Definition: decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool.
Common Related Factors
-Inadequate fluid intake
-Low-fiber diet
-Inactivity, immobility
-Medication use
-Lack of privacy
-Fear of pain with defecation
-Habitual denial and ignoring of urge to defecate
-Laxative abuse
-Stress/depression-Tumor or other obstruction mass
-Neurogenic disorders
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
-Verbalized pain or fear of pain with defecation
Common Expected Outcome
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.
Source: Nursing Care Plans Diagnoses, Interventions and Outcomes. Meg Gulanick, 8th Edition.
ETON/NORGINE CONSTIPATION RISK SCALE
LAXATIVES
1. Bulk-forming laxatives:
-Ispaghula husk (Fibrelief, Fybogel, Isogel, Ispagel orange, Regulan).
-Methylcellulose (Celevac).
-Sterculia (Normacol).
2. Stimulant laxatives:
-Bisacodyl
-Dantron (Co-danthramer, Co-danthrusate).
-Docusate sodium (Dioctyl, Docusol, Norgalax Micro-enema).
-Glycerol (Glycerol suppositories).
-Senna (Manevac, Senokot).
-Sodium picosulfate (Dulcolax).
3. Faecal softeners:
-Arachis oil
-Liquid paraffin
4. Osmotic laxatives:
-Lactulose.
-Macrogols (Laxido, Movicol).
-Magnesium salts (Magnesium hydroxide Mixture, Magnesium hydroxide with liquid paraffin, Magnesium sulphate).
-Phosphates (rectal): Carbalax, Fleet Ready-to-use enema, Phosphates Enema.
-Sodium citrate (rectal): Micolette Micro-enema, Micralax Micro-enema, Relaxit Micro-enema.
5. Bowel cleansing solutions: Citrafleet, Citramag, Fleet Phospho-soda, Klean-Prep, Moviprep, Picolax).
6. Peripheral opioid-receptor antagonists (licensed for the treatment of opioid-induced constipation in patients receiving palliative care):
-Methylnaltrexone Bromide (Relistor sc injection).
Source: BNF 57 March 2009.
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