Nursing Diagnosis for Constipation

Nursing Diagnosis: Constipation Impaction; Obstipation

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

Constipation is a common, yet complex problem; it is especially prevalent among elderly patients. Constipation often accompanies pregnancy. Diet, exercise, and daily routine are important factors in maintaining normal bowel patterns. Too little fluid, too little fiber, inactivity or immobility, and disruption in daily routines can result in constipation. Use of medications, particularly narcotic analgesics or overuse of laxatives, can cause constipation. Overuse of enemas can cause constipation, as can ignoring the need to defecate. Psychological disorders such as stress and depression can cause constipation. Because privacy is an issue for most, being away from home, hospitalized, or otherwise being deprived of adequate privacy can result in constipation. Because "normal" patterns of bowel elimination vary so widely from individual to individual, some people believe they are constipated if a day passes without a bowel movement; for others, every third or fourth day is normal. Chronic constipation can result in the development of hemorrhoids; diverticulosis (particularly in elderly patients who have a high incidence of diverticulitis); straining at stool, which can cause sudden death; and although rare, perforation of the colon. Constipation is usually episodic, although it can become a lifelong, chronic problem. Because tumors of the colon and rectum can result in obstipation (complete lack of passage of stool), it is important to rule out these possibilities. Dietary management (increasing fluid and fiber) remains the most effective treatment for constipation.

Nursing Diagnosis for Constipation

Defining Characteristics
  • Infrequent passage of stool
  • Passage of hard, dry stool
  • Straining at stools
  • Passage of liquid fecal seepage
  • Frequent but nonproductive desire to defecate
  • Anorexia
  • Abdominal distention
  • Nausea and vomiting
  • Dull headache, restlessness, and depression
  • Verbalized pain or fear of pain

Related Factors
  • Inadequate fluid intake
  • Low-fiber diet
  • Inactivity, immobility
  • Medication use
  • Lack of privacy
  • Pain
  • Fear of pain
  • Laxative abuse
  • Pregnancy
  • Tumor or other obstructing mass
  • Neurogenic disorders

Expected Outcomes
  • Patient passes soft, formed stool at a frequency perceived as "normal" by the patient.
  • Patient or caregiver verbalizes measures that will prevent recurrence of constipation.

NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels
  • Bowel Elimination
  • Medication Response
  • Self-Care Toileting

NIC Interventions (Nursing Interventions Classification)
Suggested NIC Labels
  • Constipation/Impaction Management
  • Bowel Training
  • Teaching: Prescribed Medication