Constipation Nursing Care Plan | Case Studies | NCLEX Tips

Constipation is a common yet often overlooked condition that can significantly impact a patient’s comfort, health status, and quality of life. For nurses, understanding how to assess, plan, implement, and evaluate care for patients with constipation is essential, especially when preparing for the NCLEX. In this guide, we provide a comprehensive constipation nursing care plan using the nursing process, NANDA-approved diagnoses, and evidence-based interventions.

What is Constipation

Constipation is defined as infrequent bowel movements (typically fewer than three per week), hard or lumpy stools, excessive straining, or a sensation of incomplete evacuation. It may be acute or chronic and can occur due to various causes including dietary habits, medications, immobility, dehydration, or underlying medical conditions.

Common Causes of Constipation:

• Low-fiber diet

• Inadequate fluid intake

• Lack of physical activity

• Use of opioids or anticholinergics

• Neurological disorders (e.g., Parkinson’s, spinal injury)

• Irritable Bowel Syndrome (IBS)

• Postoperative immobility

NANDA Nursing Diagnoses for Constipation

When creating a nursing care plan for constipation, it’s important to use standardized NANDA nursing diagnoses. Here are the most relevant:

1. Constipation related to insufficient dietary fiber intake and decreased physical activity as evidenced by infrequent, hard stools.

2. Risk for constipation related to immobility and opioid medication use.

3. Perceived constipation related to faulty self-diagnosis and misuse of laxatives.

Nursing Assessment for Constipation

Thorough assessment helps identify the severity and causes of constipation. Focus areas include:

• Bowel pattern history

• Dietary habits (fiber and fluid intake)

• Medication use (especially opioids, iron supplements)

• Physical activity level

• Abdominal distention, bowel sounds, and pain

• Digital rectal examination findings (if ordered)

Nursing Care Plan for Constipation

Below is a detailed nursing care plan on constipation following the nursing process:

1. Assessment

• Ask the patient about bowel movement frequency and consistency.

• Assess dietary intake, hydration, and level of physical activity.

• Check for medications that may contribute to constipation.

• Inspect and palpate abdomen for distention and tenderness.

2. Nursing Diagnosis

Constipation related to insufficient fluid and fiber intake as evidenced by infrequent, hard bowel movements and abdominal discomfort.

3. Goals and Outcomes

• Patient will have a soft, formed stool within 3 days.

• Patient will verbalize two strategies to prevent future constipation.

• Abdominal distention will resolve within 48 hours.

4. Nursing Interventions

5. Evaluation

• Patient reported a bowel movement on the second day.

• Abdominal distention reduced.

• Patient verbalized understanding of proper dietary habits and fluid intake.

Nursing Care Plan for Constipation – Case Study

Patient Name: Mrs. Linda, 68 years old
Diagnosis: Post-operative abdominal surgery
Symptoms: No bowel movement for 4 days, abdominal bloating, hard stool on digital exam

Application of Care Plan:

• Diagnosis: Constipation related to decreased physical activity and opioid use as evidenced by hard stool and abdominal bloating.

• Intervention: Increased fluid intake, gentle ambulation, fiber supplement, and administration of stool softener.

• Outcome: Patient had bowel movement within 36 hours and reported symptom relief.

Other Related Nursing Diagnoses

Patients with constipation may also experience or be at risk for:

• Imbalanced nutrition: less than body requirements

• Risk for impaired skin integrity (due to straining and hemorrhoids)

• Acute pain (related to abdominal cramping)

• Deficient knowledge (about proper bowel habits)

Tips for NCLEX and Clinical Success

If you’re preparing for the NCLEX, here are some tips related to this nursing care plan:

• Memorize the common causes and complications of constipation.

• Understand how fluid and fiber impact bowel motility.

• Review the difference between acute constipation and chronic constipation.

• Study the effects of opioids and other meds on the gastrointestinal system.

NCLEX Practice Questions – Constipation Nursing Care Plan

1. A 78-year-old patient on prolonged bed rest is experiencing decreased bowel movements. What is the most appropriate nursing diagnosis?
A. Diarrhea
B. Risk for fluid volume deficit
C. Constipation
D. Impaired skin integrity
Correct Answer: C. Constipation

2. Which intervention is most effective in promoting bowel elimination for a patient with constipation?
A. Encourage fluid intake of 1 liter/day
B. Administer antidiarrheal medication
C. Increase dietary fiber and ambulation
D. Limit dietary fiber to prevent bloating
Correct Answer: C. Increase dietary fiber and ambulation

3. A nurse is caring for a patient with opioid-induced constipation. Which laxative is most appropriate to administer?
A. Bulk-forming
B. Osmotic
C. Emollient
D. Stimulant
Correct Answer: D. Stimulant

4. Which assessment finding is most consistent with constipation?
A. Watery stools
B. Hypoactive bowel sounds
C. Nausea and frequent vomiting
D. Increased bowel frequency
Correct Answer: B. Hypoactive bowel sounds

5. A patient has not had a bowel movement in 4 days. Which nursing action should the nurse take first?
A. Call the provider for an enema order
B. Document the finding and reassess in 8 hours
C. Assess abdomen and ask about usual bowel pattern
D. Administer a stimulant laxative immediately
Correct Answer: C. Assess abdomen and ask about usual bowel pattern

6. Which of the following is a short-term goal for a patient with the nursing diagnosis of constipation?
A. The patient will maintain normal weight
B. The patient will verbalize understanding of dietary needs
C. The patient will pass a soft, formed stool within 48 hours
D. The patient will have a colonoscopy
Correct Answer: C. The patient will pass a soft, formed stool within 48 hours

7. The nurse is teaching a patient about preventing constipation. Which statement indicates a need for further education?
A. “I’ll drink at least 8 glasses of water daily.”
B. “I’ll include more fruits and vegetables in my diet.”
C. “I’ll ignore the urge to defecate until bedtime.”
D. “I’ll try to walk daily after meals.”
Correct Answer: C. “I’ll ignore the urge to defecate until bedtime.”

8. Which patient is at highest risk for developing constipation?
A. A 45-year-old female on high-fiber diet
B. A 30-year-old athlete who drinks 3L/day
C. A 70-year-old male taking iron supplements and opioids
D. A 25-year-old on a vegetarian diet
Correct Answer: C. A 70-year-old male taking iron supplements and opioids

9. Which of the following lab findings is commonly associated with chronic constipation?
A. Elevated potassium
B. Decreased hemoglobin
C. Elevated white blood cells
D. No specific lab findings
Correct Answer: D. No specific lab findings

10. Which nursing intervention helps promote regular bowel habits?
A. Offer a bedpan at unpredictable times
B. Limit caffeine and encourage physical inactivity
C. Encourage the patient to use the bathroom at the same time each day
D. Restrict fiber intake
Correct Answer: C. Encourage the patient to use the bathroom at the same time each day

Final Thoughts

Crafting a thorough constipation nursing care plan equips nurses with critical thinking and evidence-based strategies for managing bowel elimination issues. From dietary changes to medication management, each intervention must be personalized to meet the patient’s needs and prevent complications. For NCLEX students, mastering this care plan can boost confidence during exams and clinical rotations.