Nursing Diagnosis for constipation: Definition

Constipation is an abnormal defecation irregularity or difficulty in evacuating fecal matter.
Difficulties to defecate often due to high stool hardness and the presence of fewer than three stools per week.

The biggest problem with constipation is to differentiate benign functional constipation from severe organic constipation due to underlying disease (mainly colon cancer).

Nursing diagnosis for constipation
Nursing diagnosis for constipation

Main causes

Nursing diagnosis for constipation
Nursing diagnosis for constipation
  • Functional or primitive constipation
    Seats deficient in water and fiber.
    Decreased gastrointestinal motility for different reasons: decreased physical activity, excessive intake of opioids, irritable colon.
    Anomaly of the evacuation, often caused by excessive sphincter tone that does not relax during defecation.
    Psychological causes due to stress during defecation.
    Stress because of the place, the daily life.
  • Organic Constipation
    Cancer of the colon or rectum.
    Anal fissure (setting up of a reflex constipation due to pain)
    Paraplegia
    diverticulitis
    Crohns Disease
    Diabetes
    Pregnancy

Physiopathology

Transit slowdown:

  • Material progression disorder due to insufficient stool volume and poor colic motility.
  • Failure to free materials due also to insufficient stool volume or disturbance of the evacuation reflex.

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Complications

  • Fecaloma: accumulation and dehydration of a significant amount of fecal matter.
  • Sub-occlusion, occlusion, intestinal fistulas.
Nursing diagnosis for constipation
Nursing diagnosis for constipation

Medical care

  • Constipation of organic origin: medical treatment.
  • Constipation of functional origin: improve the progression of the bolus and re-education of the rectal area.
  • Patient Interrogation.
  • Compendium of eating habits.
  • Explain to the patient the necessary dietary rules and importance of fiber and hydration.
  • Stimulate the patient to resume as soon as possible a physical activity (walk in the corridors if possible) and drink about two liters of water per day.
  • Try to re-educate by proposing to go to the saddle at fixed times.
  • Possible massage of the abdomen.
  • Administration of a laxative on medical prescription only especially in immediate postoperative. On medical prescription can also be performed a rectal enema OR a rectal drip. If fecal matter is present, manually remove the fecal.
Nursing diagnosis for constipation
Nursing diagnosis for constipation

Manifestation of dependence

  • Hard and molded stools.
  • Some defecation less than 3 per week.
  • Defecation pain.
  • The principle of fullness and rectal pressure.
  • Incomplete evacuation.
  • A headache, anorexia.

Favorable Factors

  • Malnutrition.
  • Sensory and motor disorder.
  • Metabolic and endocrine disorders: anorexia nervosa, obesity, hypo or hyperthyroidism.
  • Emotional disorder.
  • Hemorrhoid.
  • Cancer.
  • Pregnancy.
  • Stress.
  • Food deficiency.
  • Dehydration.
  • Weakening.
  • Physical disability.
  • Abuse of laxatives.
  • Side effects of treatments.
  • Surgical intervention.
Nursing diagnosis for constipation
Nursing diagnosis for constipation

Nursing Actions

  • Search contributing factors to reduce or remove them.
  • Ensure a balanced diet taking into account the tastes of the person:
    o Increase consumption of high-fiber foods. Drink 1.5 liters of water.
    o Fresh fruits with skin, fresh vegetables, cereals.
    o Avoid too spicy food: itching, pain.
    o Have a glass of water or fresh juice before breakfast to stimulate intestinal evacuation.
    o Schedule a regular elimination schedule: monitoring sheet.
  • Promoting physical activity adequate and proper:
    o Do exercises according to their abilities.
    o Do mobilization activities for disabled people.
    o Encourage the person to increase muscle tone, contract the abdominal muscles, raise the legs without flexing the knees.
    o Encourage is early rising.
  • Protecting the integrity of the skin around the anus:
    o Suggest seat baths.
  • Ensure privacy and welfare of the person:
    o Isolate, install it comfortably, propose basin or “pot chair.”
  • Give some educational tips:
    o To prevent rectal pressure, avoid sheathing.
    o Go to the saddle regularly.
    o Avoid prolonged sitting.
    o Explain measures to alleviate symptoms.

Nursing assessment

  • Decreased pain at defecation.
  • Decreased abdominal bloating.
  • Decreased effort to defecation.
  • Decreased sensation of incomplete evacuation.
  • Decreased associated signs.

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