Impaired intestinal elimination

NANDA Nursing Diagnose - Impaired intestinal elimination

Code: 00344
Domain: Domain 3 - Elimination and exange
Class: Class 2 - Gastrointestinal function
Status: Current diagnoses

The NANDA-I diagnosis of 'Impaired intestinal elimination' holds significant relevance in patient care, as it encapsulates a wide range of issues that can profoundly affect a patient's quality of life. Recognizing this diagnosis enables nurses to identify, assess, and implement appropriate interventions, fostering better health outcomes and enhancing overall well-being. By understanding the complexities underlying this diagnosis, healthcare professionals can become proactive in addressing the multifaceted needs of their patients, ensuring both physical comfort and psychological support.

This exploration of the NANDA-I diagnosis 'Impaired intestinal elimination' aims to provide a thorough explanation of its definition, guiding nurses in their clinical assessments. The discussion will encompass critical elements such as defining characteristics that illustrate the diagnosis, related factors that contribute to its manifestation, and at-risk populations that may require increased vigilance. A comprehensive overview will equip practitioners with the knowledge needed to recognize, address, and manage this condition effectively in their practice.

Definition of the NANDA-I Diagnosis

The diagnosis of 'Impaired intestinal elimination' refers to a significant disruption in the normal process of defecation, which can manifest through various symptoms that indicate difficulty in expelling fecal matter from the rectum or an ostomy site. This condition may present with a range of definitional characteristics such as abdominal cramping and pain, constipation, fecal urgency, or sensations of incomplete evacuation, all of which may lead to increased strain during bowel movements. Factors contributing to impaired intestinal elimination can vary widely, including lifestyle modifications that alter routine, psychological stressors like anxiety, inadequate nutritional intake characterized by low fiber and fluid consumption, and physical limitations such as impaired mobility or postural balance. It is particularly relevant to specific at-risk populations, including pregnant individuals, the elderly, and those recovering from surgery, as they may have unique vulnerabilities that exacerbate the condition. Ultimately, this diagnosis highlights the intricate interplay between physiological, psychological, and environmental factors that can impede effective bowel function and overall gastrointestinal health.

Defining Characteristics of the NANDA-I Diagnosis

The NANDA-I diagnosis "Impaired intestinal elimination" is identified by its defining characteristics. These are explained below:

Subjective Symptoms
- Calambres abdominales: These are localized sensations of pain or discomfort, revealing potential dysfunction within the intestinal tract. Symptoms like abdominal cramps can signal an obstruction or inflammatory condition, which directly correlates with impaired elimination as they indicate increased muscular contractions that may not facilitate normal bowel movements.
- Dolor abdominal: This symptom often restricts daily activities and indicates distress within the gastrointestinal system. The presence of abdominal pain demonstrates that the body is experiencing discomfort due to complications in the elimination process, marking an essential part of assessing intestinal functionality.
- Estreñimiento: Defined as difficulty in evacuating bowel contents, it is a primary indicator of impaired intestinal elimination. The frustration and discomfort involved in constipation profoundly affect a patient's quality of life and can lead to further complications like fecal impaction if left untreated.
- Urgencia fecal: The sudden, overwhelming need to defecate can reveal significant issues with bowel control and function. This lack of control can be linked to both the physical aspects of gastrointestinal health and the psychological stress associated with impaired elimination, partially explaining the urgency.
- Necesidad de maniobras manuales para facilitar la defecación: When patients resort to using manual techniques to relieve constipation, it highlights their inability to eliminate waste through normal physiological means, indicating a critical failure in their elimination process.
- Sensación de evacuación incompleta: Feelings of incomplete evacuation after a bowel movement can exacerbate patient stress and anxiety about their condition, reflecting ineffective elimination processes and contributing to ongoing discomfort and potential behavioral impacts on health management.
- Esfuerzo durante la defecación: Engaging in significant effort to defecate indicates that normal transit through the intestines is compromised. This key indicator may reveal underlying mechanical issues like rectal prolapse or pelvic floor dysfunction, which necessitate a comprehensive clinical evaluation.
- Sensación de obstrucción ano-rectal: Patients may describe a feeling of blockage preventing normal defecation, signaling dysfunction in the anal sphincters or rectum, which necessitates further investigation into the broader intestinal health status.
- Sonidos intestinales hiperactivos: Unusual intestinal sounds may indicate high levels of peristalsis or obstructive processes, serving as clinical evidence of gastrointestinal disturbances. These manifestations can lead to insights into the functional status of the bowel and can inform treatment approaches.
Objective Symptoms
- Evidencia de síntomas en criterios diagnósticos estandarizados: This includes measurable and observable data from diagnostic tests that confirm the presence of impaired intestinal elimination, such as imaging studies showing obstructions or lab tests revealing metabolic imbalances. Documenting these standard criteria validates the diagnosis and guides treatment planning.

