Constipation/Diarrhea | Nursing Care Plan for Anemia

Nursing diagnosis: Constipation/Diarrhea related to Decreased dietary intake, changes in digestive processes Drug therapy side effects

Possibly evidenced by
Changes in frequency, characteristics, and amount of stool
Nausea, vomiting, decreased appetite
Reports of abdominal pain, urgency, cramping
Altered bowel sounds

Desired Outcomes/Evaluation Criteria—Client Will
Bowel Elimination
Establish return to normal patterns of bowel functioning.
Demonstrate changes in behaviors or lifestyle, as necessitated by causative or contributing factors.

Nursing intervention with rationale:
1. Determine stool color, consistency, frequency, and amount.
Rationale: Assists in identifying causative or contributing factors and appropriate interventions.

2. Auscultate bowel sounds.
Rationale: Bowel sounds are generally increased in diarrhea and decreased in constipation.

3. Monitor intake and output (I&O) with specific attention to food and fluid intake.
Rationale: May identify dehydration and excessive loss of fluids or aid in identifying dietary deficiencies.

4. Encourage fluid intake of 2,500 to 3,000 mL/day within cardiac tolerance.
Rationale: Assists in improving stool consistency if constipated. Helps maintain hydration status if diarrhea is present.

5. Recommend avoiding gas-forming foods.
Rationale: Decreases gastric distress and abdominal distention.

6. Assess perianal skin condition frequently, noting changes or beginning breakdown. Encourage and assist with perineal care after each bowel movement (BM) if diarrhea is present.
Rationale: Prevents skin excoriation and breakdown.

7. Discuss use of stool softeners, mild stimulants, bulk-forming laxatives, or enemas, as indicated. Monitor effectiveness.
Rationale: Facilitates defecation when constipation is present.

8. Consult with dietitian to provide well-balanced diet high in fiber and bulk.
Rationale: Fiber resists enzymatic digestion and absorbs liquids in its passage along the intestinal tract and thereby produces bulk, which acts as a stimulant to defecation.

9. Administer antidiarrheal medications, such as diphenoxylate hydrochloride with atropine (Lomotil), and water-absorbing drugs, such as Metamucil.
Rationale: Decreases intestinal motility when diarrhea is present.