Nursing Care Plan Impaired Walking

lungs 300x265 Nursing Care Plan Impaired Walking Nursing Care Plan Impaired Walking Definition :Self-diagnosis of constipation and abuse of laxatives, enemas, and suppositories to ensure a daily bowel movement When an individual is very unable to meet their own self-care requisites, a “self-care deficit” occurs. It is the job of the Registered Nurse to determine these deficits, and define a support modality.Self-care deficit nursing theory is a grand nursing theory that was developed between 1959 and 2001 by Dorothea Orem. It is also known as the Orem model of nursing. It is particularly used in rehabilitation and primary care settings where the patient is encouraged to be as independent as possible. Nursing Care Plan Impaired Walking Definition

Defining Characteristics

  • Expectation of passage of stools at the same time each day
  • Overuse of laxatives, enemas, and/or suppositories

Related Factors

  • Cultural health beliefs
  • Faulty appraisal
  • Family health beliefs
  • Impaired thought processes

Assessment Focus 

  • Activity/exercise
  • Elimination
  • Coping
  • Fluid and electrolytes
  • Behavior
  • Nutrition
  • Emotional

Expected Outcomes The Patient Will

  • Decrease use of laxatives, enemas, or suppositories.
  • State understanding of normal bowel function.
  • Discuss feelings about elimination pattern.
  • Have a return-to-normal elimination pattern.
  • Experience bowel movement every _____ day(s) without laxatives, enemas, or suppositories.
  • State understanding of factors causing constipation.
  • Get regular exercise.
  • Describe changes in personal habits to maintain normal elimination pattern.
  • State intent to use appropriate resources to help resolve emotional or psychological problems.

Suggested Noc Outcomes

Adherence Behavior; Bowel Elimination; Health Beliefs; Health Beliefs: Perceived Threat; Knowledge: Health Behavior

Interventions And Rationales

Determine: Assess patient’s dietary habits and encourage modification to include adequate fluids, fresh fruits and vegetables, and whole grain cereals and breads, which supply necessary bulk for normal elimination.Perform: If not contraindicated, increase patient’s fluid intake to about 3 qt (3 L) daily to increase functional capacity of bowel elimination.Establish and implement an individualized bowel elimination regi-men based on the patient’s needs. Knowledge of normal body func-tions will improve patient’s understanding of problem.Inform: Explain normal bowel elimination habits so patient can bet-ter understand normal and abnormal body functions.75 Instruct patient to avoid straining during elimination to avoid tis-sue damage, bleeding, and pain.Instruct patient that abdominal massage may help relieve discom-fort and promote defecation because it triggers bowel’s spastic reflex.Inform patient not to expect a bowel movement every day or even every other day to avoid the use of poor health practices to stimu-late elimination.Attend: Encourage patient to engage in daily exercise, such as brisk walking, to strengthen muscle tone and stimulate circulation.Encourage patient to evacuate at regular times to aid adaptation  and routine physiological function.Urge patient to avoid taking laxatives, if possible, or to gradually decrease their use to avoid further trauma to intestinal mucosa.Reassure patient that normal bowel function is possible without lax-atives, enemas, or suppositories to give patient the necessary confi-dence for compliance.Manage: Give information about self-help groups, as appropriate, to provide additional resources for patient and family.

Suggested Nic Interventions

Anxiety Reduction; Bowel Management; Counseling; Health Educa-tion; Nutrition Management; Teaching: Individual

Reference

Hernando-Harder, A. C., et al. (2007, March). Intestinal gas retention in patients with idiopathic slow-transit constipation. Digestive Diseases and Sciences. [Epub ahead of print.]

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