Related Factors (Etiology) of the NANDA-I Diagnosis

The etiology of "Impaired intestinal elimination" is explored through its related factors. These are explained below:

Altered Routine Changes in daily life routines can significantly impact intestinal habits. Factors such as shift changes in employment or disruptions in a household schedule can lead to irregular bowel movements, as the body thrives on consistency. When normal elimination patterns are disrupted, it can lead to constipation or other elimination issues, as the gastrointestinal system may not be adequately stimulated.
Anxiety Emotional concerns can profoundly alter normal elimination patterns. Anxiety can result in a physiological stress response that slows down intestinal motility, leading to constipation or a decreased urge to defecate. This can create a vicious cycle where constipation exacerbates feelings of anxiety, further impairing intestinal function.
Inadequate Daily Physical Activity A sedentary lifestyle is a major contributing factor to impaired intestinal elimination. Regular physical activity promotes healthy bowel motility through mechanical stimulation of the intestines and aids in the management of stress. A lack of exercise often correlates with constipation and other gastrointestinal issues due to decreased colonic transit time.
Communication Barriers Inability to express needs related to elimination can prevent appropriate interventions. Patients who cannot communicate their bowel habits may not seek help or modify their surroundings, leading to untreated or worsened constipation. This is particularly relevant in populations such as the elderly or those with cognitive impairments.
Early Formula Feeding Infants fed formula may develop different gastrointestinal flora than breastfed infants, potentially predisposing them to constipation later in life. Patterns established in infancy can persist into adulthood, resulting in chronic issues with intestinal elimination.
Excessive Stress Both emotional and physical stress can have adverse effects on intestinal function. Stress can lead to increased tension in the abdominal muscles and a subsequent decrease in the efficiency of digestive processes, including the movement of feces through the colon.
Exposure to Toxins Ingestion of harmful substances, such as chemicals or contaminated food, can disrupt normal gastrointestinal functioning. This can lead to inflammation, altered motility, and ultimately impaired elimination, either through diarrhea or constipation, depending on the nature of the toxin.
Habitual Suppression of Defecation Regularly ignoring the urge to defecate can lead to fecal retention and constipation. This behavior may stem from various factors, including lack of privacy, embarrassment, or fear of pain, reinforcing a vicious cycle of disordered elimination patterns.
Impaired Physical Mobility Reduced mobility hinders the mechanical stimulation of the intestines, often leading to constipation. Patients with decreased physical activity levels, whether due to aging, injury, or illness, may experience significant disruptions in their elimination patterns.
Postural Balance Impairment Adequate posture is vital for effective defecation. Individuals with postural disorders may find it difficult to adopt optimal positions necessary for bowel movements, potentially prolonging the elimination process and leading to chronic constipation or fecal impaction.
Inadequate Access to Safe Drinking Water Dehydration can lead to hardening of stools, making defecation painful and difficult. Without adequate hydration, the colon absorbs too much water from stool, leading to constipation. Therefore, ensuring access to sufficient water is crucial for effective bowel health.
Inadequate Access to Safe Food A poor diet lacking in essential nutrients can contribute significantly to gastrointestinal issues. The absence of proper foods can lead to insufficient fiber intake, resulting in constipation and difficulty in elimination.
Inadequate Fiber Intake A diet low in fiber is a primary cause of constipation. Dietary fiber is essential for promoting bowel regularity and maintaining stool consistency. A lack of fiber leads to harder and less bulky stools, which can greatly hinder the elimination process.
Inadequate Fluid Intake Alongside fiber, sufficient hydration is critical for bowel health. Dehydration leads to hard stools, making elimination painful and difficult. Ensuring adequate fluid intake is vital for maintaining a healthy digestive system and preventing constipation.
Inadequate Knowledge about Rotavirus Vaccination Lack of awareness regarding rotavirus vaccines can increase the susceptibility to gastrointestinal infections resulting in diarrhea, which can also lead to subsequent complications in intestinal function and elimination. Effective education about preventive measures is crucial.
Inadequate Knowledge of Safe Food Preparation Poor food handling practices can result in gastrointestinal infections. This not only compromises gastrointestinal health but can also lead to diarrhea or gastrointestinal distress, further impacting elimination.
Poor Food Storage Knowledge Improper food storage can result in foodborne illnesses, which may greatly impact elimination patterns through diarrhea or other gastrointestinal disturbances. Awareness and education around safe food practices are essential to prevent these issues.
Inadequate Personal Hygiene Practices Poor hygiene can lead to gastrointestinal infections, affecting both the quality and regularity of elimination. Ensuring proper hygiene practices is vital to maintaining gastrointestinal health and preventing complications.
Inadequate Privacy Lack of privacy during the act of defecation can lead to psychological stress and inhibit the urge to eliminate, exacerbating issues of constipation. Providing a private environment is essential to improve gastrointestinal function.
Misuse of Laxatives Overreliance or improper use of laxatives can lead to bowel dependency and altered intestinal motility. This can hinder normal elimination patterns, leading to chronic constipation when laxatives are not used.
Malnutrition Inadequate intake of essential nutrients can significantly impair gastrointestinal health. Malnutrition can lead to poor bowel motility, enhance constipation or diarrhea, and challenge the body's ability to maintain effective elimination.
Substance Misuse The use of drugs or alcohol can disrupt normal gastrointestinal function. Substance misuse may contribute to slowed gut motility or digestive disturbances, resulting in impaired elimination processes.

