Use this nursing diagnosis guide to formulate a nursing care plan for constipation. Show
Constipation is when bowel movements become less frequent than normal and is accompanied by the difficult or incomplete passage of stool. It is a common gastrointestinal symptom affecting many individuals and contributes to frequent hospitalizations every year. About 33 out of 100 adults ages 60 and above have symptoms of constipation (National Institute of Diabetes and Digestive and Kidney Diseases). Constipation can be attributed to many causes such as mechanical factors, medications used, presence of comorbidities, and impaired rectal sensory-motor dysfunction. If left untreated, constipation may progress to a more serious problem. Chronic constipation can lead to fecal impaction, fecal incontinence, hemorrhoids, rectal prolapse, and anal fissure.
CausesHere are some factors that may be related to constipation:
Signs and SymptomsThe following signs and symptoms characterize constipation:
Goals and desired outcomesThe following are the common goals and expected outcomes for constipation.
Nursing Assessment and RationalesAssessment of the patient with constipation includes a careful history and physical examination, followed by appropriate laboratory and radiological investigations. The tests conducted are directed by the clinical findings and should be used to strengthen the diagnosis and assess the depth of the problem. 1. Review the patient’s past medical and surgical history.
2. Review patients’ current medication for gastrointestinal side effects.
3. Assess and review the patient’s bowel habits and patterns of elimination.
4. Note the client’s age. 5. Assess for
laxative abuse or enema use. 6. Assess the client’s dietary regimen and activity level. 7. Assess for emotional
factors affecting defecation. 8. Auscultate abdomen for presence, location, and characteristics of bowel sounds. 9.
Palpate the abdomen for the presence of distention or masses. Perform digital rectal exam if indicated. 10. Investigate reports of painful defecation. 11. Use appropriate tools in assessing stool
characteristics. 12. Assist and prepare the patient for diagnostic procedures in evaluating constipation. 12.1. Anorectal manometry. 12.2. Colonic-transit study. 12.3. Defecography. 12.4. MRI defecography. Nursing Interventions and RationalesNursing management of constipation includes relieving the symptoms through nonpharmacological approaches such as dietary changes, lifestyle changes, and physical activity, restoring normal bowel habits, and improving the patient’s quality of life. The following are the therapeutic nursing interventions for constipation. 1. Encourage the patient to
increase fluid intake of 1.5 to 2 L/day as tolerated. 2.
Advised patients to take the recommended dose of dietary fiber of at least 20 to 30 g daily. Encourage intake of prune juice. 3. Assist the patient in doing physical activity and exercise. Consider isometric abdominal and gluteal exercises. 4.
Institute a toilet schedule or bowel training as appropriate. 5. Digitally eliminate fecal impaction. 6. Advise taking probiotics if indicated. 7. Educate about biofeedback therapy for constipation. 8. Provide warm Sitz baths as indicated. 9. Administer enema (phosphate enema, saline, tap water, and soap sud enema) if indicated. 10. Unless contraindicated, encourage the patient to use the bathroom. For bedridden patients, assist the patient in assuming a high-Fowler’s position with knees flexed. 11. Close the bathroom door or pull curtains around the bed. 12. Perform digital anorectal stimulation for patients with neurological problems. 13. Explain the use of pharmacological agents as ordered. 13.1. Bulk-forming laxatives (e.g., bran, psyllium, methylcellulose, wheat dextrin, inulin, calcium polycarbophil) 13.2. Stool softeners (e.g., Colace) 13.3. Stimulant laxatives (e.g., Bisacodyl, Senna, Castor Oil, Cascara, Aloe) 13.4. Osmotic laxatives (e.g., polyethylene glycol [PEG], lactulose, sorbitol, glycerin,
magnesium sulfate, magnesium citrate, magnesium hydroxide [Milk of Magnesia]) 13.5. Lubricants (e.g., Mineral Oil, Glycerin suppository)
13.6. Chloride-channel activator (e.g., Lubiprostone) 13.7. Guanylate cyclase-C activator (e.g., Linaclotide) 13.8. Serotonin agents (e.g., Tegaserod, Cisapride, prucalopride) 14. Perform rectal irrigation if indicated. 15. Refer the patient for surgery if indicated. Recommended ResourcesRecommended nursing diagnosis and nursing care plan books and resources. Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.
See alsoOther recommended site resources for this nursing care plan:
References and SourcesRecommended journals, books, and other interesting materials to help you learn more about constipation nursing care plans and nursing diagnosis:
When teaching a patient about ways to prevent constipation which instructions does the nurse include?Guidelines to Treat Constipation
Eat three meals each day. Do not skip meals. Gradually increase the amount of high-fiber foods in your diet. Choose more whole grain breads, cereals and rice.
When teaching the client of high fiber diet to prevent constipation which of the following should be included?Too much fiber all at once may cause cramping, bloating, and constipation. When adding fiber to your diet, be sure to drink adequate fluids (at least 64 ounces or 8 cups per day) to prevent constipation.
Which treatment is discouraged for a patient who reports constipation?Treatment. The availability of many different pharmacologic agents for constipation makes symptomatic treatment alluring. When possible, however, treatment should be directed at correcting the underlying abnormality. The chronic use of laxatives, especially stimulant laxatives, should be strongly discouraged.
Which statement provides evidence for nurse AP that an older adult who is prone to constipation is in need of further teaching?Which statement provides evidence that an older adult who is prone to constipation is in need of further teaching? “I need to take a laxative such as Milk of Magnesia if I don't have a BM every day.”
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