What sign should you assess for to determine if a 77-year-old patient who hasn't had a bowel movement in five days has a fecal impaction?

Assessing for a sudden onset of liquid stool is a critical sign to determine if a patient has a fecal impaction. When a fecal impaction occurs, the stool becomes hardened and typically obstructs further passage of solid stool. In response to this obstruction, liquid stool may sometimes leak around the impacted mass, leading to the presentation of liquid stool despite a lack of actual bowel movement. This phenomenon can easily be mistaken for diarrhea but is a significant indicator of fecal impaction.

In the case of this patient, the presence of liquid stool could suggest that the body is attempting to bypass the impaction by pushing out any liquid contents, highlighting the urgency of assessing and addressing the fecal blockage. This sign is particularly important in older adults, who may be at a higher risk for constipation and fecal impaction due to various factors, including decreased mobility and dietary changes.

Other signs and symptoms, such as abdominal pain, the patient requesting laxatives, or presenting with nausea and vomiting can be associated with constipation or bowel obstruction to some degree, but they do not specifically indicate the presence of a fecal impaction in the way that sudden onset of liquid stool does. Each of these signs may correlate with gastrointestinal distress, but the clear mechanism of