When digitally removing a fecal impaction, under what condition should the nurse stop the procedure?

When performing a digital removal of a fecal impaction, the nurse should stop the procedure if there is a significant change in vital signs indicating possible compromise or stress to the patient. A decrease in pulse rate from 78 to 52 beats per minute is critical because such a drop may suggest bradycardia, which can be a sign of vagal stimulation or autonomic nervous system response due to the procedure. This reaction can pose serious risks, including decreased cardiac output and potential loss of consciousness.

Additionally, the other vital sign changes are less immediate concerns. A slight increase in temperature typically does not indicate a need to stop unless it reaches potentially dangerous levels. An increase in respiratory rate might suggest anxiety or discomfort but is not as acute a reason for stopping as bradycardia. Lastly, while an increase in blood pressure can indicate rising stress or pain levels, it does not necessitate halting the procedure unless substantially elevated. Therefore, the significant change in pulse rate warrants discontinuation of the procedure to ensure patient safety.