Constipation

ADS
A decrease in a person's normal frequency of defecation, accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool

Defining Characteristics:
  • Change in bowel pattern; 
  • bright red blood with stool; 
  • presence of soft paste-like stool in rectum; 
  • distended abdomen; 
  • dark, black, or tarry stool; 
  • increased abdominal pressure; 
  • percussed abdominal dullness; 
  • pain with defecation; 
  • decreased volume of stool; 
  • straining with defecation; 
  • decreased frequency; 
  • dry, hard, formed stool; 
  • palpable rectal mass; 
  • feeling of rectal fullness or pressure; 
  • abdominal pain; 
  • unable to pass stool; 
  • anorexia; 
  • headache; 
  • change in abdominal growing (borborygmi); 
  • indigestion; 
  • atypical presentation in older adults (e.g., change in mental status, urinary incontinence, unexplained falls, elevated body temperature); 
  • severe flatus; 
  • generalized fatigue; 
  • hypoactive or hyperactive bowel sounds; 
  • palpable abdominal mass; 
  • abdominal tenderness with or without palpable muscle resistance; 
  • nausea and/or vomiting; oozing liquid stool

Related Factors:

Functional
Recent environmental changes; habitual denial/ignoring of urge to defecate; insufficient physical activity; irregular defecation habits; inadequate toileting (e.g., timeliness, positioning for defecation, privacy); abdominal muscle weakness

Psychological
Depression; emotional stress; mental confusion

Pharmacological
Antilipemic agents; laxative overdose; calcium carbonate; aluminum-containing antacids; nonsteroidal antiinflammatory agents; opiates; anticholinergics; diuretics; iron salts; phenothiazides; sedatives; sympathomimetics; bismuth salts; antidepressants; calcium channel blockers

Mechanical
Rectal abscess or ulcer; pregnancy; rectal anal fissures; tumors; megacolon (Hirschsprung's disease); electrolyte imbalance; rectal prolapse; prostate enlargement; neurological impairment; rectal anal stricture; rectocele; postsurgical obstruction; hemorrhoids; obesity

Physiological
Poor eating habits; decreased motility of gastrointestinal tract; inadequate dentition or oral hygiene; insufficient fiber intake; insufficient fluid intake; change in usual foods and eating patterns; dehydration


NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels
  • Bowel Elimination
  • Hydration
Client Outcomes
  • Maintains passage of soft, formed stool every 1 to 3 days without straining
  • States relief from discomfort of constipation
  • Identifies measures that prevent or treat constipation
NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels
  • Constipation/Impaction Management

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