Nursing Diagnosis:Risk for Constipation
Risk factors may include
- Irritation of the GI mucosa from either chemotherapy or radiation therapy;malabsorption of fat
- Hormone-secreting tumor, carcinoma of colon
- Poor fluid intake, low-bulk diet, lack of exercise, use of opiates/narcotics
Possibly evidenced by
[Not applicable; presence of signs and symptoms establishes an actual diagnosis]
- Bowel Elimination
- Maintain usual bowel consistency/pattern.
- Verbalize understanding of factors and appropriate interventions/solutions related to individual situation.
Risk for Constipation-Cancer Nursing Care Plan
|Ascertain usual elimination habits.||Data required as baseline for future evaluation of therapeutic needs/effectiveness.|
|Assess bowel sounds and monitor/record bowel movements (BMs) including frequency, consistency (particularly during first 3–5 days of Vinca alkaloid therapy).||Defines problem, i.e., diarrhea, constipation. Note: Constipation is one of the earliest manifestations of neurotoxicity.|
|Monitor I&O and weight.||Dehydration, weight loss, and electrolyte imbalance are complications of diarrhea. Inadequate fluid intake may potentiate constipation.|
|Encourage adequate fluid intake (e.g., 2000 mL/24 hr), increased fiber in diet; regular exercise.||May reduce potential for constipation by improving stool consistency and stimulating peristalsis; can prevent dehydration associated with diarrhea.|
|Provide small, frequent meals of foods low in residue (if not contraindicated), maintaining needed protein and carbohydrates (e.g., eggs., cooked cereal, bland cooked vegetables).||Reduces gastric irritation. Use of low-fiber foods can decrease irritability and provide bowel rest when diarrhea present.|
|Adjust diet as appropriate: avoid foods high in fat (e.g., butter, fried foods, nuts); foods with high-fiber content; those known to cause diarrhea or gas (e.g., cabbage, baked beans, chili); food/fluids high in caffeine; or extremely hot or cold food/fluids.||GI stimulants that may increase gastric motility/
frequency of stools.
|Check for impaction if patient has not had BM in 3 days or if abdominal distension, cramping, headache are present.||Further interventions/alternative bowel care may be needed.|
|Monitor laboratory studies as indicated, e.g., electrolytes.||Electrolyte imbalances may be the result of/contribute to altered GI function.|
|Administer IV fluids;||Prevents dehydration, dilutes chemotherapy agents to diminish side effects|
|Antidiarrheal agents;||May be indicated to control severe diarrhea.|
|Stool softeners, laxatives, enemas as indicated.||Prophylactic use may prevent further complications in some patients (e.g., those who will receive Vinca alkaloid, have poor bowel pattern before treatment, or have decreased motility).|