The nurse is caring for a patient on the medical-surgical unit.The patient states,"I really don't like to talk about my bowel movements,but what is considered a normal bowel movement?" What is the best response by the nurse? Select all that apply.

A) "We usually like to set an acceptable standard of at least one bowel movement per week."
B) "We can say normal frequency is anything from several times a day to once per week. It depends on your normal pattern."
C) "We also consider whether you have to strain with bowel movements, use laxatives, or have to rush to the toilet."
D) "There is no such thing as normal. All people are different, so don't worry about it."

Part of the confusion about bowel function is that there is a wide range of "normal." The frequency of BMs may range from several times per day to once a week.As long as the person passes stools without excessive urgency (needing to rush to the toilet),with minimal effort and no straining,without blood loss,and without the use of laxative,you can regard bowel function as normal.The best responses by the nurse are therefore the ones that provide the patient with the most information.Although telling a patient there is no such thing as normal and all people are different is not incorrect,it does not provide the patient any information regarding what constitutes "normal" as far as number of BMs,what they should look like,defecation without much straining,and so on.Moreover,that statement advises the patient not to worry about it,which is condescending and negates feelings.