Nursing Care Plan – Alteration in bowel elimination –Constipation
Related to:
Goals
Intervention
Overall: Resident will
maintain/establish normal
bowel habits.
1. Insufficient
Residents will drink a
Assess for resident for dehydration. Review intake
fluid
minimum of 1500 ml. of
records.
fluid per 24 hours.
Encourage fluid intake up to 1.5 L/day. Offer
residents fluids before and after exercise. Minimize
caffeinated or alcoholic beverages.
If fluid is insufficient, consult physician.
2. Decreased
Resident will eat an
Monitor fibre intake.
fibre in diet.
adequate amount of fibre
Encourage adequate dietary fibre through high
to ensure normal, regular
fibre meal choices.
bowel movements.
Have high fibre choice readily available, ie. Pureed
prunes, bran
Consult dietician if necessary.
3. Decreased
Resident will be as active Encourage resident to participate in exercise
mobility due to
as possible given abilities program
lack of exercise. and health condition.
Walk resident to & from dining room if able.
Encourage resident to move independently.
4. Lack of
Staff will respond
Toilet in an upright (squat) position on toilet,
recognition of
promptly to resident’s
commode or lying on side.
urge to
urge to defecate.
Toilet resident at resident’s usual defecation time,
defecate.
usually after a triggering meal or upon request.
5. Ineffective
Resident will use the least Use bulk-forming laxatives and stool softeners with
peristalsis
invasive method to ensure caution. Moniter exercise levels and fluid intake
regular bowel
before using bulk laxatives and stool softeners.
movements.
Before implementing a bowel routine: Review
recent records for bowel movements; assess for
abdominal distention, and bowel sounds.
Bowel Routine:
Day 1-Increase fluid & fiber intake.
Day 2- Give osmotic or stimulant laxative as
ordered by physician.
Day 3 –Give suppository or enema as ordered by
physician.
6. Medications
Resident will use the
Assess resident for use of constipating
that cause
minimum amount of
medications. Consider impact of polypharmacy.
constipation
constipating medications
Refer to pharmacist for consultation.
required to address health
conditions.
7. Due to lack
Resident will understand
Educate resident and family regarding the impact
of
the reasons for
on elimination of:
understanding
constipation.
- Diet and hydration
of impairments
- medication
- value of regular toileting
- available equipment and supplies.
Initiate and teach bowel routine.
Monitor and educate re: risk factors for secondary
conditions.
References: University of Iowa. 2001. Management of Constipation. RNAO.2005. Prevention of Constipation in the Older Adult
Population. Rehabilitation Nursing Foundation. 2002. Practice Guidelines for the Management of Constipation in Adults. Heart &
Stroke Foundation.2002. Tips and Tools for Everyday Living: A Guide for Stroke Caregivers.
Constipation Nursing Care Plan – NWO. BPG in LTC Initiative Revised June 18, 2007
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