Need help with care plan for constipation

[jdeesbrown]

This is my 1st post, I hope i am in the correct forum and posting this right. I am a 1st semester student writing a care plan on bowel elmination. This is what ive got so far. ND: Constipation rt decreased activity. my goal is to have pt verbalize knowledge of measures that promote bowel elimination, my interventions 1. teach importance of a high fiber diet 2. advise a fluid intake of at lease 2-3 l/day 3. maximize activity level within limitations of pt's endurance, therapy, and pain....here's where I need help. My instructor says our interventions must be related to the etiology. (decreased activity) but my pt is on bedrest because of a fractured foot, so I'm thinking she really cant increase her activity at this time, and I can't think of anything she can do to increase activity, she is 91 yrs old. so I was going to teach her other methods to help with constipation. SO if I want to keep the same goal and interventions what could I change my diagnosis to?

[Clovery]

i don't think you should change the diagnosis if the decreased activity is truly the related factor. but the constipation might also be related to pain meds or change in diet (hospital food). Some other interventions might be to auscultate bowel sounds or change the patient's position if possible. Like have her sit up on the edge of the bed, switch sides that she is laying on, etc. You could also give a stool softener if ordered. I'm not sure your patient needs an in-depth lecture about the high fiber diet if she doesn't usually have a problem with constipation, but you could make sure she has fibrous menu choices like whole grains and fruit, and encourage her to eat them and avoid dairy.

edited to add: 2 to 3 liters of fluid per day seems like a bit much for a 91 yr old. i believe 1.5-2 L is the recommended intake for the elderly. more if they are overweight. is she continent? does she have a foley in? using a bedpan? if not, drinking that much more fluid will cause her to ambulate to the bathroom frequently on a fractured foot. It'd be even worse if she takes Lasix, which is common with geri patients. I think "at least 2" would be better, along with assessing for signs of adequate hydration.

[pc2801]

whatever happened to prune juice? I fractured my patella and was on narcotic pain meds which caused me to have a problem. All the Colace and water I could drink wasn't helping, but the first glass of prune juice one afternoon worked in just a few hours.

[chevyv, BSN, RN]

and warm prune juice is even better.