Risk for Constipation | Nursing Care Plan for Renal Dialysis

Nursing diagnosis: risk for Constipation

Risk factors may include
Decreased fluid intake, altered dietary pattern
Reduced intestinal motility, compression of bowel (peritoneal dialysate), electrolyte imbalances, decreased mobility

Possibly evidenced by
(Not applicable; presence of signs and symptoms establishes an actual diagnosis)

Desired Outcomes/Evaluation Criteria—Client Will
Bowel Elimination
Maintain usual or improved bowel function.

Nursing intervention with rationale:
1. Auscultate bowel sounds. Note consistency and frequency of bowel movements (BMs) and presence of abdominal distention.
Rationale: Decreased bowel sounds; passage of hard-formed or dry stools suggests constipation and requires ongoing intervention to manage.

2. Review current medication regimen.
Rationale: Side effects of some drugs, such as iron products and some antacids, may compound problem.

3. Ascertain usual dietary pattern and food choices.
Rationale: Although restrictions may be present, thoughtful consideration of menu choices can aid in controlling problem.

4. Suggest adding fresh fruits, vegetables, and fiber to diet within restrictions, when indicated.
Rationale: Provides bulk, which improves stool consistency.

5. Encourage or assist with ambulation, when able.
Rationale: Activity may stimulate peristalsis, promoting return to normal bowel activity.

6. Provide privacy at bedside commode and bathroom.
Rationale: Promotes psychological comfort needed for elimination.

7. Administer stool softeners, such as Colace or bulk-forming laxatives, such as Metamucil, as appropriate.
Rationale: Produces a softer, more easily evacuated stool.

8. Keep client nothing by mouth (NPO) status; insert NG tube, as indicated.
Rationale: Decompresses stomach when recurrent episodes of unrelieved vomiting occur. Large gastric output suggests ileus, a common early complication of PD, with accumulation of gas and intestinal fluid that cannot be passed rectally.