Bowel Elimination nursing diagnosis

[Kar1678]

I am doing a complete nursing assessment and need nursing diagnosis for each category (circulation, neuro, elimination, psychosocial, etc.) My patient was admitted with acute bronchitis had a urinary catheter and bowel elimination was normal. I need to come up with a actual nursing diagnosis (cannot be a risk for) for each category and I am at a stand still. Was wondering if anyone had any ideas. Thank you!

[Fiona59]

Consider keeping the elimination normal. Look into dehydration due to use of meds.

[Kar1678]

So there really isn't a nursing diagnosis for keeping her elimination normal since she is "ok" in this area. She was not dehydrated (pitting edema in lower extremities). thanks for any help!

[LadyFree28, BSN, LPN, RN]

So there really isn't a nursing diagnosis for keeping her elimination normal since she is "ok" in this area. She was not dehydrated (pitting edema in lower extremities). thanks for any help!

There is...it's Readiness for Enhanced Bowel Elimination...it's a wellness NANDA diagnosis.

For more nursing diagnoses by system:

http://jxzy.smu.edu.cn/jkpg/UploadFiles/file/TF_06928152357_nursing%20diagnoses%20grouped%20by%20functional%20health%20patterns.pdf

I suggest getting the NANDA book on Amazon.com...this is a great resource in helping identify nursing diagnoses and interventions.

[Kar1678]

Thank you! I have Ackley and another care plan book. I am just stumped as to where to go for a person who says that she is regular, but my teachers want a definitive ND, I could do risk for all day long!

[Kar1678]

Toileting self-care deficit is one I found as well

[Esme12, ASN, BSN, RN]

Toileting self-care deficit is one I found as well

but why would this patient have toileting self care deficit? What evidence do you have? Just becasue the patient has LE edema doesn't mean they can't get constipated from the use of diuretics......

[Esme12, ASN, BSN, RN]

Thank you! I have Ackley and another care plan book. I am just stumped as to where to go for a person who says that she is regular, but my teachers want a definitive ND, I could do risk for all day long!

I use Ackley s well....but it isn't strong in the wellness diagnosis....I use the NANDA I as well.....I think you need to look at the wellness ND ......Readiness for Enhanced Bowel Elimination

[Kar1678]

I thought the toileting self care deficit would work because the edema has her bedridden, she is morbidly obese, had an indwelling catheter as well and she was unable to clean herself after having a BM. That was my thought.

[LadyFree28, BSN, LPN, RN]

I thought the toileting self care deficit would work because the edema has her bedridden she is morbidly obese, had an indwelling catheter as well and she was unable to clean herself after having a BM. That was my thought.[/quote']

True but has more to so with ADL, not bowel; at least I wouldn't pick that as a diagnoses upfront relating to bowel; because the pt's bowel issues are "normal" in elimination pattern; then having a wellness diagnosis I suggested is NOT a bad thing...it's an actual diagnoses to the information at hand.

Not every patient is going to have a "problem" diagnoses; in this category, the patient doesn't; but in other systems this patient has them; having ONE wellness diagnoses is NOT king to hurt...

[nurseprnRN, BSN, RN]

I am actually a member of NANDA-I (any RN can be) and we have just been looking at some new nsg dx and rewriting some older ones. One reason is that for some unknown reason a number of people (alas, many of them nursing faculty) have gotten it into their heads that "risk for" diagnoses are somehow not "actual" or "real." This is, of course, completely wrongheaded, and they recognized it almost as soon as they got wind of faculty doing that in the first place. But in the meantime, nearly a generation of nursing students have carried this fallacy into the workplace. It's nonsense. Nearly all of the nursing diagnoses in the Safety/Protection Domain are "risk for" diagnoses; surely these faculty aren't suggesting that safety and protection are somehow not "actual" or "real" concerns for the nurse?

We would be poor nurses indeed if we did not have the knowledge and ability to foresee potential complications and address prevention as part of a nursing assessment and plan of care. It is perfectly acceptable to use "risk for" diagnoses, and you can tell your faculty s/he is wrong to say otherwise. But meanwhile this is one of the reasons why we were asked to vote on changing the wording on those to "Vulnerable to.." The 2015-2017 edition will be out in due time.

Now, of course, the faculty may be concerned that students will be lazy and stack their care plans with nothing but "risk for" diagnoses without adequate justification. Well, to a point, they are correct-- anybody who's sick enough to be in a hospital should have some actual problems as well as some potential ones. However, "Risk for constipation" is still on the books, as it were, (page 206, Domain 3,Elimination and exchange; Class 2, GI function) and includes functional, psychological, physiological, pharmacological, and mechanical risk factors. I am sure that your patient probably exhibits several of those, and the prudent nurse would indeed be on the lookout for ways to decrease those risks to prevent the complication. You can tell them I said so.

And I don't see a "readiness for enhanced bowel elimination" in NANDA-I Nursing Diagnoses, Definitions and Classifications 2012-2014. There is one for urinary elimination, but not for bowel. Am I missing it? What's the source?

[LadyFree28, BSN, LPN, RN]

Grn, I posted the link; it is NOT from NANDA-I itself.

I have used the readiness for enhanced bowel in my BSN program as an actual diagnosis; that was about 2 years ago I used it on a patient that had no GI issues, and I needed a diagnosis that was not a risk diagnosis; the rationale from my instructor is that risks diagnoses are apparent; I think she wanted is to get out of the safety zone of always risk and use actual and wellness; our clinical theme was more towards health promotion.

I definitely plan on joining NANDA-I.