Constipation | Nursing Care Plan for Disc Surgery

Nursing diagonsis: Constipation related to pain and swelling in surgical area, immobilization, decreased physical activity, altered nerve stimulation, ileus, emotional stress, lack of privacy, changes and restriction of dietary intake

Possibly evidenced by
Decreased bowel sounds
Increased abdominal girth
Abdominal pain or rectal fullness, nausea
Change in frequency, consistency, and amount of stool

Desired Outcomes/Evaluation Criteria—Client Will
Bowel Elimination
Reestablish normal patterns of bowel functioning.
Pass stool of soft or semiformed consistency without straining.

Nursing intervention with rationale:
1. Note abdominal distention and auscultate bowel sounds.
Rationale: Abdominal distention and absence of bowel sounds indicate that bowel is not functioning. Possible cause would be the sudden loss of parasympathetic innervation of the gastrointestinal (GI) system.

2. Use fracture or child-size bedpan until allowed out of bed.
Rationale: Careful movement promotes comfort and reduces muscle tension.

3. Provide privacy.
Rationale: Promotes psychological comfort.

4. Encourage early ambulation.
Rationale: Stimulates peristalsis and thereby facilitates passage of flatus.

5. Begin progressive diet, as tolerated.
Rationale: Solid foods are not started until bowel sounds have returned, flatus has been passed, and danger of ileus formation has abated.

6. Provide rectal tube, suppositories, and enemas, as needed.
Rationale: May be necessary to relieve abdominal distention and promote resumption of normal bowel habits.

7. Administer laxatives or stool softeners, as indicated.
Rationale: Soften stools, promote normal bowel habits or evacuation, and decrease straining.