Nursing Care Plan (NCP): Altered Bowel Elimination

Nursing Care Plan (NCP): Altered Bowel Elimination – Constipation

November 29th, 2012

Nurse Hussein

Constipation is a common condition that affects people of all ages. It can mean that you are not passing stools regularly, or you are unable to completely empty your bowels. Constipation can also cause your stools to be hard, lumpy, large or small. The severity of constipation varies from person to person. Many people only experience constipation for a short time, but for others, constipation can be a chronic (long-term) condition that causes significant pain and discomfort and affects quality of life. (Source: NHS.uk)

Nursing Diagnosis

Constipation related to lowfiber diet and inactivity (as evidenced by infrequent, hard stools; painful defecation; abdominal distention)

Desired Outcomes

Bowel Elimination, as evidenced by

Comfort of stool passage
Stool soft and formed
Passage of stool without aids

Nursing Interventions for Constipation

Nursing Interventions	Rationale
Identify factors (e.g., medications, bed rest, diet) that may cause or contribute to constipation.	Assessing causative factors is an essential first step in teaching and planning for improved bowel elimination.
Encourage increased fluid intake, unless contraindicated.	Sufficient fluid intake is necessary for the bowel to absorb sufficient amounts of liquid to promote proper stool consistency
Evaluate medication profile for gastrointestinal side effects.	Constipation is a common side effect of many drugs including narcotics and antacids.
Teach client how to keep a food diary.	An appraisal of food intake will help identify if client is eating a well-balanced diet and consuming adequate amounts of fluid and fiber. Excessive meat or refined food intake will produce small, hard stools.
Instruct client on a high-fiber diet, as appropriate.	Fiber absorbs water, which adds bulk and softness to the stool and speeds up passage through the intestines.
Instruct her on the relationship of diet, exercise, and fluid intake to constipation and impaction.	Fiber without adequate fluid can aggravate, not facilitate, bowel function.
Encourage verbalization of feelings about exercise or need for exercise.	Perceptions of the need for exercise may be influenced by misconceptions, cultural and social beliefs, fears, or age.
Determine client’s motivation to begin/continue an exercise program.	Individuals who have been successful in an exercise program can assist client by providing incentive and enhancing motivation. For example, a walking partner may be beneficial.
Inform client about the health benefits and physiologic effects of exercise.	Activity influences bowel elimination by improving muscle tone and stimulating peristalsis.
Instruct her about appropriate types of exercise for her level of health, in collaboration with a primary care provider.	Any individual beginning an exercise program should consult a primary care provider primarily for a cardiac evaluation. Client’s age and lack of activity should be considered in planning the level of activity.
Assist client to set short-term and long-term goals for the exercise program.	Realistic goal setting provides direction and motivation.

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