Constipation Nursing Diagnosis and Interventions
Actions/Interventions
NURSING PRIORITY NO. 1.
To identify causative/contributing factors:
Review daily dietary regimen. Note oral/dental health that can impact intake.
Determine fluid intake, to note deficits.
Evaluate medication/drug usage and note interactions or side effects (e.g., narcotics, antacids, chemotherapy, iron, contrast media such as barium, steroids).
Note energy/activity level and exercise pattern.
Identify areas of stress (e.g., personal relationships, occupational factors, financial problems).
Determine access to bathroom, privacy, and ability to perform self-care activities.
Investigate reports of pain with defecation. Inspect perianal area for hemorrhoids, fissures, skin breakdown, or other abnormal findings.
Discuss laxative/enema use. Note signs/reports of laxative abuse.
Review medical/surgical history (e.g., metabolic or endocrine disorders, pregnancy, prior surgery, megacolon).
Palpate abdomen for presence of distention, masses.
Check for presence of fecal impaction as indicated.
Assist with medical workup for identification of other possible causative factors.
NURSING PRIORITY NO. 2.
To determine usual pattern of elimination:
Discuss usual elimination pattern and problem.
Note factors that usually stimulate bowel activity and any interferences present.
NURSING PRIORITY NO. 3.
To assess current pattern of elimination:
Note color, odor, consistency, amount, and frequency of stool. Provides a baseline for comparison, promotes recognition of changes.
Ascertain duration of current problem and degree of concern (e.g., long-standing condition that client has “lived with” or a postsurgical event that causes great distress) as client’s response may be inappropriate in relation to severity of condition.
Auscultate abdomen for presence, location, and characteristics of bowel sounds reflecting bowel activity.
Note laxative/enema use.
Review current fluid/dietary intake.
NURSING PRIORITY NO. 4.
To facilitate return to usual/acceptable pattern of elimination:
Instruct in/encourage balanced fiber and bulk in diet to improve consistency of stool and facilitate passage through colon.
Promote adequate fluid intake, including high-fiber fruit juices; suggest drinking warm, stimulating fluids (e.g., decaffeinated coffee, hot water, tea) to promote moist/soft stool.
Encourage activity/exercise within limits of individual ability to stimulate contractions of the intestines.
Provide privacy and routinely scheduled time for defecation (bathroom or commode preferable to bedpan).
Encourage/support treatment of underlying medical cause where appropriate (e.g., thyroid treatment) to improve body function, including the bowel.
Administer stool softeners, mild stimulants, or bulk-forming agents as ordered, and/or routinely when appropriate (e.g., client receiving opiates, decreased level of activity/immobility).
Apply lubricant/anesthetic ointment to anus if needed.
Administer enemas; digitally remove impacted stool.
Provide sitz bath after stools for soothing effect to rectal area.
Establish bowel program to include glycerin suppositories and digital stimulation as appropriate when long-term or permanent bowel dysfunction is present.
NURSING PRIORITY NO. 5.
To promote wellness (Teaching/ Discharge Considerations):
Discuss physiology and acceptable variations in elimination.
Provide information about relationship of diet, exercise, fluid, and appropriate use of laxatives as indicated.
Discuss rationale for and encourage continuation of successful interventions.
Encourage client to maintain elimination diary if appropriate to facilitate monitoring of long-term problem.
Identify specific actions to be taken if problem recurs to promote timely intervention, enhancing client’s independence.
NURSING PRIORITY NO. 1.
To identify causative/contributing factors:
Review daily dietary regimen. Note oral/dental health that can impact intake.
Determine fluid intake, to note deficits.
Evaluate medication/drug usage and note interactions or side effects (e.g., narcotics, antacids, chemotherapy, iron, contrast media such as barium, steroids).
Note energy/activity level and exercise pattern.
Identify areas of stress (e.g., personal relationships, occupational factors, financial problems).
Determine access to bathroom, privacy, and ability to perform self-care activities.
Investigate reports of pain with defecation. Inspect perianal area for hemorrhoids, fissures, skin breakdown, or other abnormal findings.
Discuss laxative/enema use. Note signs/reports of laxative abuse.
Review medical/surgical history (e.g., metabolic or endocrine disorders, pregnancy, prior surgery, megacolon).
Palpate abdomen for presence of distention, masses.
Check for presence of fecal impaction as indicated.
Assist with medical workup for identification of other possible causative factors.
NURSING PRIORITY NO. 2.
To determine usual pattern of elimination:
Discuss usual elimination pattern and problem.
Note factors that usually stimulate bowel activity and any interferences present.
NURSING PRIORITY NO. 3.
To assess current pattern of elimination:
Note color, odor, consistency, amount, and frequency of stool. Provides a baseline for comparison, promotes recognition of changes.
Ascertain duration of current problem and degree of concern (e.g., long-standing condition that client has “lived with” or a postsurgical event that causes great distress) as client’s response may be inappropriate in relation to severity of condition.
Auscultate abdomen for presence, location, and characteristics of bowel sounds reflecting bowel activity.
Note laxative/enema use.
Review current fluid/dietary intake.
NURSING PRIORITY NO. 4.
To facilitate return to usual/acceptable pattern of elimination:
Instruct in/encourage balanced fiber and bulk in diet to improve consistency of stool and facilitate passage through colon.
Promote adequate fluid intake, including high-fiber fruit juices; suggest drinking warm, stimulating fluids (e.g., decaffeinated coffee, hot water, tea) to promote moist/soft stool.
Encourage activity/exercise within limits of individual ability to stimulate contractions of the intestines.
Provide privacy and routinely scheduled time for defecation (bathroom or commode preferable to bedpan).
Encourage/support treatment of underlying medical cause where appropriate (e.g., thyroid treatment) to improve body function, including the bowel.
Administer stool softeners, mild stimulants, or bulk-forming agents as ordered, and/or routinely when appropriate (e.g., client receiving opiates, decreased level of activity/immobility).
Apply lubricant/anesthetic ointment to anus if needed.
Administer enemas; digitally remove impacted stool.
Provide sitz bath after stools for soothing effect to rectal area.
Establish bowel program to include glycerin suppositories and digital stimulation as appropriate when long-term or permanent bowel dysfunction is present.
NURSING PRIORITY NO. 5.
To promote wellness (Teaching/ Discharge Considerations):
Discuss physiology and acceptable variations in elimination.
Provide information about relationship of diet, exercise, fluid, and appropriate use of laxatives as indicated.
Discuss rationale for and encourage continuation of successful interventions.
Encourage client to maintain elimination diary if appropriate to facilitate monitoring of long-term problem.
Identify specific actions to be taken if problem recurs to promote timely intervention, enhancing client’s independence.
