Bowel Regimen

  1. I am new to home hospice and palliative care. My background is mainly ICU.... where bowel issues are more excessive diarrhea, rather than constipation.

    What is a good bowel regimen for a hospice patient? I can't seem to figure it out, not having experience with it and I am a little embarrased. What should be daily and PRN? If a patient has not been eating, hasn't had a BM in 4 days and has positive BS and abdomen is soft and po senna is not making a BM, do we go to a suppository?

    I'm almost embarassed to really tell my bosses who have been doing this for 20 years, I don't know what the best combos are for patients.
    •  
  2. 4 Comments

  3. by   FreckledCoffeeRN
    I'm no expert in the least but a fellow nurse that I work with, has like a 15 yr history working in nursing home (We work Tele) said that what always worked with her patients was warm milk and prune juice mixed (1:1 ratio, but must be warm) and when what always worked didn't work warm milk and molasses.

    I don't know if your patients are able, or want to eat/drink anything but it's a nice nonpharmacological measure to try, and if not- then maybe you can take the tip home with you for whenever you have that family member that knows you're a nurse and asks you to look at every scratch, bump, and constipation issue. lol

    Cassie
  4. by   tewdles
    warm prune juice with MOM?
    colace
    senna
  5. by   MomRN0913
    Thanks! Senna seems the to be the popular go-to in our hospice. That was working for a patient who was also drinking fresh made apricot juice. Then they broke out the MOM and said she used to use this with success, so I said go for it.

    I called and found out it did the trick. My patient really did not want a supository, so I am glad it worked! I think I am scared of overstimulating their bowels and that they are going to get harsh dehydrating diarrhea.
  6. by   momof2guys
    At my company how we deal w/constipation is base on what disease process is creating the problem ie: pain meds vs liver disease. If pain med we start senna plus then advance toward ducolax supp after rectal check for impaction. If liver issues we start w/ lactulose TID daily. Hope this bit of info helps.

close