Definition of Constipation
Decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool
Defining Characteristics of Constipation
- Palpable rectal or abdominal mass
- Borborygmi, hypoactive or hyperactive bowel sounds, or abdominal dullness on percussion
- Bright red blood with stools; bark-colored or black, tarry stools; hard, dry stools; or oozing liquid stools
- Change in bowel pattern; decreased frequency and volume of stool
- Changes in mental status, urinary incontinence, unexplained falls, or elevated body temperature in older adults
- Distended or tender abdomen and feeling of fullness or pressure
- General fatigue, anorexia, headache, indigestion, nausea, or vomiting
- Severe flatus; straining and possible pain during defecation
Related Factors of Constipation
- Functional: habitual denial or ignoring urge to defecate, irregular defecation patterns, insufficient physical activity
- Psychological: depression, emotional stress, mental confusion
- Pharmacological: aluminum containing antacids, and drugs that affect bowels
- Mechanical: electrolyte imbalance, hemorrhoids, prostate enlargement, rectal abscess, anal fissure, or stricture
- Physiological: change in eating patterns or usual foods, dehydration, inadequate dentition or oral hygiene, insufficient fiber or fluid intake
Nursing Diagnosis for Constipation | Assessment Focus
Nursing Diagnosis for Constipation | Assessment Focus
Assessment Focus (Refer To Comprehensive Assessment Parameters.)
- Elimination
- Nutrition
- Pharmacological function
- Tissue integrity
Expected Outcomes | Nursing Diagnosis for Constipation
The patient will
- Participate in development of bowel program.
- Report urge to defecate, as appropriate.
- Increase fluid and fiber intake.
- Report easy and complete evacuation of stools.
- Have elimination pattern within normal limits.
- Adopt personal habits that maintain normal elimination.
Suggested NOC Outcomes | Nursing Diagnosis for Constipation
Bowel Elimination; Hydration; Nutritional Status: Food & Fluid Intake
Nursing Diagnosis for Constipation | Nursing Interventions
Nursing Diagnosis for Constipation | Nursing Interventions and Rationales
Nursing Interventions of Constipation and Rationales
- Monitor frequency and characteristics of patient’s stool daily. Careful monitoring forms the basis of an effective treatment plan.
- Monitor and record patient’s fluid intake and output. Inadequate fluid intake contributes to dry feces and constipation.
- Provide privacy for elimination to promote physiological functioning.
- Plan and implement an individualized bowel regimen to establish a regular elimination schedule; and exercise routine to promote abdominal and pelvic muscle tone.
- Emphasize importance of responding to urge to defecate. A timely response to the urge to defecate is necessary to maintain normal physiological functioning.
- Teach patient to locate public restrooms and to wear easily removable clothing on outings to promote normal bowel functioning.
- Teach patient to massage abdomen once per day and how to locate and gently massage along the transverse and descending colon. In the older patient, the neural centers in the lower intestinal wall may be impaired, making it more difficult for the body to evacuate feces. Massage may help stimulate peristalsis and the urge to defecate.
- Teach patient sensible use of laxatives and enemas to avoid laxative dependency. Overuse of laxatives and enemas may cause fluid and electrolyte loss and damage to intestinal mucosa.
- Encourage patient to use a bedside commode or walk to toilet facilities to encourage normal position for evacuation. Encourage intake of high-fiber foods to supply bulk for normal elimination and improve muscle tone. Unless contraindicated, encourage fluid intake of 6–8 glasses (1,420–1,900 ml) daily to maintain normal metabolic processes.
- Help patient understand diet modification plan along with dietitian, if appropriate, to encourage compliance with prescribed diet.
Suggested NIC Interventions | Nursing Diagnosis for Constipation
Bowel Management; Constipation/Impaction Management; Exercise Promotion; Fluid Management; Nutrition Management
This is a sample of Nursing Diagnosis for Constipation.
