Effective Nursing Management of Constipation. Constipation Care Plan

Healthcare professionals notice that they have to cope with numerous constipation issues in patients. Noteworthy, although constipation is a common problem, different patients have different symptoms; therefore, they require different treatment. Obviously, the issue should be thoroughly evaluated in order to identify the underlying causes of constipation for treating them effectively. Sometimes, the nurse cannot find out the poor habits of the patient that lead to constipation. Consequently, it is necessary to be well informed about the ways of finding out the causes of constipation, as well as the most effective ways of its treatment. In this regard, a constipation care plan is a perfect tool for reaching this goal.

Nursing Care Plan for Constipation

A nursing care plan aims to identify and describe the actions, which should be undertaken in the process of treatment as a part of nursing practice. This plan is usually the responsibility of registered nurseorlicensed practical nurse. After the thorough examination of the patient`s medical history, as well as his/herhealth condition, the nurse creates the plan of care. Further, the nurse works with the patient in accordance with this plan trying to fulfill the goals and objectives set.

Although the design of all constipation care plans depends on the particular healthcare establishment, these plans can be divided into four major categories: nursing diagnoses and problem lists, nursing orders, goals and criteria for the potential outcome, as well as the evaluation plans.

Constipation Care Plan: Things to Consider

1.Define the Causative and Contributing Factors:

  • Conduct a careful review of the patient`s diet;
  • Make an analysis of fluid intake;
  • Talk to the patient about the enema/laxative usage looking for the abuse signs;
  • Find out the peculiarities of the patient`s medication looking for the possible adverse effects or interactions;
  • Analyze the level of physical activity of the patient;
  • Look through the patient`s surgical history;
  • Check the fecal impaction;
  • Assess the ability of the patient to take care of himself/herself;
  • Examine whether the patient has the opportunity to access the toilet;
  • Check if the defecation brings unpleasant symptoms for the patient.

2. Evaluate the Common Defecation Pattern:

  • Discuss the issues related to defecation, as well as the common trip to the bathroom;
  • Talk about the instruments that stimulate the patient`s bowel activity, as well as potential interferences.

3. Assess The Current Defecation Patters:

  • Note the color, odor, consistency, quantity, and frequency of the stool as it will help recognize any changes.
  • Ask the patient about his/her concerns, clarifying how long does the patient has constipation.
  • Find out if the patient is currently taking enemas or laxatives.
  • Find out the current patient`s food and fluid intake.

4. To Aid a Return to the Desirable Pattern of Defecation:

  • Create the nursing diagnosis list for constipation;
  • Suggest the patient incorporate bulk and fiber into the diet;
  • Advise the patient to drink fluids such as fruit juices rich in fiber and stimulating drinks to promote the softer and moister stool.
  • Suggest increasing the patient`s physical activity in order to promote intestinal contractions.
  • Create the schedule for bathroom trips and ask the patient to follow it as much as possible to enable him/her to defecate in private.
  • Provide the patient with the effective medicines including bulk-forming agents, mild stimulants, as well as stool softeners.
  • If necessary, apply the anesthetic ointment or the lubricant to the patient’s anus.
  • Accompany the patient to the bath to check the rectal area after defecation.
  • In case the patient experiences chronic dysfunction, suggest a bowel program that will include the effective digital stimulation.

5. Promote Post-Hospital Health:

  • Discuss underlying defecation physiology and acceptable variations with the patient;
  • Provide the patient with the necessary information about the diet, exercise, or fluid intake, as well as the appropriate laxative usage.
  • Discuss the reasons for medical intervention;
  • Encourage the patient to create an elimination journal in which he/she will note the potential signs of constipation;
  • Outline the specific plan of actions that will help the patient cope with the problem if it is not too serious.

6. Focus on Documentation

Assessment/Reassessment:

  • The characteristics of the stool;
  • The dynamics of defecation;
  • The patient’s common bowel procedure;
  • The dynamics of the problem.

Planning:

  • A teaching plan;
  • A clear intervention plan that will define the necessary lifestyle changes.

Evaluation/Implementation:

  • Record all the responses to the suggested intervention;
  • Record all changes in the stool;
  • Record the progress;
  • Record all changes to the constipation care plan;

Discharge planning:

  • Explain how to perform the follow-up care;
  • Find out the patient`s long-term requirements;
  • Define the nurse responsible for fulfilling the patient`s goals;
  • Mention the specific referrals.

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