Which nursing intervention is $\mathbf{most}$ effective in promoting normal defecation for a patient who has muscle weakness in the legs?

A) Administer a soapsuds enema every 2 hours.
B) Use a mobility device to place the patient on a bedside commode.
C) Give the patient a pillow to brace against the abdomen while bearing down.
D) Elevate the head of the bed 20 degrees 60 minutes after breakfast while on bedpan.

The best way to promote normal defecation is to assist the patient into a posture that is as normal as possible for defecation. Using a mobility device promotes nurse and patient safety. Elevating the head of the bed is appropriate but is not the most effective; closer to 30 to 45 degrees is the proper position for the patient on a bedpan, and the patient is not on bed rest so a bedside commode is the best choice. Giving the patient a pillow may reduce discomfort, but this is not the best way to promote defecation. A soapsuds enema is indicated for a patient who needs assistance to stimulate peristalsis. It promotes non-natural defecation.