Constipation Nursing Care Plan

What is a Constipation Nursing Care Plan template?

Constipation occurs when regular bowel movements decrease, often resulting in challenging or incomplete passage of stool. Affecting nearly 33 out of every 100 adults aged 60 or over, this prevalent gastrointestinal issue contributes significantly to annual hospitalizations (NIDDK, 2019). Constipation can be caused by an array of factors, such as medication use, the presence of comorbidities, and compromised rectal sensory-motor functionality. Bowel function can be impacted by the patient's fluid intake, sedentary lifestyle, and conditions such as diabetes or irritable bowel syndrome. Should the condition go unmanaged, serious issues such as fecal impaction, incontinence, hemorrhoids, rectal prolapse, and anal fissures may develop. 

Using a constipation nursing care plan is key for addressing physiological, functional, psychological, pharmacological, and mechanical factors contributing to or exacerbating constipation. 

This well-designed care plan helps you identify signs and symptoms of the condition and chart the appropriate assessments and interventions needed to meet the goals of care. Common goals of a constipation nursing care plan involve the improvement of bowel functionality and relieving symptoms such as bloating and abdominal pain. Through establishing this care plan, the patient is expected to report a change in stool formation, aiming for a soft and formed stool. The patient will confirm relief from pain and straining during movements and feel empowered with information on prevention actions for constipation in the future. 

How does it work?

Step 1: Gather your resources

Constipation nursing care plans are a valuable resource and essential to keep on hand. Make sure that you have a copy of the free printable PDF when the need arises by either clicking the “Download Template” or “Use Template” button or by searching “ Constipation Nursing Care Plan” on Carepatron’s template library’s search bar on the website or app.

Step 2: Collate Essential Information

Once the patient's key information has been collected, an assessment can be made on the severity and prominence of the patient's constipation. Utilizing the constipation nursing care plan template to ensure all care goals are met, and interventions are clearly charted for is a seamless operation and easily accessible to relevant parties via Carepatron’s centralized workspace. 

The care plan allows for individualized treatment options and acts as a scaffolding to ensure goals of care are met, and the next steps are recorded for future reference or for distribution to other healthcare specialists who are part of the patient's care team. 

Step 3: Store the chart securely

After reviewing the constipation nursing care plan and creating a viable and individualized plan for the patient, you need to secure the plan so that access is only granted to relevant parties. 

Ensure this through Carepatrons HIPAA-compliant free patient records software. Here, all relevant medical records can be safely stored and collated for ease and security. 

When would you use this template?

A constipation nursing care plan is utilized when patients experience difficulties in bowel movements, resulting in infrequent or uncomfortable passage of stool. Here are some potential scenarios where this care plan is used: 

Hospitalized patients

Individuals admitted to hospitals often experience constipation due to various factors such as changes in diet, reduced mobility, medications (like opioids or certain painkillers), dehydration, or the stress of hospitalization. Care plans aim to prevent and manage constipation during their stay.

Elderly care facilities

Older adults are prone to constipation due to age-related changes in bowel function, dietary habits, reduced physical activity, and medication use. Care plans in nursing homes or assisted living facilities focus on strategies to prevent and manage constipation in this population.

Chronic health conditions

Patients with chronic illnesses like irritable bowel syndrome (IBS), diabetes, neurological disorders, or spinal cord injuries often experience constipation as a symptom. Care plans address this issue as part of holistic management for these conditions.

Postoperative recovery

After surgeries, especially abdominal or pelvic procedures, patients commonly experience constipation due to anesthesia, reduced mobility, and changes in bowel function. Care plans include measures to promote bowel regularity and prevent complications post-surgery.

Home healthcare

Patients receiving care at home, particularly those with limited mobility or chronic conditions, may require specific constipation management strategies. Care plans emphasize dietary modifications, hydration, exercise, and medication adjustments to alleviate constipation.

Facilitate client health management smoothly with our all-in-one care plan template and nursing care plan template.

What do the results mean?

When gathering physical, psychosocial, emotional, and diagnostic information, a nursing care plan for constipation will include the following aspects of assessment:

• Assessment for changes in bowels: The frequency, time of day, pain or straining, and any previous charting of laxative or stool softener.
• Observation of stool characteristics: By creating a baseline for future comparison, the intervention's effectiveness can therefore be seen. The amount, consistency, color, and odor will be recorded. Utilizing the Bristol Stool Scale for consistent charting between care staff is key. 

1. Type One: Separate hard lumps, hard to pass.
2. Type Two: Sausage-shaped yet lumpy.
3. Type Three: Sausage-like but with cracks on the surface.
4. Type Four: Sausage-like or snake-like. Soft and smooth.
5. Type Five: Soft blobs with clear-cut edges that are passed easily.
6. Type Six: Fluffy pieces with ragged edges, a mushy stool.
7. Type Seven: Watery with no solid pieces. Entirely liquid.

• Assessment of the patient's lifestyle choices: A sedentary lifestyle and particular diets can trigger constipation, and a clearer picture of lifestyle and habits helps create preventive measures and education in the future to prevent further occurrences. 
• Review of the patient's medical history and current medication use: Medical conditions such as hypothyroidism or the use of opioids can cause constipation. By identifying potential root causes, proper intervention can be made.

• Assessment for the presence of emotional distress: Depression and anxiety, along with stress, may contribute to constipation. 
• Assessment for laxative misuse: Particularly in the older population of patients, excessive use or misuse of stimulant laxatives may be present. 

• Investigation into the cause of pain during stool passing: Difficulty passing stool may be due to hemorrhoids, rectal fissures, or skin breakdown. Identification of these will assist in appropriate intervention. 

If the patient has been constipated for 3-6 months with unsuccessful intervention, then anorectal testing may be required. Below are some of the typical nursing interventions made for treating constipation and assisting in the recovery process:

• Manual disimpaction
• Prescription for laxative or stool softeners and proper use
• Lubrication or anesthetic cream
• Education about lifestyle changes and high-fiber diets
• Promoting adequate fluid intake
• Avoiding consumption of gastrointestinal aggravators such as alcohol and caffeine
• Encouragement for daily tracking of it is a chronic issue
• Education on abdominal massage

Research & evidence

Affecting 26% of men and 34% of women over the age of 65, chronic constipation is an issue that requires careful management and the utilization of a thorough nursing care plan (Varma et al., 1988). With an increasing aging population, 75% are prescribed laxatives within the hospital care or nursing home setting (Varma et al., 1988). This jarring figure leads healthcare professionals to review how we manage, assess, and treat the condition and whether all interventions are being considered before using laxatives. 

The straining and pain associated with constipation is a concerning symptom and highlights the importance of quick instigation of a well-made care plan for quick and long-lasting relief. Constipation can be a concern for those recovering from surgery, receiving narcotic-based care within the palliative care setting, and for individuals with gastrointestinal issues (Hungin, 2021). The presence of chronic constipation can be an indicator of a much larger health issue. Work completed by Guérin et al. (2014) found links between chronic constipation and colorectal cancer, as well as benign colorectal neoplasms. 

Utilizing a uniform charting and reference system like the Bristol Stool Scale is paramount for accurate charting and effective management of the intervention. This is a well-known grading tool with research backing just how widespread its use and comprehension is for both healthcare professionals and patients (Amarenco, 2014). By implementing, encouraging, and educating on using the Bristol Stool Chart, better health outcomes and accurate intervention success can be seen. 

References

Amarenco, G. (2014). Bristol Stool Chart: étude prospective et monocentrique de “l’introspection fécale” chez des sujets volontaires. Progrès En Urologie, 24(11), 708–713. https://doi.org/10.1016/j.purol.2014.06.008

Guérin, A., Mody, R., Fok, B., Lasch, K. L., Zhou, Z., Wu, E. Q., Zhou, W., & Talley, N. J. (2014). Risk of developing colorectal cancer and benign colorectal neoplasm in patients with chronic constipation. Alimentary Pharmacology & Therapeutics, 40(1), 83–92. https://doi.org/10.1111/apt.12789

Hungin, A. P. (2021). Chronic Constipation in Adults: the Primary Care Approach. Digestive Diseases. https://doi.org/10.1159/000516489

NIDDK. (2019, March 14). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/

Varma, J. S., J. Bradnock, Smith, R., & Smith, A. N. (1988). Constipation in the elderly. Diseases of the Colon & Rectum, 31(2), 111–115. https://doi.org/10.1007/bf02562640