Problem: Pauline White is 92 years old. She has dementia as well as congestive heart failure. She is a chronic user of laxatives, and often requires a laxative in order to have a bowel movement. You have been assigned to care for her today, and when you are helping her wash up and dress for breakfast, she holds her abdomen and groans. You note her abdomen is swollen. In report, you were told that she had not had a bowel movement for 3 days, and was given a laxative with no results. After breakfast, you find that she is oozing stool from her anus. You are unable to wipe her clean.