CONCEPT MAP Altered Bowel Elimination by vvp81194

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									   CONCEPT MAP                      Altered Bowel Elimination

                            • Recent widow, lives alone.           •   Height: 162 cm (5'4")               •   BP: 128/74
EB                            C/O hard, painful stools             •   Weight: 65 kg (143 lb)              •   Active bowel sounds
78 y.o.      assess           q3–4 days x 1 month.                 •   Temperature: 36.2°C (97.2°F)        •   Abdomen slightly distended
female                        Irregular eating pattern.            •   Pulse: 82                           •   CBC: Hgb 10.8
                                                                   •   Respirations: 20/min                •   UA - negative

                                                                generate nursing diagnosis

                            Constipation r/t low-fiber diet and inactivity (aeb infrequent, hard stools;
                            painful defecation; abdominal distention)

                                            outcome                                       Outcome not met
                                                                                          • Mrs B. has kept a food diary and is able to identify
                                                                                            the need for more fluid and fiber but has not
                                                                                            consistently included fiber in her diet
                                 Bowel Elimination aeb                                    • She has started a walking program with a neighbor
                                 • Comfort of stool passage                                 but is only able to walk for 10 minutes at a time
                                 • Stool soft and formed                                    twice a week
                                 • Passage of stool without aids                          • She states her last bowel movement was 3 days ago

                                 nursing intervention                        nursing intervention

               Constipation/Impaction Management                                                           Exercise Promotion

                                                     activity                                                                         activity

          activity                                                                              activity

                      activity            activity                                                             activity    activity
                                                        Evaluate                                                                         Instruct about
                                                        medication                                                                       appropriate types
Encourage                                               profile for                Determine her                                         of exercise for her
increased fluid                                         gastrointestinal           motivation to                                         level of health, in
intake, unless                                          side effects               begin/continue                                        collaboration with
contraindicated             activity                                               exercise program                  activity            a primary care

   Identity factors                               Instruct on                             Encourage                               Assist her to set
   (e.g., medications,                            a high-fiber diet,                      verbalization                           short-term and
   bed rest, diet) that                           as appropriate                          of feelings                             long-term goals
   may cause or                                                                           about exercise                          for the exercise
   contribute to                                                                          or need for                             program
   constipation                        activity                                           exercise

Instruct her on the relationship           Teach how to keep                                               Inform her about the
of diet, exercise, and fluid               a food diary                                                    health benefits and
intake to constipation and                                                                                 physiologic effects of
impaction                                                                                                  exercise

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