Nursing diagnosis – PERCEIVED CONSTIPATION

PERCEIVED  CONSTIPATION

DEFINITION

Self-diagnosis of constipation and abuse of laxatives, enemas, and

suppositories to ensure a daily bowel movement

DEFINING CHARACTERISTICS

• Expectation of passage of stools at the same time each day

• Overuse of laxatives, enemas, and/or suppositories

RELATED FACTORS

• Cultural health beliefs

• Faulty appraisal

• Family health beliefs

• Impaired thought processes

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Activity/exercise

• Elimination

• Coping

• Fluid and electrolytes

• Behavior

• Nutrition

• Emotional

EXPECTED OUTCOMES

The patient will

• Decrease use of laxatives, enemas, or suppositories.

• State understanding of normal bowel function.

• Discuss feelings about elimination pattern.

• Have a return-to-normal elimination pattern.

• Experience bowel movement every _____ day(s) without laxatives,

enemas, or suppositories.

• State understanding of factors causing constipation.

• Get regular exercise.

• Describe changes in personal habits to maintain normal

elimination pattern.

• State intent to use appropriate resources to help resolve emotional

or psychological problems.

SUGGESTED NOC OUTCOMES

Adherence Behavior; Bowel Elimination; Health Beliefs; Health

Beliefs: Perceived Threat; Knowledge: Health Behavior

INTERVENTIONS AND RATIONALES

Determine: Assess patient’s dietary habits and encourage modification

to include adequate fluids, fresh fruits and vegetables, and whole grain

cereals and breads, which supply necessary bulk for normal elimination.

Perform: If not contraindicated, increase patient’s fluid intake to about

3 qt (3 L) daily to increase functional capacity of bowel elimination.

Establish and implement an individualized bowel elimination regi-

men based on the patient’s needs. Knowledge of normal body func-

tions will improve patient’s understanding of problem.

Inform: Explain normal bowel elimination habits so patient can bet-

ter understand normal and abnormal body functions.

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Instruct patient to avoid straining during elimination to avoid tis-

sue damage, bleeding, and pain.

Instruct patient that abdominal massage may help relieve discom-

fort and promote defecation because it triggers bowel’s spastic

reflex.

Inform patient not to expect a bowel movement every day or even

every other day to avoid the use of poor health practices to stimu-

late elimination.

Attend: Encourage patient to engage in daily exercise, such as brisk

walking, to strengthen muscle tone and stimulate circulation.

Encourage patient to evacuate at regular times to aid adaptation

and routine physiological function.

Urge patient to avoid taking laxatives, if possible, or to gradually

decrease their use to avoid further trauma to intestinal mucosa.

Reassure patient that normal bowel function is possible without lax-

atives, enemas, or suppositories to give patient the necessary confi-

dence for compliance.

Manage: Give information about self-help groups, as appropriate, to

provide additional resources for patient and family.

SUGGESTED NIC INTERVENTIONS

Anxiety Reduction; Bowel Management; Counseling; Health Educa-

tion; Nutrition Management; Teaching: Individual

Reference

Hernando-Harder, A. C., et al. (2007, March). Intestinal gas retention in

patients with idiopathic slow-transit constipation. Digestive Diseases and
Sciences. [Epub ahead of print.]

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