Nursing Dx

Definition: Decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard,dry stool

Related Factors
FUNCTIONAL
Irregular defecation habits; inadequate toileting (e.g., timeliness, positioning for defecation, privacy)
Insufficient physical activity; abdominal muscle weakness
Recent environmental changes
Habitual denial/ignoring of urge to defecate
PSYCHOLOGICAL
Emotional stress; depression; mental confusion
PHARMACOLOGICAL
Antilipemic agents; laxative overdose; calcium carbonate; aluminum-containing antacids; nonsteroidal anti-inflammatory agents; opiates; anticholinergics; diuretics; iron salts; phenothiazides; sedatives; sympathomimetics; bismuth salts; antidepressants; calcium channel blockers
MECHANICAL
Hemorrhoids; pregnancy; obesity
Rectal abscess or ulcer, anal fissures, prolapse; anal strictures; rectocele
Prostate enlargement; postsurgical obstruction
Neurological impairment; megacolon (Hirschsprung’s disease); tumors
Electrolyte imbalance
PHYSIOLOGICAL
Poor eating habits; change in usual foods and eating patterns; insufficient fiber intake; insufficient fluid intake, dehydration Inadequate dentition or oral hygiene
Decreased motility of gastrointestinal tract

Defining Characteristics
SUBJECTIVE
Change in bowel pattern; unable to pass stool; decreased frequency; decreased volume of stool
Change in usual foods and eating patterns; increased abdominal pressure; feeling of rectal fullness or pressure
Abdominal pain; pain with defecation; nausea and/or vomiting; headache; indigestion; generalized fatigue
OBJECTIVE
Dry, hard, formed stool
Straining with defecation
Hypoactive or hyperactive bowel sounds; change in abdominal growling (borborygmi)
Distended abdomen; abdominal tenderness with or without palpable muscle resistance
Percussed abdominal dullness
Presence of soft pastelike stool in rectum; oozing liquid stool; bright red blood with stool; dark or black or tarry stool
Severe flatus; anorexia
Atypical presentations in older adults (e.g., change in mental status, urinary incontinence, unexplained falls, elevated body temperature)

Desired Outcomes/Evaluation
Criteria—Client Will:
• Establish/regain normal pattern of bowel functioning.
• Verbalize understanding of etiology and appropriate interventions/ solutions for individual situation.
• Demonstrate behaviors or lifestyle changes to prevent recurrence of problem.
• Participate in bowel program as indicated.