At-Risk Population for the NANDA-I Diagnosis

Certain groups are more susceptible to "Impaired intestinal elimination". These are explained below:

Gender-Specific Vulnerabilities
- Cisgender Women: Women may experience varied physiological changes throughout their life cycle, such as menstrual cycles, pregnancy, and menopause, which can significantly affect gut motility and hormonal balance. Hormonal fluctuations, particularly during menstruation or pregnancy, can lead to constipation or diarrhea due to changes in body fluid levels and muscle tone in the intestines. Additionally, women tend to have a higher prevalence of conditions such as irritable bowel syndrome (IBS), which can exacerbate issues with intestinal elimination.
Environmental Influences
- Frequent Travelers: Individuals who travel often can encounter changes in diet, hydration, and routine. These shifts may disrupt normal intestinal function, leading to conditions like traveler's diarrhea or constipation. The stress of traveling, combined with changes in water quality and dietary habits, can also lead to gastrointestinal upset and impaired elimination.
- Hospitalized Individuals: The hospital environment often presents multiple stressors for patients, including changes in diet, medication side effects (like opioids), and reduced mobility. These factors can hinder the body’s natural elimination processes. Moreover, the anxiety related to being hospitalized or undergoing procedures can exacerbate gastrointestinal complications.
Age-Related Factors
- Children and Elderly Individuals: Both ends of the age spectrum are at increased risk for impaired intestinal elimination due to differences in digestive and metabolic efficiency. Children may struggle with dietary habits and may not always drink enough fluids or consume adequate fiber. On the other hand, the elderly may experience a decline in gastrointestinal motility, reduced fluid intake, and side effects from medications that can contribute to constipation or difficulty in elimination.
Healthcare Settings
- Individuals in Elder Care: Those receiving care in elder care facilities often face specific health challenges, including diminished cognitive function, decreased mobility, and polypharmacy, all of which can interfere with regular bowel habits. Health care staff may also overlook regular toilet routines, further complicating elimination issues.
- Postoperative Individuals: After surgery, particularly abdominal or pelvic procedures, patients may experience a temporary paralysis of the bowel (ileus) which can lead to delayed or impaired intestinal elimination. The use of narcotic analgesia post-surgery further complicates this issue, as these medications can inhibit bowel motility and lead to constipation.
Socia-Economic Factors
- Pregnant Individuals: Pregnancy causes numerous physical changes that can impact intestinal health. Hormonal changes increase progesterone levels, which can relax the smooth muscle of the intestines, leading to delayed intestinal transit and constipation. Additionally, the pressure of the growing uterus can physically obstruct bowel movements, creating further risk for impaired elimination.

