Signs and symptoms Objective: >Abdominal tenderness >hypoactive bowel sounds >dry, hard and formed stools Subjective:

>difficulty in passing stools >decreased frequency of defecation >change in eating patterns >patient verbalized: hindi ako makadumi >nagbago ang pagkain ko >masakit ang ilalim ng tiyan ko

Nursing diagnosis Constipation related to activation of renintestinal reflexes secondary to the presence of kidney stones in the renal pelvis

Planning After 7 hours of nursing intervention the client will be able to: >demonstrate behaviors that will help him defecate >understand the information about proper defecation and the intervention to be done to promote defecation >defecate adequately >comply with the health teachings that will be given >participate in the bowel program

Nursing intervention Discuss laxative or enema use

Rationale To inform patient and relative about the benefits of these To know if the patient is at risk for increase pressure and infection secondary to obstruction of the intestines To know the present state of the intestines and check if the patient is at risk for other complications of constipation To improve consistency of stool and facilitate passage through colon To promote soft and moist stool To promote self worth and promote defecation through task repitition

Evaluation After 7 hours of nursing interventions the client was able to: >demonstrate behaviors that will help him defecate >understand the information about proper defecation and the intervention to be done to promote defecation >defecate adequately >comply with the health teachings that will be given >agreed to participate in the bowel program that will be taught by the health care team

Check for fecal impaction

Auscultate abdomen for presence, location and characteristics of bowel sounds

Instruct intake of balanced fiber and bulk in diet

Promote adequate fluid intake Provide privacy and routinely scheduled time for defecation

Support treatment of underlying medical cause Provide sitz bath after stools

To improve body function including bowel For soothing effect to rectal area

Dependent: Administer stool softeners, mild stimulants or bulk forming agents as ordered Administer enemas, digitally remove impacted stool To promote defecation of stools

To promote excretion of stools and remove impacted stools that may cause obstruction in the intestines

Interdependent: Establish bowel program to include glycerin suppositories and digital stimulation as appropriate when long term or To promote healthy and normal defecation of stools and to prevent complications of inability of passing stools

permanent bowel dysfunction is present