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]

Desired Outcomes

  • 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

Nursing actions Rationale
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).