RISK FOR DYSFUNCTIONAL
Risk for increased, decreased, ineffective, or lack of peristaltic activity
within the gastrointestinal system
• Abdominal surgery
• Gastroesophageal reﬂux
• Unsanitary food preparation
• Decreased gastrointestinal
• Pharmaceutical agents (e.g.,
narcotics, antibiotics, proton
pump inhibitors, and laxatives)
• Food intolerance (e.g., gluten,
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Physical regulation
The patient will
• Maintain adequate ﬂuid and electrolyte balance.
• Identify diet selections and lifestyle changes that would promote
healthy GI function.
• Not experience altered GI motility related to prescribed
• Recognize chronic conditions that may contribute to altered GI
motility, for example, diabetes, GERD.
SUGGESTED NOC OUTCOMES
Electrolyte and Acid–Base Balance; Fluid Balance; Bowel Elimination
INTERVENTIONS AND RATIONALES
Determine: Assess patient for signs of ﬂuid or electrolyte imbalance
related to increased or decreased GI motility. Fluid and electrolyte
alterations can result from either increased or decreased
Assess patient for positive risk factors for altered GI motility. This
will allow for timely interventions to prevent complications associ-
ated with GI dysfunction.
Perform: Assist patients taking prescribed medications that affect
motility with strategies to avoid GI complications. Awareness of pre-
ventive measures will decrease GI complications.
Encourage early ambulation for postoperative patients receiving
opioids for pain control. Early ambulation will reduce the risk of
Inform: Educate patient regarding the risk factors related to altered
GI motility, including certain food choices, ﬂuid intake, medications,
and activity. Promotion of healthy lifestyle choices will contribute to
positive patient outcomes.
Attend: Provide encouragement and support for behaviors that
enhance gastrointestinal health. Positive reinforcement results in
improved conﬁdence in self-management of health behaviors.
Manage: Coordinate care with other disciplines as needed to
reinforce positive behaviors or to assist with complex situations.
SUGGESTED NIC INTERVENTIONS
Diarrhea Management; Electrolyte Monitoring; Fluid Management;
Mazumdar, A., Mishra, S., Bhatnagar, S., & Gupta, D. (2008). Intravenous
morphine can avoid distressing constipation associated with oral morphine:
A retrospective analysis of our experience in 11 patients in the palliative
care in-patient unit. The American Journal of Hospice & Palliative Care,