RISK FOR CONSTIPATION
At risk for a decrease in normal frequency of defecation accompa-
nied by difﬁcult or incomplete passage of stool and/or passage of
excessively hard, dry stool
• Functional: Habitual denial
and ignoring urge to defecate,
recent environmental changes,
inadequate toileting, irregular
defecation habits, insufﬁcient
physical activity, and abdomi-
nal muscle weakness
antacids, laxative overuse, iron
salts, anticholinergics, antide-
antilipemic agents, calcium
channel blockers, calcium
• Mechanical: Rectal abscess or
carbonate, diuretics, sympath-
ulcer, pregnancy, rectal anal
stricture, postsurgical obstruc-
tion, rectal anal ﬁssures, mega-
colon (Hirschsprung’s disease),
electrolyte imbalance, tumors,
rectocele, rectal prolapse, neu-
hemorrhoids, and obesity
omimetics, opiates, and
• Physiological: Insufﬁcient ﬁber
intake, dehydration, inadequate
dentition/oral hygiene, poor
eating habits, insufﬁcient ﬂuid
intake, change in usual
foods/eating patterns, and
decreased motility of GI tract
• Psychological: Emotional stress,
mental confusion, depression
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Risk management
The patient will
• Experience no signs or symptoms of constipation.
• Maintain bowel movement every ______ day(s).
• Consume a high-ﬁber or high-bulk diet, unless contraindicated.
• Maintain ﬂuid intake of ______ ml daily (specify).
• Express understanding of the relationship between constipation
and dietary intake, bulk, and activity.
• Express understanding of preventive measures, such as eating fruit
and whole grain breads and cereals and engaging in mild activity,
SUGGESTED NOC OUTCOMES
Bowel Elimination; Self-Care: Toileting
INTERVENTIONS AND RATIONALES
Determine: Assess bowel sounds and check patient for abdominal
distention. Monitor and record frequency and characteristics of
stools to develop an effective treatment plan for preventing constipa-
tion and fecal impaction.
Record intake and output accurately to ensure accurate ﬂuid
Perform: Initiate bowel program. Place patient on a bedpan or com-
mode at speciﬁc times daily, as close to usual evacuation time (if
known) as possible, to aid adaptation to routine physiological func-
Administer a laxative, an enema, or suppositories, as prescribed,
to promote elimination of solids and gases from GI tract. Monitor
Inform: Teach patient to gently massage along the transverse and
descending colon to stimulate the bowel’s spastic reﬂex and aid in
Instruct patient, family member, or caregiver in the relationship
between diet, activity and exercise, and ﬂuid intake and constipation
to discourage departure from prescribed diet and assist in promoting
Review care plan with patient, family member, or caregiver,
emphasizing the relationship between the risk factors for
constipation and preventive measures to foster understanding.
Attend: Encourage ﬂuid intake of 21⁄2 qt (2.5 L) daily, unless
contraindicated, to promote ﬂuid replacement therapy and hydration.
Manage: Consult with a dietitian about how to increase ﬁber and
bulk in patient’s diet to the maximum amount prescribed by the
physician to improve intestinal muscle tone and promote
Include a program of mild exercise in your care plan to promote
muscle tone and circulation.
SUGGESTED NIC INTERVENTIONS
Bowel Management; Constipation/Impaction Management; Exercise
Promotion; Fluid Management; Fluid Monitoring; Nutrition
Norton, C. (2006, February–March). Constipation in older patients: Effects on
quality of life. British Journal of Nursing, 15(4), 188–192.