Nursing Care Plan

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Showing posts with label Constipation. Show all posts
Showing posts with label Constipation. Show all posts

Nursing Care Plan for Constipation

Definition: A decrease in a person's normal frequency of defecation, accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool

Defining Characteristics: Change in bowel pattern; bright red blood with stool; presence of soft paste-like stool in rectum; distended abdomen; dark, black, or tarry stool; increased abdominal pressure; percussed abdominal dullness; pain with defecation; decreased volume of stool; straining with defecation; decreased frequency; dry, hard, formed stool; palpable rectal mass; feeling of rectal fullness or pressure; abdominal pain; unable to pass stool; anorexia; headache; change in abdominal growing (borborygmi); indigestion; atypical presentation in older adults (e.g., change in mental status, urinary incontinence, unexplained falls, elevated body temperature); severe flatus; generalized fatigue; hypoactive or hyperactive bowel sounds; palpable abdominal mass; abdominal tenderness with or without palpable muscle resistance; nausea and/or vomiting; oozing liquid stool.


Related To:
  • Malnutrition
  • Metabolic and endocrine disorders
  • Sensory/motor disorders
  • Stress
  • Immobility
  • Inadequate diet
  • Irregular evacuation pattern

As evidenced by


Major: Hard formed stool and/or defecation occurs fewer than three times per week.
Minor:
  • Decreased bowel sounds.
  • Reported feeling of rectal fullness or pressure around rectum.
  • Straining and pain on defecation.
  • Palpable impaction.

Outcome

The patient will:
  • Have soft formed stool.
  • Patient and/or significant other will verbalize an understanding of method for preventing and/or treating constipation.

Nursing Interventions for Constipation
  • Assess abdomen for distention, bowel sounds.
  • Assess bowel elimination.
  • Asses factors responsible for constipation :
    • stress
    • discomfort
    • sedentary lifestyle
    • laxative abuse
    • debilitation
    • lack of time/privacy
    • drug side effect

  • Promote corrective measures :
    • review daily routine
    • provide privacy/time
    • provide comfort
    • encourage adequate exercise

Nursing Care Plan for Alteration in Bowel Elimination : Constipation

Alteration in Bowel Elimination: Constipation

Definition:

A situation where an individual experience or a higher risk of static in the large intestine, resulting in a rare bowel movements, hard, dry stools.

Related Factors:

Pathophysiology
Related to innervation disorders, pelvic floor muscles are weak, and immobilization:
Spinal cord lesions
Spinal cord injury
Dementia
Cerebrovascular injury (CSV, stroke)
Neurological Disease
Related to a reduced metabolic rate:
Obesity
Diabetic neuropathic
Uremia
Hypothyroidism
Hyperparathyroidism
Related to decreased peristalsis:
Hypoxia (cardiac, pulmonary)
Action
Related to side effects (specific):
Aluminum antacids
Aspirin anesthetic
Iron Fenotiasine
Barium Calcium
Anticholinergics Diuretics
Narcotics Agents antiparkinson
Situational
Related to decreased peristaltis
Immobilization
Gestation
Stress
Lack of exercise
Related to elimination pattern ketitakteraturan
Dealing with fear of pain
Related to fluid intake takadekuat

Major Data
  • Frequency decreased
  • Stool hard, dry
  • Straining at stool issue
  • Abdominal distension

Minor Data
  • Pressure on the rectal
  • Headache, decreased appetite
  • Abdominal pain

Expected Outcomes Nursing Care Plan for Alteration in Bowel Elimination : Constipation

Individuals will:
  1. Describe the therapeutic program defecation
  2. reported or showed increased bowel elimination
  3. explain the rationale of intervention

Nursing Intervention Nursing Care Plan for Alteration in Bowel Elimination : Constipation

Teach the importance of balance diet
  • Review the list of foods that contain lots of bulk
    • Fresh fruits skinned
    • Chaff
    • Nuts
    • Bread and cereals
    • Fruits and vegetables are cooked
    • Fruit juice
  • Includes nearly 800 grams of fruit and vegetables every day for normal defecation
  • Gradually increase fiber foods
  • Suggest 2 liters of fluid intake (8-10 glasses) unless there are contraindications
  • Recommend drinking a glass of warm water 30 minutes before breakfast which can stimulate spending feces.
  • Set a regular time of elimination
  • Assist individuals to normal position rather squat to allow optimum use of abdominal muscles and the effects of gravity.
  • Teach how to memasase lightly on the bottom of the abdomen while on the toilet
  • If there is hardening of the stool, put the warm mineral oil and let stand for 20-30 minutes. Use gloves lubricated with a good, hard stools resolve and dispose of floating-fractions. Keep track of vagal stimulation (dizziness, weak pulse)
  • Explain the dangers of the use of laxatives and enemas.