Associated Conditions for the NANDA-I Diagnosis

The diagnosis "Impaired intestinal elimination" can coexist with other conditions. These are explained below:

Critical Illness
Impaired intestinal elimination is frequently observed in patients suffering from critical illnesses. The stress of severe conditions can disrupt the normal functioning of the digestive system due to factors such as altered blood flow and hormonal changes. Additionally, the body's systemic response to critical injury or illness often leads to increased metabolic demands and may compromise gastrointestinal motility and secretion. Understanding this association is essential for nurses in order to implement interventions to stabilize gut function and facilitate recovery, as well as to recognize when to consult a dietitian for possible nutritional interventions.
Developmental Disabilities
Children and adults with developmental disabilities often face barriers to effective communication, which can limit their ability to express gastrointestinal issues. This underreporting can lead to unmanaged constipation or diarrhea, exacerbating their condition. Moreover, their physical limitations may hinder access to adequate care, resulting in further complications. It is critical for nurses to develop tailored care plans that incorporate routine gastrointestinal assessments and promote effective communication strategies for self-advocacy in patients with developmental disabilities.
Enteral Nutrition
The use of enteral feeding, or tube feeding, can significantly affect bowel function and may lead to impaired intestinal elimination. The composition and viscosity of enteral formulas can result in alterations in stool consistency and frequency. The nurse's role involves monitoring the patient’s tolerance to enteral nutrition, adjusting the regimen as necessary, and ensuring proper hydration to mitigate potential complications like constipation or diarrhea.
Immunosuppression
Patients with weakened immune systems, such as those undergoing chemotherapy, are at increased risk for gastrointestinal infections and subsequent impaired elimination. These infections can lead to conditions like diarrhea or constipation, compounding the difficulties in managing intestinal elimination. It is crucial for nursing assessments to include screening for signs of infection and promoting infection control measures to safeguard the gastrointestinal tract of immunocompromised individuals.
Neurocognitive Disorders
Patients with neurocognitive disorders may exhibit parallels in their ability to perceive and control bowel function. Conditions such as dementia can impair judgment and the ability to recognize the bodily cues for elimination, leading to neglect of personal hygiene and exacerbation of elimination issues. Nursing care must focus on creating structured routines, using assistive technologies, and providing education to caregiver staff, facilitating an environment that supports bowel health.
Pharmaceutical Preparations
Certain medications, particularly opioids and antihistamines, are known to impact gastrointestinal motility, resulting in constipation and decreased intestinal elimination. It is vital for nurses to conduct thorough medication reviews to identify potential drug side effects and work collaboratively with the healthcare team to adjust medication regimens or implement side-effect management strategies, ensuring that medications prescribed do not compromise the patient’s gastrointestinal function.
Treatment Regimens
Diverse medical treatments, including surgical interventions and radiation therapy, can alter the flora and function of the gut. These regimens may lead to short- or long-term complications such as ileus, diarrhea, or chronic constipation, impacting intestinal elimination. Careful monitoring and proactive planning for gastrointestinal side effects must be part of comprehensive patient care post-treatment, aimed at preserving intestinal function and quality of life.

NOC Objectives / Expected Outcomes

For the NANDA-I diagnosis "Impaired intestinal elimination", the following expected outcomes (NOC) are proposed to guide the evaluation of the effectiveness of nursing interventions. These objectives focus on improving the patient's status in relation to the manifestations and etiological factors of the diagnosis:

Elimination Pattern
This outcome is crucial as it assesses the regularity and quality of bowel movements. Monitoring the elimination pattern helps evaluate improvements in the frequency and consistency of bowel movements, indicating the resolution of impaired intestinal elimination and overall gastrointestinal health.
Perceived Quality of Life
Evaluating the patient's perception of their quality of life related to bowel functioning is essential. As bowel issues can significantly impact one's psychological and emotional well-being, this outcome helps measure the patient's ability to cope with and adapt to changes in their elimination status, highlighting the psychosocial aspects of care.
Self-Care Behavior
This outcome focuses on the patient's ability to engage in self-care activities that promote healthy elimination, such as dietary changes, exercise, and stress management. It is relevant because an increase in self-care behaviors can prevent or mitigate further issues related to impaired intestinal elimination.
Fluid Intake
Monitoring fluid intake is vital for assessing hydration status and its impact on bowel function. Proper hydration is necessary for maintaining stool consistency and promoting effective elimination. This outcome ensures the patient is adequately hydrating, which is often a key factor in resolving issues related to impaired intestinal elimination.

