Constipation care plan

[alusiq]

I am a first year nursing student and have my clinical placement at LTC facitliy. Can anyone tell me if i am on the right truck? My supervisor is very detail oriented so I want to make sure it looks good. My resources are pretty limited ex. fiber diet.

this is what i came up with

Constipation r/t diverticular disease of intestine, chronic kidney failure aeb type 1, small amount of hard stool, insufficient physical activity, wheelchair dependent, severe obesity (BMI 40.7), hypoactive bowel sound x 4

goal: The client will report a relief from constipation and pass type 2-4 stool (Bristol Stool Chart) by Tuesday, April 3^rd, 2012.

Interventions: The nursing student will Assist the client with passive ROM flexion and extension of knee. Assist the client with active and passive ROM flexion, extension of fingers, wrist, elbow, shoulder and supination and pronation of the forearm. 5 repetitions for each exercise. 15 minutes total.

For my second intervention I wanted to put The nurse will auscultate bowel sounds x 4, each for full 5 minutes if suspected absent sounds.

I cannot encourage more fluid as is because of pitting edema on his legs.

Thank you for any info!!

[psu_213, BSN, RN]

I appreciate you coming here with ideas of your own!

A minor point: hypoactive bowel sounds are not a manifestation of constipation. Poor intestinal motility can make constipation worse, but it does not follow that someone must be constipated if they bowel sounds are hypoactive. Along with that, I really don't think that listening for bowel sounds for 5 minutes is necessary intervention.

I may be missing something obvious, but how does the chronic kidney failure cause his constipation (if it does, write this in terms of non-medical dx.).

[alusiq]

Thank you,

Previous assessments let me came up with this diagnosis of constipation. I am just confused what other intervention I could use beside exercise.

[alusiq]

meds, laxatives are still out of my scope

[Esme12, ASN, BSN, RN]

How about food that assists with digestion of stooling like prunes or prune juice and increased fiber from fruits.

[nurseprnRN, BSN, RN]

constipation r/t diverticular disease of intestine, chronic kidney failure aeb type 1, small amount of hard stool, insufficient physical activity, wheelchair dependent, severe obesity (bmi 40.7), hypoactive bowel sound x 4

not sure how you think renal failure causes constipation. can you clarify? also, insufficient physical activity, wheelchair dependency, and obesity aren't evidence for constipation, either, are they? see if you can reorder these elements so they tell the story more logically.

goal: the client will report a relief from constipation and pass type 2-4 stool (bristol stool chart) by tuesday, april 3^rd, 2012.

this is a good goal, and nicely measurable and specific.

interventions: the nursing student will assist the client with passive rom flexion and extension of knee. assist the client with active and passive rom flexion, extension of fingers, wrist, elbow, shoulder and supination and pronation of the forearm. 5 repetitions for each exercise. 15 minutes total.

none of these are interventions for constipation.hint: look at the things that are causes (after you re-order your information as above) and then think of what nursing interventions could be done for them.

for my second intervention i wanted to put the nurse will auscultate bowel sounds x 4, each for full 5 minutes if suspected absent sounds.

assessments are not interventions. interventions are things you do to change the status quo. what are other interventions that the nurse can do to help bowel function more normally?