Diarrhea | Nursing Care Plan for Bariatric Surgery

Nursing diagnosis: Diarrhea related to Rapid transit of food through shortened small intestine , Changes in dietary fiber and bulk, Inflammation, irritation, and malabsorption of bowel

Possibly evidenced by
Loose, liquid stools, increased frequency
Increased and hyperactive bowel sounds

Desired Outcomes/Evaluation Criteria—Client Will
Treatment Behavior: Illness or Injury
Verbalize understanding of causative factors and rationale of treatment regimen.
Follow through with treatment recommendations.
Bowel Elimination
Regain near-normal bowel function.

Nursing intervention with rationale:
1. Observe and record stool frequency, characteristics, and amount.
Rationale: Diarrhea often develops after resumption of diet because of shortened transit time through the GI tract and dumping syndrome. This condition is usually self-limiting, but can cause discomfort and social difficulties when persistent.

2. Encourage diet high in fiber and bulk within dietary limitations, with moderate fluid intake as diet resumes.
Rationale: Increases consistency of the effluent. Although fluid is necessary for optimal body function, excessive amounts contribute to diarrhea.

3. Restrict fat intake, as indicated.
Rationale: Low-fat diet reduces risk of steatorrhea and limits laxative effect of decreased fat absorption.

4. Observe for signs of dumping syndrome such as instant diarrhea, sweating, nausea, and weakness after eating.
Rationale: Rapid emptying of food from the stomach may result in gastric distress and alter bowel function.

5. Assist with frequent perianal care, using ointments as indicated. Provide whirlpool bath
Rationale: Anal irritation, excoriation, and pruritus occur because of diarrhea. The client often cannot reach the area for proper cleansing and may be embarrassed to ask for help.

6. Administer medications such as diphenoxylate with atropine (Lomotil), as indicated.
Rationale: Antidiarrheals may be necessary to control frequency of stools until body adjusts to changes in function brought about by surgery.

7. Monitor serum electrolytes.
Rationale: Large gastric losses potentiate the risk of electrolyte imbalance, which can lead to more serious or life-threatening complications.