constipation - page 2

by adrienurse 16,176 Views | 25 Comments

I was going to post this in the geriatric nursing forum, but issue is not unique to geriatrics. A co-worker and I are doing research on treatment of constipation. We are trying to overhaul our existing system. Does your... Read More


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    For intractable clog-ups, we always go with a Shaw's Cocktail (does anyone know who "Shaw" was??!!)
    - 1-2 tablespoon Senekot granules
    - 1-2 tablespoon Agarol (MOM)
    - 2 crushed durolax tablets
    dissolved in warm water & mixed with melted icecream.
    Tastes like a chocolate thickshake, but GUARANTEED to work within 24 hours!!
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    Warmed up prune juice mixed with a dose of MOM is quite effective and not too harsh for my hospitalized patients. I hate giving the elderly enemas...they are so hard on them. A Dulcolox suppository is my fave if something is needed 'below'...hehe.

    Some poor old folks coming from home (specially those with a bit of dementia) and haven't had a BM in weeks will need need digging out...they can't pass the huge hard mass (unfortunately)..so time for RotoRooter Nurse to go into action...LOL! If they're from LTC they usually have been on a bowel program there and we try to follow it.

    Home patients we try to institute a bowel regimen they can remember...diet and fibre first, then meds if no results. And yes, many docs prefer their own protocols so we nurses have to institute those....
    Last edit by mattsmom81 on Jul 19, '02
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    This is really interesting. I have so many pt's with constipation in homecare. Most secondary to pain meds.

    We tell pt's to inc fluids, eat prunes, and one nurse swears by raisins w excellent results! We also have a handout which rx senna tea w prune juice, 1:1 mix and warmed of course.

    I also think fleets don't do much, and prefer dulcolax sup. Have a lot of pt's on lactulose daily, it keeps them fairly regular, though not ideal, better than being admitted for bowel obstruction.

    I remember one pt, a post op heart, who had major complications post op. He hadn't moved his bowels for 3 weeks, they tried everything!! Finally, they got out the dynamite...a enteral continuous "feeding" of Go-Lytely(bowel prep drink.) It ran for about 3 days before any result, but when he went...let's just say it was a code brown! Every night I worked I prayed it wouldn't be the night he went, b/c I knew it wasn't gonna be pretty!!! God must have heard my prayer, b/c I was off!!! LOL!!!
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    In my assisted living,,,,,, try to deal with it first with diet and plenty of fluid intake,,,,,,
    Prunes,,,,warmed,,,,,, or prune juice,,,warmed,,,,,next,,,,,,,,,,
    Then MOM with the warmed prune juice,,,, works most everytime,,,,,
    LOL,,,, most of my residents are bowel obsessed,,,, so first we have to be sure they are really constipated,,,,, some would like bowel movement everytime they urinate!!!!!!! LMAO,,,, ~Moon
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    The bowel routine for most of our in-patients is MOM 3xs wk at HS, Duloclax suppository 3xs wk in am following the MOM.
    Some patients get rid of this routine when they go home and have had sucess with the bran, applesauce, prune juice concoction that Nurse Ratched posted. The recipe is
    cup prune juice
    1 cup of applesauce
    2 cups all bran cereal
    Place ingredients in a bowl and let sit for 10 minutes.Mix ingredients together.Store in airtight container in the refrigerator for up 2 weeks.
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    Happeewendee
    I KNOW it was a typo (I hope)
    but I was laughing so hard when I read
    "Surfak 1 tab OD..."
    Is that only in the right eye?
    I thought they had come up with a new bowel routine!
    I'm sorry, I have to run after all this bathroom talk....
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    Here in Canada OD means once a day in am. If we mean right eye, we say right eye. :chuckle :chuckle Funny though.
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    Try holistic lower abdominal massage to stimulate peristalsis. It's drug-free and usually works like a charm. Let us know what you think. Hope this helps you out. Warrior Woman.
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    Our unit uses MOM and cascara aka a black and white M-W-F @ HS for the chronics followed by a fleet enema in the am if no results. How I hate those d@mn fleets! Dulcolax supps work better I think. Some receive senna 2-3 tabs OD, w/ a prn B&W, others receive Colace OD or BID and a prn fleets. Seems that no one likes prune juice. We used to use the bran /applesauce mix, but I haven't seen that in a long time. Of course lots of liquids, ^ activities and ROUGHAGE helps, good old Mag citrate works wonders for the more difficult residents and then there's Lactulose--that sweet, sticky, syrupy stuff which you don't ever want to spill! And last but not least, Metamucil OD. If nothing else works, there's always a quarter stick of dynomite that's guaranteed to work EVERY time!
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    Once spilled Lactulose all over my shoe and sock. Not fun!
    Does anyone use microlax enema (no relation to OUR micro). What are H and H enemas?


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