A Nursing Care Plan On

LOOSE BOWEL MOVEMENT

In Partial Fulfillment of the

Requirements in NCM 207 - RLE

PRE-CLINICAL ROTATION

Submitted to:
MS. VILMA T. ATILLO, RN, MN
Clinical Instructor

Submitted by:
PATRICK JOHN G. FLORES, St. N
BSN 2B - Group 1

August 18, 2022

 Name of Patient: Malachi, Star Age: 26 Sex: Female Room and Bed No.: Rm 242, Bed 1

Chief Complaint: LBM Diagnosis: Attending Physician: Dr. Araw

Date/Time Cues Need Nursing Diagnosis Patient Outcome Nursing Intervention Implemen Evaluation
tation

August 17, Objective: E Risk for constipation as Within 8 hours span a. Encourage the patient to 1 Within 8 hours span
2022 - No bowel L evidenced by no bowel of care, the patient increase fluid intake of of care, the patient
movement I movement. will be able to regain 1.5 to 2 L/day as was able to regain
7-3 Shift - VS taken as M regular pattern of tolerated. regular pattern of
follows: I Rationale: bowel functioning, bowel functioning,
@7am - BP: 120/80 N Patient was admitted last and will specifically R: Adequate fluid intake makes and was specifically
- PR: 78 A August 5 due to LBM and be able to: the stool softer and easier to able to:
- RR: 19 T as stated in NANDA pass throughout the large
I (2021), individuals a. Demonstrate intestine. In addition, a. Demonstrate
O admitted to hospital and behaviors or constipated clients should behaviors or
N experiencing prolonged lifestyle refrain from drinking alcohol, lifestyle
hospitalization are at risk changes to coffee, or tea due to their changes to
for this problem in which prevent diuretic effects. prevent
their regular routine was recurrence of recurrence of
altered. Whereas problem b. Advise the patient to 2 problem
Doenges et. al defines b. State ways on take the recommended b. Stated ways
Risk for Constipation as how to dose of dietary fiber of on how to
vulnerable to a decrease maintain at least 20 to 30 g daily. maintain
in frequency of defecation, regular bowel Encourage intake of regular bowel
which may compromise motions by prune juice. motions by
health. Constipation is naming what naming what
when bowel movements foods to eat R: Patients are encouraged to foods to eat
become less frequent than and the increase their dietary fiber by and the
normal (once or twice a amount of consuming whole grains, bran, amount of
day). fluids to drink. nuts, fruits, and vegetables. fluids to drink.
However, quickly adding fiber to
the diet may cause flatulence, THE GOAL WAS
abdominal cramping, and COMPLETELY MET
References: bloating. Thus, fiber
Herdman, T. H., supplementation should be
Kamitsuru, S., & Lopes, C. introduced in small amounts
(2021). Nanda and gradually increased. Prune
International Nursing juice, a mild natural laxative,
Diagnoses: definitions & has a high fiber content that
classification. Thieme can soften the stools,
Medical Publishers. increasing their bulk and
facilitating intestinal mobility.
Wayne, G. B. (2022b,
March 19). Constipation c. Assist the patient in 3
Nursing Care Plan. doing physical activity
Nurseslabs. and exercise. Consider
https://nurseslabs.com/co isometric abdominal and
nstipation/ gluteal exercises.

R: Walking and mild physical

activity stimulates peristalsis
that promotes defecation.
Allowing individuals to be
physically active facilitates
normal bowel function,
enhances appetite, and
improves the quality of life.

d. Institute a toilet 4
schedule or bowel
training as appropriate.

R: Defecation is considered a
conditioned reflex, which allows
individuals to defecate at
approximately the same time
every day, notably in the
morning or after meals when
the gastrocolic reflex is most
active in stimulating peristalsis,
which makes the defecation
process easy. Developing a
toileting routine and ensuring
privacy will assist normal bowel
function.

e. Digitally eliminate fecal 5

impaction, if necessary.

R: Fecal impaction might make

it difficult to develop a regular
bowel habit.

f. Keep bedside commode 6

and assistive device on
sight.

R: Immediate access to suitable

restrooms helps prevent
unnecessary "accidents."

g. Advise taking probiotics 7

if indicated.

R: Probiotics may serve as an

alternative management for
constipation. They can shorten
bowel transit and soften stools,
most likely by the increased
short-chain fatty acid
concentration.

h. Educate about 8
biofeedback therapy for
constipation
R: The rationale of
neuromuscular training using
biofeedback therapy is to
restore a normal pattern of
bowel function.

i. Provide warm Sitz baths 9

as indicated.

The warm temperature of the

water relaxes the anal
sphincter, relieves painful
defecation, and minimizes
rectal discomfort.

j. Unless contraindicated, 10
encourage the patient to
use the bathroom.

R: A sitting position with knees

flexed straightens the rectum,
enhances abdominal muscles,
and facilitates defecation.

k. Explain the use of 11

pharmacological agents
as ordered.

R: Laxatives are recommended

when non pharmacological
measures such as behavioral
modification and diet are
ineffective in managing
constipation. However, the use
 of laxatives must be Prepared by:
individualized with extra caution
for older adults due to existing
cardiac and renal conditions,
adverse effects, and potential
drug interactions.
Patrick John G.
Flores, St. N

References:

Herdman, T. H., Kamitsuru, S., & Lopes, C. (2021). Nanda International Nursing Diagnoses: definitions & classification. Thieme Medical Publishers.

Davis, F.A., (2016). Nurse's Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales (14th ed.). F.A. Davis Company.

Wayne, G. B. (2022b, March 19). Constipation Nursing Care Plan. Nurseslabs. Retrieved from https://nurseslabs.com/constipation/