NIC Interventions / Nursing Care Plan

To address the NANDA-I diagnosis "Impaired intestinal elimination" and achieve the proposed NOC objectives, the following nursing interventions (NIC) are suggested. These interventions are designed to treat the etiological factors and manifestations of the diagnosis:

Bowel Training
Bowel training involves establishing a regular schedule for defecation and promoting bowel habits through interventions such as dietary modifications, fluid intake, and timing. This intervention helps patients regain control over their elimination pattern, thereby improving bowel function and reducing episodes of constipation or incontinence.
Encourage Increased Fluid Intake
This intervention focuses on promoting adequate hydration to facilitate bowel movements. Increasing fluid intake helps to soften stool, prevent constipation, and encourages regular intestinal activity. Education on the importance of fluids in supporting healthy bowel function is also part of this intervention.
Dietary Management
Dietary management entails assessing and modifying the patient's diet to include adequate fiber and to avoid foods that may exacerbate elimination problems. By optimizing nutrition, this intervention supports bowel regularity and overall digestive health, leading to improved elimination patterns.
Physical Activity Promotion
Encouraging physical activity helps stimulate intestinal motility and supports effective elimination. This intervention can include recommending exercises, mobility aids, or simple activities that the patient can engage in, thereby enhancing bowel function and reducing the risks of complications related to immobility.
Medication Management
This intervention includes the assessment and administration of medications that may promote intestinal health, such as laxatives or stool softeners, as indicated. It is essential to evaluate the appropriateness of these medications and educate the patient about their use to manage and improve elimination patterns effectively.

Detailed Nursing Activities

The NIC interventions for the NANDA-I diagnosis "Impaired intestinal elimination" are composed of specific activities that nursing staff carry out to provide effective care. Below, examples of activities for the key identified interventions are detailed:

For the NIC Intervention: Bowel Training

Assess the patient's regular elimination pattern to identify optimal times for bowel training; this helps in scheduling the training effectively according to the patient’s habits.
Encourage the patient to maintain a diary of bowel movements and associated times to track progress and identify trends; this enhances understanding and engagement in their bowel training plan.
Assist the patient in setting a regular routine for bowel elimination, such as after meals, to leverage the gastrocolic reflex; this can improve the effectiveness of bowel training.
Provide education on comfort measures, such as positioning and relaxation techniques, to encourage successful bowel movements during training sessions.

For the NIC Intervention: Encourage Increased Fluid Intake

Assess the patient's current fluid intake and hydration status to set realistic daily fluid goals; adequate intake is crucial for preventing constipation.
Educate the patient on the benefits of increased fluid intake for bowel health and provide options for fluid sources, such as water, herbal teas, and broth.
Develop a fluid intake schedule that includes reminders to drink fluids at regular intervals throughout the day; this helps in promoting consistent hydration habits.
Encourage the use of a marked water bottle or drinking system to visually track fluid intake throughout the day, providing a constant reminder to stay hydrated.

For the NIC Intervention: Dietary Management

Conduct a dietary assessment to identify current nutritional habits and barriers that may contribute to impaired elimination; individualized recommendations are more effective.
Collaborate with a dietitian to create a fiber-rich diet plan that includes fruits, vegetables, and whole grains, which are essential for promoting regular bowel movements.
Educate the patient on identifying and avoiding foods that may exacerbate elimination issues, such as dairy or highly processed foods, to enhance dietary management.
Monitor the patient’s response to dietary changes, adjusting the meal plan as necessary based on their feedback and clinical outcomes.

Practical Tips and Advice

To more effectively manage the NANDA-I diagnosis "Impaired intestinal elimination" and improve well-being, the following suggestions and tips are offered for patients and their families:

Increase Fiber Intake

Adding more fiber-rich foods like fruits, vegetables, and whole grains to your diet can help promote regular bowel movements. Aim for at least 25-30 grams of fiber each day, and gradually increase it to avoid discomfort.
Stay Hydrated

Drinking plenty of water (at least 8 cups a day) is essential for softening stool and preventing constipation. Make it a habit to carry a water bottle and set reminders if necessary.
Establish a Routine

