nausea
3. Stimulant laxative and softener, fluids, mobility
4. Wait a week before any intervention

Answer: C) Stimulant laxative and softener, fluids, mobility. Opioid constipation does not resolve with continued use, so a stimulant plus softener is used preventively, with fluids, mobility and fibre as tolerated. Analgesia is not stopped without an alternative.