Perceived constipation

Domain 3. Elimination and exchange
Class 2. Gastrointestinal function
Diagnostic Code: 00012
Nanda label: Perceived constipation
Diagnostic focus: Constipation

Nursing diagnosis is a field of nursing which focuses on identifying potential healthcare issues among patients and formulating individualized plans for care. One of the most common concerns among patients who visit healthcare facilities is perceived constipation, where sufferers believe they have underlying bowel issues which lead to frequent constipation or irregular bowel movements.

NANDA Nursing Diagnosis Definition

NANDA-International (NANDA-I) defines perceived constipation as “a state in which an individual perceives difficulty with defecation characterized by infrequent, inadequate or difficult evacuation of stools”. This can be caused by many factors such as emotional distress, stress, mental health issues such as depression, physical health conditions and other lifestyle concerns.

Defining Characteristics

Subjective

When evaluating a patient for perceived constipation, many healthcare professionals focus on the subjective defining characteristics. These characteristics can include:

• Frequent complaints of difficulty passing stool;
• Excessive straining during attempts to defecate;
• Reports of feelings of incomplete rectal emptying;
• Long periods of time between bowel movements;
• Feelings of being unable to empty the bowel;
• Abdominal discomfort and bloating;
• Symptoms of nausea, fatigue, and/or abdominal cramps.

Objective

The objective defining characteristics of perceived constipation may include:

• Infrequent bowel movements (less than 3 times per week);
• Small, hard bowel moments;
• Decreased intestinal sounds;
• Abdominal tenderness and pain when palpated;
• Loss of normal postural changes associated with defecation;
• Evidence of excessive straining during voiding;
• Lack of blood flow to the colon and rectum.

Related Factors

Perceived constipation is often caused by various physical, psychological, and lifestyle factors. Physical factors may include medical conditions such as diabetes, Parkinson's disease, multiple sclerosis, and spinal cord injuries, while psychological issues such as depression and anxiety are also known to cause constipation. Everyday lifestyle behaviors such as inadequate hydration, lack of exercise, and poor dietary habits can also contribute to constipation.

Suggestions Of Use

When treating patients for perceived constipation, it is essential for healthcare professionals to assess possible underlying causes and create appropriate treatments to address those causes. In cases of physical illness or medical conditions, it may be necessary to treat the condition itself in order to resolve the constipation. Additionally, lifestyle modifications such as increasing water intake, exercising regularly, and consuming sufficient amounts of dietary fiber can be recommended to help alleviate or prevent constipation.

Suggested Alternative NANDA Nursing Diagnoses

In addition to perceived constipation, there are other recognized NANDA Nursing Diagnoses which can indicate possible underlying issues when evaluating chronic constipation. Some of these diagnoses include:

• Ineffective Health Maintenance;
• Risk for Impaired Skin Integrity;
• Impaired Comfort;
• Activity Intolerance;
• Bowel Incontinence;
• Impaired Skin Integrity;
• Risk for Fluid Volume Deficit;
• Impaired Tissue Integrity;
• Imbalanced Nutrition: Less Than Body Requirements.

Usage Tips

It is important for healthcare professionals to remember that when diagnosing and treating perceived constipation, it is critical to recognize any possible underlying causes of the condition, in order for successful treatment. Additionally, it is beneficial for healthcare providers and patients to collaborate, so that any lifestyle modifications can be implemented as well.

NOC Outcomes

The Nursing Outcomes Classification (NOC) system provides a standardized approach to measuring a patient's outcome to a plan of care. The following NOC outcomes are associated with perceived constipation:

• Bowel Elimination: Ability to empty the bowel at predetermined intervals and consistency.
• Comfort Level: Management of physical and psychological distress.
• Fluid Balance: Balance between fluid intake and output.
• Coping: Capacity to learn and use effective strategies to respond to threatening event or challenge.
• Nutrition: Provision of a balanced diet, including appropriate hydration.

Evaluation Objectives and Criteria

When assessing the effectiveness of treatments for perceived constipation, healthcare professionals will evaluate:

• The patient's ability to pass stool in a normal, timely manner;
• The consistency of the stool material;
• The patient's comfort level;
• The patient's fluid and nutrition balance;
• The patient's overall coping abilities.

NIC Interventions

The Nursing Interventions Classification (NIC) system is the primary index for nursing interventions, containing evidence-based instructions for nursing interventions. Some NIC interventions applicable to the treatment of perceived constipation include:

• Bowel Training: Structured program of timed toilet visits to help establish regular bowel habits.
• Hygiene: Initiation of routine bathing and grooming practices.
• Diet Monitoring: Promotion of healthy eating habits by monitoring food intake.
• Nutrition Therapy: Intervention aimed at providing patients with information on healthy nutrition.
• Stool Softeners: Administration of medications such as Dulcolax or Colace to aid in the elimination of stool.

Nursing Activities

To provide optimal care to patients suffering from constipation, there are certain nursing activities which should be carried out. These nursing activities include:

• Assessing and recording patient symptoms;
• Collaborating with the patient to create an individualized plan of care;
• Incorporating lifestyle modifications for improved comfort and elimination;
• Providing education on proper nutrition, exercise, and hygiene habits;
• Initiating bowel training exercises;
• Administering prescribed medications;
• Monitoring the patient's progress and adjusting care as needed.

Conclusion

Perceived constipation is a common concern among patients who visit healthcare facilities and can be caused by a variety of physical, psychological, and lifestyle explanations. When assessing and treating this condition, healthcare providers must recognize any potential underlying causes and create an individualized plan of care. With the right interventions, patients can experience improved comfort, nutrition and fluid balance, bowel habits, and overall functioning.

FAQs

Q1: What is perceived constipation?
A1: Perceived constipation is a state in which an individual perceives difficulty with defecation characterized by infrequent, inadequate or difficult evacuation of stools.

Q2: What are the defining characteristics of perceived constipation?
A2: The defining characteristics of perceived constipation may include frequent complaints of difficulty passing stool, excessive straining during attempts to defecate, reports of feelings of incomplete rectal emptying, long periods of time between bowel movements, feelings of being unable to empty the bowel, abdominal discomfort and bloating, and symptoms of nausea, fatigue, and/or abdominal cramps.

Q3: What underlying causes can lead to perceived constipation?
A3: Underlying causes of perceived constipation may include medical conditions such as diabetes, Parkinson's disease, multiple sclerosis, and spinal cord injuries, psychological issues such as depression and anxiety, and everyday lifestyle behaviors such as inadequate hydration, lack of exercise, and poor dietary habits.

Q4: What are some treatments for perceived constipation?
A4: Treatments for perceived constipation include assessing for possible underlying causes and creating appropriate treatments to address those causes, incorporating lifestyle modifications such as increasing water intake, exercising regularly, and consuming sufficient amounts of dietary fiber, and administering medications such as stool softeners.

Q5: What are the associated NOC outcomes of perceived constipation?
A5: The Nursing Outcomes Classification (NOC) system associated with perceived constipation includes Bowel Elimination, Comfort Level, Fluid Balance, Coping, and Nutrition.