Constipation Nursing Diagnosis

Constipation Nursing Diagnosis

1. What concerns would you have about Mr. Gutierrez's health?

Mr. Gutierrez's health concerns are related to his dietary habits and medication history. He prefers taking meat, eggs (in huevos rancheros), and white flour, rather than complex carbohydrates and vegetables with fiber. This high protein, high fat, and high-calorie foods could slow digestion. There would be concerns over his safety with drug administration, especially digoxin, which causes adverse health complications in case of overdose or extended use.

2. What food groups may be missing from Mr. Gutierrez's diet? Could this have any effect on his bowel elimination?

Mr. Gutierrez's diet is lacking in fruits and vegetables. Vitamins confer a host of benefits to the consumer, and missing on them places Mr. Gutierrez at risk of developing health complications associated with the deficiency of vitamins and roughage. Essentially, he is likely to suffer from constipation and difficulty passing stool because food cannot move properly through the digestive tract unless it is fiber-rich.

3. What effects might Mr. Gutierrez's medications have on bowel elimination?

Mr. Gutierrez's medication comprises of stool softeners that increase the bulk in his stool and cause movement of the intestines. The medicine would increase the amount of water in his stool, making the stool softer and easier to pass.

4. What would you do if you were the student nurse and Mr. Gutierrez were your patient?

Vickie is playing the role of a community health nurse, and her primary focus should be on assisting Mr. Gutierrez to take care of his health. If in her position, I would first perform the scene size-up involving Mr. Gutierrez's surroundings. Next, I would perform a preliminary assessment, obtain his medical history, perform a secondary assessment, and provide a reassessment of his condition.

5. What do you see as similarities and differences between the problems of Vickie's former patient and Mr. Gutierrez's bowel problems?

Both Mr. Gutierrez and the previous patient suffer from elimination problems associated with the consumption of too much fat and calorie diets. Both patients stay at home care facilities, implying that their digestion complications could also result from the effects of old age on the gastrointestinal tract. One notable difference, however, is that Mr. Gutierrez has not suffered the effects of high fat and calorie diets for long- his condition has only lasted 48 hours after he took a big meal.

6. What do Mr. Gutierrez's symptoms indicate? How will Vickie determine a diagnosis?

Mr. Gutierrez's symptoms of abdominal bloating and distention indicate that he is suffering from constipation. Vickie will conduct a subjective assessment and a physical examination to determine a diagnosis.

7. What assessment steps will Vickie want to take?

First, she must establish, from the patients’ medical history to ascertain that the symptoms are not caused by an underlying undiagnosed health condition. Next, she should develop Mr. Gutierrez's symptom profile to plan individualized bowel care. The most important consideration of the assessment for Vickie to consider Mr. Gutierrez's medical history when assessing his current symptoms. The following should be taken into account when making the subjective assessment:

• Checking Mr. Gutierrez pattern of elimination, such as stool frequency and consistency of the stool

• Reviewing the possible use of laxative and enema, including their types and frequency.

• Taking Mr. Gutierrez usual eating habits into account- including eating schedules and liquid intake

• Assessing Mr. Gutierrez activity level

• Classifying the current medication usage which may cause constipation

• Evaluating for fear of the pain of defecation

• Considering the degree to which Mr. Gutierrez responds to the urge to defecate.

Vickie should also carry out a physical examination of the patient's abdomen. Considering that Mr. Gutierrez has not passed stool for two days and that the last stool was hard, it is appropriate that Vickie makes observations of perineal movements and does an anal sphincter squeeze. These would reveal the presence of poor muscle coordination, which is suggestive of obstructive defecation. Overall, an inspection of the perineal area should enable her to identify other abnormalities such as fecal soiling, gaping anus, or rectal prolapse.

8. What nursing diagnosis would Vickie choose? What goals would she set?

Nursing diagnosis: Constipation

Nursing goals for alleviating constipation:

• Encourage the patient to prioritize balanced diets comprising of sufficient fiber, fresh fruits, vegetables, and whole grains. Mr. Gutierrez to consume at least 20 grams of fiber every day.

• Encourage him to consume at least 2000 to 3000 ml of fluids per day,

• Regular exercise in moderation

• Prescribe bulk fiber medications such as Metamucil and similar products.