Constipation Nursing Care Plan
Constipation is when bowel movements become less frequent than normal and is accompanied
by the difficult or incomplete passage of stool. It is a common gastrointestinal symptom affecting
many individuals and contributes to frequent hospitalizations every year. About 33 out of 100
adults ages 60 and above have symptoms of constipation (National Institute of Diabetes and
Digestive and Kidney Diseases).
Constipation can be attributed to many causes such as mechanical factors, medications used,
presence of comorbidities, and impaired rectal sensory-motor dysfunction. If left untreated,
constipation may progress to a more serious problem. Chronic constipation can lead to fecal
impaction, fecal incontinence, hemorrhoids, rectal prolapse, and anal fissure.
Causes
Here are some factors that may be related to constipation:
● Physiological factors
○ Low-fiber diet
○ Inadequate fluid intake
○ Decrease gastrointestinal motility
○ Inadequate oral hygiene
● Functional factors
○ Insufficient activity; immobility
○ Ignoring the urge to defecate
○ Fear of pain with defecation
○ Abdominal muscle weakness
○ Environmental changes
○ Lack of privacy
● Psychological factors
○ Stress
○ Confusion
● Pharmacological factors
○ Chronic use of laxatives
○ Medication use (e.g., anticholinergics, opioids, bile acid sequestrants)
● Mechanical factors
○ Pregnancy
○ Colon, anal, or rectal stricture
○ Diverticulosis
○ Bowel tumors
○ Hirschsprung’s disease
, Signs and Symptoms
The following signs and symptoms characterize constipation:
● Infrequent passage of stool- fewer than three bowel movements per week
● Passage of dry, hard stool
● Passage of liquid fecal seepage
● Frequent but non-productive desire to defecate
● Straining at stools
● Pain upon defecation
● Abdominal pain or distention
● Anorexia
● Dull headache
● Nausea and vomiting
Goals and desired outcomes
The following are the common goals and expected outcomes for constipation.
● Within 4 hours of nursing intervention and treatment, the patient will identify
measures that prevent or treat constipation.
● Within 4 hours of nursing intervention and treatment, the patient or caregiver will
determine measures that will prevent recurrence of constipation.
● Within 8 hours of nursing intervention and treatment, the patient will verbalize relief
from the discomfort of constipation.
● Within 12 hours of nursing intervention and treatment, the patient will maintain
passage of soft, formed stool at a frequency perceived as “normal” by the patient.
Nursing Assessment and Rationales
Assessment of the patient with constipation includes a careful history and physical examination,
followed by appropriate laboratory and radiological investigations. The tests conducted are
directed by the clinical findings and should be used to strengthen the diagnosis and assess the
depth of the problem.
1. Review the patient’s past medical and surgical history.
Past medical history of a client with constipation would reveal the following related conditions
such as:
Constipation is when bowel movements become less frequent than normal and is accompanied
by the difficult or incomplete passage of stool. It is a common gastrointestinal symptom affecting
many individuals and contributes to frequent hospitalizations every year. About 33 out of 100
adults ages 60 and above have symptoms of constipation (National Institute of Diabetes and
Digestive and Kidney Diseases).
Constipation can be attributed to many causes such as mechanical factors, medications used,
presence of comorbidities, and impaired rectal sensory-motor dysfunction. If left untreated,
constipation may progress to a more serious problem. Chronic constipation can lead to fecal
impaction, fecal incontinence, hemorrhoids, rectal prolapse, and anal fissure.
Causes
Here are some factors that may be related to constipation:
● Physiological factors
○ Low-fiber diet
○ Inadequate fluid intake
○ Decrease gastrointestinal motility
○ Inadequate oral hygiene
● Functional factors
○ Insufficient activity; immobility
○ Ignoring the urge to defecate
○ Fear of pain with defecation
○ Abdominal muscle weakness
○ Environmental changes
○ Lack of privacy
● Psychological factors
○ Stress
○ Confusion
● Pharmacological factors
○ Chronic use of laxatives
○ Medication use (e.g., anticholinergics, opioids, bile acid sequestrants)
● Mechanical factors
○ Pregnancy
○ Colon, anal, or rectal stricture
○ Diverticulosis
○ Bowel tumors
○ Hirschsprung’s disease
, Signs and Symptoms
The following signs and symptoms characterize constipation:
● Infrequent passage of stool- fewer than three bowel movements per week
● Passage of dry, hard stool
● Passage of liquid fecal seepage
● Frequent but non-productive desire to defecate
● Straining at stools
● Pain upon defecation
● Abdominal pain or distention
● Anorexia
● Dull headache
● Nausea and vomiting
Goals and desired outcomes
The following are the common goals and expected outcomes for constipation.
● Within 4 hours of nursing intervention and treatment, the patient will identify
measures that prevent or treat constipation.
● Within 4 hours of nursing intervention and treatment, the patient or caregiver will
determine measures that will prevent recurrence of constipation.
● Within 8 hours of nursing intervention and treatment, the patient will verbalize relief
from the discomfort of constipation.
● Within 12 hours of nursing intervention and treatment, the patient will maintain
passage of soft, formed stool at a frequency perceived as “normal” by the patient.
Nursing Assessment and Rationales
Assessment of the patient with constipation includes a careful history and physical examination,
followed by appropriate laboratory and radiological investigations. The tests conducted are
directed by the clinical findings and should be used to strengthen the diagnosis and assess the
depth of the problem.
1. Review the patient’s past medical and surgical history.
Past medical history of a client with constipation would reveal the following related conditions
such as:
