My Nusing Diagnosis is constipation. I know some interventions but the problem is my pt. is NPO. So i cant say increase her fiber intake or anything like that. She is on no laxatives and stool softeners. She had a colon resection. Sorry if this is vague but do you have any ideas for constipation. For example I have intervention: encourage pt to be involved in ADL's and to walk halls every day. Rationale:Movement helps cause an increase in peristalsis. Any ideas. Im stuck thanks.
z's playa 2,056 Posts Apr 19, 2005 Maybe she should be on laxatives or enemas.Glycerin suppositories? Now this may be a big no no but it sees to be the most obvious short of manualy disimpacting the pt. :) Just to let anyone wondering.....I'm only asking if this could be right. I by no means think it is for sure. I was only looking through my diagnosis book and saw this as a possible intervention. I'm learning.Z
Tweety, BSN, RN 32,944 Posts Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 31 years experience. Apr 19, 2005 I don't want to set you behind in your care planning, but constipation isn't the best diagnosis for the post-operative colectomy (or partial colectomy patient). The patient probably isn't constipated, but has a surgically induced ileus, which is normal and takes several days to resolve usually before the bowels move (usually liquid stool at first), and walking definately helps. If I were you I would stick the other post-operative nursing diagnosises and not constipation. Good luck
collegegurl_2003 112 Posts Apr 19, 2005 She has been post op for 10 days that is why I put it also she has not passed gas...I also have others I have to put Like imbalanced nutrition, Excess fluid volume (overhydration from IV fluid), etc Thanks
Tweety, BSN, RN 32,944 Posts Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 31 years experience. Apr 19, 2005 She has been post op for 10 days that is why I put it also she has not passed gas...I also have others I have to put Like imbalanced nutrition, Excess fluid volume (overhydration from IV fluid), etc ThanksStill sounds like the post operative thing going on in the bowels since she's not passing gas, but it after 10 days she should have been doing something by now. It's more like obstipation than constipation. Good luck. Sorry, but I can't come up with any more interventions either.
collegegurl_2003 112 Posts Apr 19, 2005 Thats ok trust me I am so confused right now also..This teacher grades these so hard and I cant come up with anything.
Nikki730 112 Posts Apr 19, 2005 How about digital stimulation? Don't know if the patient would comply though.
Sis123 197 Posts Apr 19, 2005 How could this patient possibly be constipated? A patient coming in for a colectomy will have a complete bowel prep (golytely) then take 2-3 days of heavy duty antibiotics while on a clear liquid diet, then a couple fleets enemas the night before or the morning of surgery. Then the patient has surgery, and goes to the Med/Surg floor with NPO orders.How could this patient be constipated? There's nothing in there! What this patient needs is to walk the hallways to get over the post surgical ileus, pass gas and then pass some stool, usually a small bit of liquid stool (from bile only). Only then do they get to eat anything.
madwife2002, BSN, RN 74 Articles; 4,777 Posts Specializes in RN, BSN, CHDN. Has 26 years experience. Apr 19, 2005 She has been post op for 10 days that is why I put it also she has not passed gas...I also have others I have to put Like imbalanced nutrition, Excess fluid volume (overhydration from IV fluid), etc Thanks10 days sounds a long time pt has to have ileus and that would need further exploration. I would have expected somebody with bowel surgery to have an ileus fo 3-5 days but then for bowel sounds to return.
collegegurl_2003 112 Posts Apr 19, 2005 Well I changed my number one to Nausea My number 1 was Nausea2. Balanced Nutrition Less than3. Excess fluid volume (IV osmol was low and so was H&H)The reason I thought of nausea was because that was why she wasnt eating and b/c of her not eating they had to push IV fluids. So I think the constipation was not on the top of the list b/c she was not eating. Thanks for letting me see it that way.
Nrs_angie, BSN, RN 163 Posts Specializes in Med-Surg, Tele, Vascular, Plastics. Has 2 years experience. Apr 20, 2005 You can use it.... Constipation r/t decreased gastric motility, decreased food or fluid intake, anesthesia, pain medication, narcotics...I also responded to your other post that was in the Student Nurse Assistance category.If she is post op- then she will have been on anesthesia, and will be on pain medication both will increase her risk for developing constipation. Also you have the fact that she has not had any BM for 10 days- that is your objective data. Also since she is nauseated she will have decreased food and fluid intake.
