Physical Activity in constipation management
Working in a medical adult day program, I frequently hear about the discomfort that constipation causes. McKay, Fravel and Schoenfelder (2012) describe constipation as a “reduction in the frequency of stool or difficulty in formation or passage of stool.” Clients complain of a stomachache, discomfort and become more irritable. They are often prescribed stool softeners and laxatives, but with the prevalence of polypharmacy, could their constipation be managed by nursing interventions and without additional medications?
According to Kyle (2011), assessing for constipation can be challenging for nurses, as “communication barriers associated with bowel habits and the embarrassment associated with an intimate rectal examination need to be overcome.” The ideal outcome in treating constipation is to establish a bowel regimen which provides relief but also prevents future occurrences of constipation (Kyle, 2011). Lifestyle changes, including exercise, increased fluid intake and increased fiber intake, are recommended as the first interventi...
Patients often have complex care needs, and often present with multiple co-morbidities or problems. The process of conducting a comprehensive nursing assessment, and the coordination of care based on these findings is central to the role of the Registered Nurse (NMBA 2006). Evidence-based interventions must then be planned and implemented in a patient-centred approach in order to achieve agreed treatment goals and optimise health (Brown & Edwards 2012).
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Irritable bowel syndrome (IBS) is a functional GI disorder (FGID) characterized by abdominal pain in association with altered bowel habits in the absence of any identifiable structural or biochemical abnormalities. It is a very common disorder that can have a profound negative impact on a patient’s quality of life and constitutes a considerable social and economic burden on society. Extensive research over the last few decades has led to a better understanding of this complex syndrome and improvements in treatment. After a brief review of the clinical manifestations and diagnosis of IBS, the current understanding of the complex physiological mechanisms contributing to the syndrome will be addressed. The remainder of this paper will focus on a number of important topics at the interface of IBS and psychiatry, including psychiatric comorbidity in IBS, the complex role of psychosocial stressors in the onset and perpetuation of symptoms in IBS, and various considerations in the management of IBS from the perspective of psychiatry.
K. Lynn Wieck, RN, PhD, FAAN, is the Jacqueline M. Braithwaite Professor, College of Nursing, The University of Texas at Tyler, Tyler, TX, and CEO, Management Solutions for Healthcare, Houston, TX; Jean Dois, RN, PhD, NEA-BC, FACHE, is the System Director for Quality and Nursing, CHRISTUS Health System, Houston, TX; and Peggy Landrum, RN, PhD, is Clinical Professor, College of Nursing, Texas Woman 's University, Houston,
If symptoms are mild then they may not require specific treatment as the symptoms can clear up by itself. Certain foods may trigger diarrhoea and bloating. They should be given lifestyle and dietary advice. They should be advised to drink plenty of fluids and eat small amounts of food throughout the day. Patients should avoid high fibre foods such as bran, beans and nuts. They may also limit their intake of milk products if they are lactose intolerant. Finally they should avoi...
More often than not positive patient outcomes come from these procedures, but not without challenges along the road to recovery. Recently I had a patient that underwent a bowel resection with establishment of an end colostomy for the treatment of her diverticulitis. Fortunate, the procedure went without complications from a surgeon’s point of view, but sadly this was not the case for the patient. Caring for this patient postoperatively presented great opportunity for me to practice presence. The pain and suffering my patient was experiencing had nothing to do with the mechanical aspect of her surgery, but rather the emotional craters created by discovering her colostomy bag. For the patient, a colostomy was the absolute worst case scenario. New colostomies require frequent attention from nurses; checking for viable tissue, emptying output, and watching for signs of infection. Each time I assessed the ostomy humiliation and shame consumed her spirit and body. After the second flood of these emotions, I stopped dead in my tracks, pulled up a chair and asked the patient “how are you feeling”. A constant stream of tears ran down her face as she expresses to me the fear she has in telling her significant other that she will forever have “a bad of feces” on the outside of her abdomen. My heart cried for her! I couldn’t imagine how she must feel. As a woman, she previously viewed her body as a sacred part of her that she was able to share with her partner, but she no longer felt beautiful and sexy, but rather a disgrace. Her painful emotions struck my heart like a bolt of lightning, how was I supposed to help her see the beauty of this colostomy? In the end, it was my time and patience coupled with positive affirmations that relieved her fears of the unknown. I had every opportunity to place ignorance at the frontline of my care and ignore the obvious
There are six set standards of the nursing practice; assessment, diagnosis, outcome identification, planning, implementation, and evaluation (ANA, 2010; pp. 9-10). Throughout a typical shift on the unit I work for, I have set tasks I am expected to complete in order to progress the patient’s care, and to keep the patient safe. I begin my shift by completing my initial assessment on my patient. During this time, I am getting to know my patient and assessing if there are any new issues that need my immediate intervention. From here, I am able to discuss appropriate goals for the day with my patient. This may come in the form of increasing mobility by walking around the unit, decreasing pain, or simply taking a bath. Next, I plan when and how these tasks will be able to be done, and coordinate care with the appropriate members of the team; such as, nursing assistants and physical therapists. Evaluating the patient after any intervention assists in discovering what works and what does not for the individual. “The nursing process in practice is not linear as often conceptualized, with a feedback loop from evaluation to assessment. Rather, it relies heavily on the bi-directional feedback loop...
To sustained the PSI a clear recognition from senior healthcare staffs such as continence nurse advisers, the nurse specialist and community nurse and support by training, coping and adopting strategy to change is needed (NHS ΙΙΙ 2008). The role of the nurse involves investigating patient, communicating with the other healthcare team members such as community nurses to help ensuring the use of the cover for the catheter stand is an essential element of care, rather than being dismissed or patient isolating them self due to stigma (RCN 2013).
In this section the researchers explain the complications that can occur based on non-adherence to a proper self-catheterization regimen. A spinal cord injury can cause an interruption in neural pathways which affect the function of the bladder causing urinary incontinence, urinary retention, urinary reflux, and recurrent urinary tract infections. These problems can ultimately lead to an increase in renal morbidity and mortality (Shaw & Logan, 2013) Later, in the discussion section of the article, the authors focus on the importance of nursing education to teach patients proper methods to perform and cope with ISC in order to eliminate these common occurrences in patients suffering from SCIs (Shaw & Logan, 2013). The perception of performing this task may vary from patient to patient. This research helps identify various educational approaches that could be taken to accommodate all patients. Therefore, the research is significant to nursing due to the fact that nurses are considered the primary educators and are expected to address practical issues with patients performing ISC and help them manage the psychological issues that are faced with this
Potter, P.A., Perry, A.G., Stocker, P.A., & Hall. (2017). Fundamentals of Nursing (9th ed.). St. Louis, MO:
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Elimination pattern varies among family members. No bowel or bladder problems. They all have regular bowel movements and voids frequently without complaints. The mother and daughter exercises at least three days per week. The father, who can be unbalanced at times, walks every day for one hour. If there is no one at home to accompany him, he will do so by himself and this has been going on for two years without a problem. While walking he stays in touch with family members every fifteen minutes. Due to his illness, he is unable to do other forms of exercises. He however enjoys going to the movies and shows with his wife and
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has learning disabilities it was imperative to identify any barriers with communication (Nursing standards 2006).
The RN uses exploring technique to seek more information about the patient’s GI problem. The RN demonstrated caring and concern for the patient’s health when she described her symptoms.
Irritable Bowel Syndrome. Mayo Foundation for Medical Education and Research, 2014. Web. 20 May 2014.