Try to go to the bathroom at the same time every day, ideally after meals. This can help train your body to have regular bowel movements.
Engage in Regular Physical Activity

Regular exercise stimulates gut activity and may promote regular bowel movements. Aim for at least 30 minutes of moderate activity most days of the week, such as walking or swimming.
Limit High-Fat and Processed Foods

Cut down on foods high in fat and sugar, as they can contribute to gut issues. Focus on whole, unprocessed foods to support digestive health.
Monitor Medications

Discuss with your healthcare provider any medications that may affect bowel movements. Some prescriptions can lead to constipation or diarrhea, and adjustments may be necessary.
Manage Stress Levels

Stress can significantly impact your digestion. Practices such as mindfulness, yoga, or deep breathing exercises can help alleviate stress and support your gut health.

Practical Example / Illustrative Case Study

To illustrate how the NANDA-I diagnosis "Impaired intestinal elimination" is applied in clinical practice and how it is addressed, let's consider the following case:

Patient Presentation and Clinical Context

The patient is a 68-year-old female with a history of diabetes mellitus and chronic renal failure. She presented to the clinic with complaints of constipation for the past two weeks, experiencing abdominal discomfort and infrequent bowel movements. The patient reports straining during bowel movements and states that her last bowel movement occurred three days ago.

Nursing Assessment

During the assessment, the following significant data were collected:

Key Subjective Datum 1: Patient reports feeling bloated and has not had a bowel movement in the last three days.
Key Subjective Datum 2: Patient states she is experiencing straining during attempted bowel movements and discomfort in the lower abdomen.
Key Objective Datum 1: Abdominal assessment reveals firm, distended abdomen upon palpation.
Key Objective Datum 2: Vital signs within normal limits, but patient exhibits signs of anxiety regarding her condition.
Key Objective Datum 3: Bowel sounds are decreased upon auscultation.

Analysis and Formulation of the NANDA-I Nursing Diagnosis

The analysis of the assessment data leads to the identification of the following nursing diagnosis: Impaired intestinal elimination. This conclusion is based on the patient’s reported symptoms of constipation, abdominal discomfort, and the physical findings of abdominal distention and decreased bowel sounds, which are consistent with defining characteristics of this diagnosis.

Proposed Care Plan (Key Objectives and Interventions)

The care plan will focus on addressing the "Impaired intestinal elimination" diagnosis with the following priority elements:

Objectives (Suggested NOCs)

Maintain regular bowel elimination patterns.
Decrease patient anxiety related to bowel elimination.

Interventions (Suggested NICs)

Promotion of Bowel Elimination:
- Encourage the patient to increase dietary fiber intake by incorporating fruits and vegetables.
- Assist with hydration by encouraging 8-10 glasses of water daily, unless contraindicated.
Patient Education:
- Provide information on the importance of regular bowel habits and strategies to promote elimination.

Progress and Expected Outcomes

With the implementation of the proposed interventions, it is expected that the patient will have improved bowel mobility, with the resolution of constipation within one week, indicated by regular bowel movements and decreased abdominal discomfort. Continuous monitoring will allow evaluation of the plan's effectiveness.

Frequently Asked Questions (FAQ)

Below are answers to some frequently asked questions about the NANDA-I diagnosis "Impaired intestinal elimination":

What does "impaired intestinal elimination" mean?

"Impaired intestinal elimination" refers to difficulties in the normal process of bowel movements, which may include constipation, diarrhea, or irregular bowel patterns, affecting an individual's overall well-being.

What are the common causes of impaired intestinal elimination?

Common causes include dietary factors (such as low fiber intake), lack of physical activity, side effects of medications, stress, and underlying medical conditions like irritable bowel syndrome or diabetes.

How can impaired intestinal elimination be managed?

Management includes dietary modifications (increasing fiber and fluid intake), regular exercise, establishing a routine for bowel movements, and medication adjustments if necessary. Consulting a healthcare provider is essential for personalized care.

When should I seek medical help for impaired intestinal elimination?

Seek medical help if you experience severe abdominal pain, persistent changes in bowel habits, blood in stools, or if you cannot relieve constipation despite home remedies, as these may indicate a more serious condition.

How can nursing care help with impaired intestinal elimination?

Nursing care can help by assessing bowel patterns, providing education on diet and hydration, assisting with mobility, and monitoring for complications, while also offering emotional support and encouragement throughout the process.