CONSTIPATION NURSING DIAGNOSIS & CARE PLAN

CONSTIPATION NURSING DIAGNOSIS & CARE PLAN

Constipation is the decrease in normal frequency of bowel movements. It is also typically accompanied by difficult or incomplete passage of stool and stool that is often extremely hard and dry. Constipation is very common and one of the most frequently seen gastrointestinal complaints. It can affect anyone however the following individuals are more prone to constipation:

▪️Elderly: typically, these individuals are less active, have slower metabolisms, and less muscle strength along the digestive tract

▪️Women (particularly pregnant women or shortly after childbirth): changes in hormones can cause constipation and for pregnant women the baby often pushes on the intestines resulting in a slower passage of stool

▪️Individuals with neurological disease

CAUSES

There are several causes of constipation from lifestyle choices, to medications, and different medical conditions. A list of common causes is listed below.

▪️Low fiber diet

▪️Dehydration

▪️Low exercise/activity level

▪️Changes in regular daily routine

▪️Increased consumption of milk or cheese products

▪️Stress

▪️Resisting the urge to have a bowel movement

▪️Due to the following Medications

{1.Pain medications, especially narcotics

2. NSAIDs

3. Antidepressants

4. Antacids with calcium or aluminum

5. Iron supplements

6. Allergy medications

7. Some blood pressure medications

8. Psychiatric medications

9. Antiemetics

10. Anticonvulsants

11. Endocrine Disease (i.e hypothyroidism)

12. Colorectal cancer

13. IBS

14. Diverticular Disease

15. Neurological diseases such as spinal cord injuries, stroke, or Parkinson’s disease

16.Intestinal obstruction

17. Structural defects within the digestive tract }

SIGNS AND SYMPTOMS

  1. Less than 3 bowel movements per week

2. Hard, dry stool

3. Lumpy stool

4. Difficulty/straining to pass stool, painful

5. Stomach pain, aches, or cramps

6. Sensation of feeling bloated or nauseous

7. Sensation that you have not fully emptied your bowel after a bowel movement

ASSESSMENT

  1. Assess medical history as it relates to potential constipation (history of constipation, activity level, medications used routinely for constipation)
  2. Assess for abdominal pain using age appropriate pain scale

▪️ Location of pain

▪️ Severity of pain

▪️ Duration of pain

▪️ Description of pain

▪️Specific actions that improve or worsen pain

3. Complete comprehensive abdominal assessment

▪️Inspection

▪️Auscultation

▪️Percussion

▪️Palpation

4. Assess stool characteristics per patient

▪️Color, consistency, amount

▪️Use appropriate tools as needed (i.e. Bristol Stool Chart)

NURSING INTERVENTIONS

▪️Treat pain/discomfort as needed with appropriate non-pharmacological and pharmacological methods as necessary

▪️Perform abdominal massage

▪️Administer appropriate stool softeners/laxatives as ordered

▪️Increase patient’s activity level as patient is able to tolerate

▪️Increase hydration

▪️Increase fiber rich foods in diet

TREATMENT

Unless it is a severe case of constipation, most cases are treated at home with self-care activities. Self-care activities that can help treat constipation include:

▪️Increase daily water intake

▪️Avoid caffeine

▪️Avoid alcohol

▪️Increase fiber within the daily diet

▪️Increase activity level

▪️Take over the counter medication (stool softener or mild laxative) as needed.

If these measures are not effective than it is possible a stronger medication could be prescribed. Although unlikely, surgery is needed in very rare instances if there is a structural problem with the colon.

PREVENTION

Prevention is a huge factor in the management of constipation. By eating a well-balanced diet rich in fiber, increasing hydration, and maintaining a regular activity level an individual can typically also maintain a regular bowel routine.

  1. Fiber-rich foods:

▪️Fruit: raspberries, strawberries, blueberries, pears, apples, bananas

▪️Vegetables: peas, broccoli, brussels sprouts, potatoes, sweet corn, cauliflower, carrots

▪️Grains: barley, quinoa, bran, oatmeal, brown rice, whole wheat bread

▪️Legumes and nuts: split peas, lentils, baked beans, black beans, chia seeds

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