Constipation

Domain 3. Elimination and exchange
Class 2. Gastrointestinal function
Diagnostic Code: 00011
Nanda label: Constipation
Diagnostic focus: Constipation

Constipation is a common problem for people of all ages, affecting both mental and physical wellbeing. Nursing diagnosis constipation refers to the diagnosis of this medical condition by a nurse based on their professional knowledge and experience. This includes assessing patient symptoms, gathering medical history and using evidence-based guidelines to accurately diagnose the problem. Constipation can be caused by many different factors, including diet, medication, lifestyle changes, underlying conditions, age and more. It is important to properly understand the potential causes of constipation in order to effectively treat it.

NANDA Nursing Diagnosis Definition

This nursing diagnosis is defined by NANDA (North American Nursing Diagnosis Association) as “the state of having less than three bowel movements per week, with difficulty or discomfort associated with evacuation.” Typical symptoms of constipation include hard stools, abdominal pain, cramping, bloating, and feelings of incomplete evacuation after a period of time. Other related symptoms can include nausea, vomiting and anal fissures.

Defining Characteristics

The defining characteristics of constipation are subjective and objective:

• Subjective: Reports of decreased bowel movements and associated discomfort or difficulty.
• Objective: Fewer than three bowel movements per week, dry or hard stools, abdominal tenderness, feeling of incomplete evacuation, presence of anal fissures.

Related Factors

There are several factors that can contribute to constipation. These can include:

• Diet: A diet low in fiber and water can cause infrequent bowel movements and constipation.
• Medication: Certain medications can interfere with the digestive system and cause constipation. Medications commonly linked to constipation include opioids, antacids, antidepressants, and calcium channel blockers.
• Lifestyle Changes: Stress, lack of exercise and insufficient fluid intake can lead to constipation.
• Underlying Conditions: High blood sugar, thyroid issues, and IBS have been associated with constipation in some cases.
• Age: Babies and older adults are more susceptible to constipation.

At Risk Population

Individuals who may be at risk for constipation include:

• Babies: Breastfeeding babies are less likely to experience constipation than formula fed babies. If a formula-fed baby becomes constipated, a doctor should be consulted.
• Older Adults: As people age, their digestive systems can become less efficient. Eating regularly and getting plenty of exercise can help prevent constipation in seniors.
• Individuals with Chronic Illnesses: People with chronic illnesses, such as cancer, Parkinson’s Disease, and multiple sclerosis, may be more prone to constipation due to taking medications or having muscle coordination issues.

Associated Conditions

There are several conditions which are associated with constipation. These include:

• Hemorrhoids: Hemorrhoids can occur when straining during a bowel movement leading to painful swelling.
• Anal Fissures: Anal fissures are tears in the lining of the anus which can be painful and cause bleeding.
• Impaction: Impaction occurs when a large, hard mass of stool becomes stuck in the intestines, leading to further constipation and other serious complications.

Suggestions for Use

Nursing diagnosis constipation can be used to accurately assess and diagnose patients experiencing constipation and associated health issues. The information gathered through this assessment can be used to develop an effective treatment plan that caters to the individual needs of the patient.

Suggested Alternative NANDA Nursing Diagnosis

For those patients who do not fit into the criteria of nursing diagnosis constipation, there are alternative nursings diagnosis that can be considered. These include:

• Diarrhea: Diarrhea is defined as frequent liquid stools.
• Obstructed Bowel: Obstructed bowel is a blockage in the digestive tract.
• Ileus: Ileus is an obstruction in the ileocecal region of the small intestine.
• Impaired Gas Exchange: Impaired gas exchange is an inability to effectively exchange gases between the air and the lungs.

Usage Tips

When using nursing diagnosis constipation, it is important to remember to carefully assess the patient’s history, make an accurate diagnosis, and provide an appropriate plan of care. Different individuals may respond differently to different treatments and therapies, so it is important to tailor the plan of care accordingly.

NOC Outcomes

The NOC (Nursing Outcomes Classification) has outlined six outcomes related to constipation. These include:

• Fecal Continence:This outcome measures the ability of the patient to control their bowel movements.
• Bowel Elimination: This outcome measures the ability of the patient to complete the process of defecation (bowel elimination).
• Nutrition: This outcome measures the patient’s ability to maintain adequate nutrition.
• Body Weight: This outcome measures the patient’s body weight stability.
• Pain Management: This outcome measures the individual’s ability to effectively manage abdominal and anal discomfort.
• Health Beliefs: This outcome measures the patient’s knowledge and understanding of their condition, the treatments available, and the effects of those treatments.

Evaluation Objectives & Criteria

When evaluating these outcomes, the following criteria should be taken into account:

• Effectiveness: Has the patient achieved improvement in the desired outcome?
• Safety: Has the patient experienced any adverse effects?
• Adherence: Has the patient followed the prescribed treatments and interventions?
• Resource Utilization: Have available resources and services been used appropriately?
• Cost: Has there been an effective balance between cost and value?

NIC Interventions

The NIC (Nursing Interventions Classification) has outlined several interventions related to constipation. These include:

• Dietary Management: Encouraging the patient to increase their fiber and fluid intake, and reduce sugary foods or caffeine.
• Stool Softeners: Administering stool softeners or laxatives as prescribed.
• Exercise: Promoting regular physical activity to help stimulate the bowel.
• Skin Care: Providing care to anal area to protect skin integrity and prevent further complications.
• Therapeutic Communication: Educating the patient on the importance of utilizing available resources and treatment plans.

Nursing Activities

The nurse’s activities related to constipation management include:

• Assessing the patient’s medical history, physical signs and symptoms to determine the cause of constipation.
• Monitoring the patient’s vital signs and other bodily responses.
• Developing an appropriate treatment plan based on the patient’s assessment and individual needs.
• Educating patient and family on proper nutrition, exercise, and available treatments and resources.
• Providing monitoring and support throughout the duration of treatment.
• Evaluating outcomes and adjusting treatments plans as needed.

Conclusion

Nursing diagnosis constipation is an important tool for assessing and treating constipation in patients. Nurses must accurately assess the patient’s history, symptoms and underlying conditions in order to provide an effective plan of care. Through the use of evidence-based guidelines and interventions, nurses can ensure that their patients receive the best possible care.

FAQs

1. What is nursing diagnosis constipation?
   • Nursing diagnosis constipation refers to the diagnosis of this medical condition by a nurse based on their professional knowledge and experience. This includes assessing patient symptoms, gathering medical history and using evidence-based guidelines to accurately diagnose the problem.
2. What are the causes of constipation?
   • The causes of constipation can include diet, medication, lifestyle changes, underlying conditions, age and more.
3. What are the associated conditions of constipation?
   • The associated conditions of constipation include hemorrhoids, anal fissures, and impaction.
4. What are the NOC outcomes related to constipation?
   • The NOC outcomes related to constipation include Fecal Continence, Bowel Elimination, Nutrition, Body Weight, Pain Management, and Health Beliefs.
5. What are the NIC interventions for constipation?
   • The NIC interventions for constipation include Dietary Management, Stool Softeners, Exercise, Skin Care, and Therapeutic Communication.