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bowel incont...

Posted

Im working on a NCP bowel incontinence.....

my patient has left sided hemiparesis and debilitating arthritis so this pt is unable to get OOB to use the restroom.

the problem I am running into is that all of the goals im finding are that pt will be continent of stool...(my pt cant be continent of stool because he/she cant walk).

Are there any other goals that anyone can help me with??

Thanks for any help

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

let's talk about the nursing process and goals for a minute. the nursing process is the problem solving process that we use. in care planning the steps of the nursing process should be followed in order to maximize the problem solving. goals fit under step #3. once the patient is assessed, abnormal data, in this case bowel incontinence, falls out. the patient problem is identified (step #2) and named (nursing diagnosis). in step #3 goals and nursing interventions are brought into the mix and they are based on the signs and symptoms that were assessed back in step #1. when you are thinking about goals you are also thinking about the strategies you will probably employ for this person's bowel incontinence. the idea behind goals is that when these various strategies have been put into action, the goal(s) are what you predict, or expect, will happen. [when you put a new light bulb in a lamp what do you expect that light bulb will do when you turn the lamp on?] long-term goals, overall, can have 3 results:

  • improvement of the patient's condition/remedy
  • stabilization of the patient's condition
  • support for the deterioration of the patient's condition

you know the bowel incontinence may not be "cured" so stabilization may be appropriate as a long term goal for it. however, if one of the interventions you would think of employing is to be something like:

  • patient to be placed on and allowed to remain on bedpan and in high fowler's position for 10 minutes daily after breakfast (to encourage bm).

an appropriate goal would be:

  • to have a daily bm after breakfast per bedpan.

as you can see the intervention and goal are related to each other. if the intervention is done correctly, the goal will result. [if the new light bulb is properly installed in the lamp, there will be light.]

quit looking for goals in care plan books. examine your nursing interventions for the patient. why did you order them? what did you expect to happen when you ordered them? those are your goals--now, you just have to put them into words. it really is that simple. the hard part is thinking up the words so it sounds like professional nursing! you'll lose more sleep over the wording although you clearly know in your mind what you mean.

BluegrassRN

Has 14 years experience.

Why can't your pt be continent of stool? Bowel continence means that they have control over their bowels. If a pt cannot get out of bed, then they use a bedpan. Just because they have limited activity does not automatically equate bowel incontinence.