The first instruction the nurse should give a constipated patient is to increase fluid intake. When patients are dehydrated, their colon reabsorbs water from the stool to maintain homeostasis. This hardens the stool and makes it more difficult to pass. Ensuring proper hydration will keep the stool less hard and easier to pass. Increasing the roughage in the diet will help add bulk to the stool which stimulates peristalsis, but increasing roughage without increasing water intake will worsen constipation. A laxative or enema may be necessary but increasing fluid intake, dietary fiber, and exercise are the first interventions.