concept map for bowel elimination

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Specializes in NICU, Labor and Deliver, ED.

Hello all,

I'm writing a concept map for bowel elimination for simulation lab. I need just one nursing diagnosis, and my teacher told me to use "alteration in elimination", but my diagnosis book doesn't have that...and I can't really find it online.

Here's the scenario:

My "patient" has an ileostomy due to fecal drainage into an abdominal wound. They diverted the stool to allow the abd wound to heal better.

I essentially was thinking: Alteration in elimination R/T ileostomy bowel diversion AEB...and that's where I struggle. I want to say AEB a pouch attached to her abdomen and stool in it! But I'm sure that wont be acceptable.

Please help!

Thank you all in advance,

Sophie

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Specializes in NICU, Labor and Deliver, ED.

Hello all,

I'm writing a concept map for bowel elimination for simulation lab. I need just one nursing diagnosis, and my teacher told me to use "alteration in elimination", but my diagnosis book doesn't have that...and I can't really find it online.

Here's the scenario:

My "patient" has an ileostomy due to fecal drainage into an abdominal wound. They diverted the stool to allow the abd wound to heal better.

I essentially was thinking: Alteration in elimination R/T ileostomy bowel diversion AEB...and that's where I struggle. I want to say AEB a pouch attached to her abdomen and stool in it! But I'm sure that wont be acceptable.

Please help!

Thank you all in advance,

Sophie

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Specializes in Complex pedi to LTC/SA & now a manager.

There is no such nursing diagnosis as "altered elimination " hence why you cannot find it.

The current NANDA-I nursing diagnosis relating to bowel elimination are:

Constipation

Perceived Constipation

Risk for constipation

Diarrhea

Dysfunctional GI motility

Risk for dysfunctional GI motility

Bowel incontinence

(Ileostomy is not a related factor or defining characteristic for any of the above)

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Specializes in Complex pedi to LTC/SA & now a manager.

As I replied to your other post, there is no such nursing diagnosis as altered elimination.

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Specializes in NICU, Labor and Deliver, ED.

OK, thanks!

But none of those apply to my patient at all. Perhaps I could use Risk for dysfunctional GI motility R/T inadequate dietary intake, AEB minimal stool output in ileostomy bag...secondary to.....?

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Specializes in Complex pedi to LTC/SA & now a manager.
OK, thanks!

But none of those apply to my patient at all. Perhaps I could use Risk for dysfunctional GI motility R/T inadequate dietary intake, AEB minimal stool output in ileostomy bag...secondary to.....?

The definition of risk for dysfunctional GI motility: at risk for increased, decreased, ineffective or lack of peristaltic activity within the GI system.

Inadequate dietary intake is NOT a risk factor.

(There are NO related factors for risk factor nursing dx. Only risk factors)

Is there stool leakage at the stoma site? Are there complications?

You can look at

Delayed surgical recovery (extension of the # of post-op days req to initiate and perform activities that maintain, life, health & well being

Defining factors include: evidence of interrupted healing at surgical area, loss of appetite (with or without nausea), requires help for self-care, fatigue...

Related factors: pain, extensive surgical procedures, obesity, post-OP site infection, prolonged surgical procedure)

Deficient knowledge r/t unfamiliarity with information resources for stoma care, nutrition post ileostomy, AEB patient unfamiliar with stoma care, patient refuses to look at stoma or self-care, patient states " I don't know how to do this (ileostomy care and precautions)"

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I believe I have seen this as a nursing care plan at my facility. If your instructor says it's fine, then use it! I would suggest Altered Elimination r/t abdominal wound AEB need for bowel diversion via ileiostomy.

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Specializes in Complex pedi to LTC/SA & now a manager.

It's still not a valid diagnosis as per NANDA-I 2012-2014.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

This confuses me......Why is your school not using NANDA I?

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Specializes in NICU, Labor and Deliver, ED.

We are using the most up to date NANDA, for this class we have 3 diff teachers..one of which is a little more old school, and she is the one grading my concept map this week and the one who told me to write Alteration in Elimination. I'd rather not use it, as I cannot find it NANDA approved, and I don't feel like using "You said I could!" as an excuse. So risk for motility dysfunction wont work either...ugh, I don't want to feel like I copped out, but the risk for skin excoriation could be used I suppose. Not in those exact words obviously, but she's only had the ileostomy for a couple days, so certainly there is risk. Plus, then my interventions could include making sure she knows how to pouch it herself and empty it without getting it on her skin.

Thoughts?

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Specializes in NICU, Labor and Deliver, ED.

I love the end of this, the R/T and after. But I guess I'm too scared to use a non NANDA diagnosis..that would be the perfect R/T and AEB if I could find a good diagnosis to fit it. Thank you!!

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Specializes in NICU, Labor and Deliver, ED.

Sorry to be confusing. I meant maybe using the deficient knowledge one from JustBeachyNurse's comment on my same thread on a different post. Figured I would just combine them, but left out some pretty pertinent information.

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