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Nursing Care Plan Risk For Constipation

IBD Deficient Fluid Volume Nursing Care Plan Risk  For  ConstipationNursing Care Plan Risk  For  Constipation Definition:At risk for a decrease in normal frequency of defecation accompa- nied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool nursing diagnosis which is defined as “the state in which an individual is at risk to be invaded by an opportunistic or pathogenic agent (virus, fungus, bacteria, protozoa, or other parasite) from endogenous or exogenous sources and was approved by nanda in 1986.Although anyone can become infected by a pathogen, patients with this diagnosis are at an elevated risk and extra infection controls should be considered. Nursing Care Plan Risk For  Constipation

Risk Factors

  • Functional: Habitual denial anti-inflammatory agents,and ignoring urge to defecate,
    recent environmental changes,inadequate toileting, irregular defecation habits, insufficient physical activity, and abdomi- nal muscle weakness sedatives, aluminum-containing antacids, laxative overuse, iron salts, anticholinergics, antide- pressants, anticonvulsants, antilipemic agents, calcium channel blockers, calcium
  • Mechanical: Rectal abscess or carbonate, diuretics, sympath-ulcer, pregnancy, rectal anal
    stricture, postsurgical obstruc-tion, rectal anal fissures, mega-colon (Hirschsprung’s disease),electrolyte imbalance, tumors,prostate enlargement,rectocele, rectal prolapse, neu-rologic impairment,hemorrhoids, and obesity omimetics, opiates, and bismuth salts
  • Physiological: Insufficient fiber intake, dehydration, inadequate dentition/oral hygiene, poor eating habits, insufficient fluid intake, change in usual foods/eating patterns, and decreased motility of GI tract
  • Pharmacological:
  • Psychological: Emotional stress,
  • Phenothiazines, nonsteroidal mental confusion, depression

Assessment Focus    

  • Activity/rest
  • Fluid and electrolytes
  • Behavior
  • Nutrition
  • Elimination
  • Risk management

Expected Outcomes

The patient will

  • Experience no signs or symptoms of constipation.
  • Maintain bowel movement every ______ day(s).
  • Consume a high-fiber or high-bulk diet, unless contraindicated.
  • Maintain fluid intake of ______ ml daily (specify).
  • Express understanding of the relationship between constipation and dietary intake, bulk, and activity.
  • Express understanding of preventive measures, such as eating fruit and whole grain breads and cereals and engaging in mild activity,if appropriate.

Suggested Noc Outcomes

Bowel Elimination; Self-Care: Toileting 77

Interventions And Rationales

Determine: Assess bowel sounds and check patient for abdominal distention. Monitor and record frequency and characteristics of stools to develop an effective treatment plan for preventing constipa-tion and fecal impaction.Record intake and output accurately to ensure accurate fluid replacement therapy.Perform: Initiate bowel program. Place patient on a bedpan or com-mode at specific times daily, as close to usual evacuation time (if known) as possible, to aid adaptation to routine physiological func-tion.Administer a laxative, an enema, or suppositories, as prescribed,to promote elimination of solids and gases from GI tract. Monitor effectiveness. Inform: Teach patient to gently massage along the transverse and descending colon to stimulate the bowel’s spastic reflex and aid in stools passage.Instruct patient, family member, or caregiver in the relationship between diet, activity and exercise, and fluid intake and constipation to discourage departure from prescribed diet and assist in promoting elimination. Review care plan with patient, family member, or caregiver, emphasizing the relationship between the risk factors for constipation and preventive measures to foster understanding. Attend: Encourage fluid intake of 21⁄2 qt (2.5 L) daily, unless contraindicated, to promote fluid replacement therapy and hydration.Manage: Consult with a dietitian about how to increase fiber and bulk in patient’s diet to the maximum amount prescribed by the physician to improve intestinal muscle tone and promote comfortable elimination.Include a program of mild exercise in your care plan to promote muscle tone and circulation.

Suggested Nic Interventions

Bowel Management; Constipation/Impaction Management; Exercise Promotion; Fluid Management; Fluid Monitoring; Nutrition Management

Reference

Norton, C. (2006, February–March). Constipation in older patients: Effects on quality of life. British Journal of Nursing, 15(4), 188–192.