ACTION

Performance Task
1. With your respective block in class, you will be clustered to five (5) members each.
2. Every group is expected to accomplish the desired output and have it submitted
thru email on FRIDAY 12 MN

CASE SCENARIO:

Mr Nash is a 75 year old widowed. He lives alone and has two children, 5
grandchildren ages 2-12. Who visits regularly. His prescribed medications are baby
aspirin, a beta-blocker, a thiazide diuretic and warfarin. His none prescribe OTC
medication are a multivitamin, Vitamin C, Vitamin E, Calcium tablet, and Bayer Pm
for sleep. For an upset stomach he takes Tums, and for headache either aspirin or
acetaminophen. He also takes laxatives for constipation which he develops recently.
He is considered about feeling wash out, sleeping poorly and feeling chronic fatigue.

Within the last two weeks, He has not been able to do his usual daily half mile walk.
@4 hour diet revealed the following:
Breakfast-grape fruit juice, blueberry muffin, coffee with cream
Lunch-grilled cheese and tea
Late afternoon-glass of milk with cookies
Dinner-cheese with crackers and wine, broiled chicken, peas, carrots, mashed potato.
Butter, chocolate ice cream
Bed time snack-coffee flavoured yogurt

With the Case presented, make a NURSING CARE PLAN following the format
below, prioritizing the needs of the client:
 Nursing Care Plan

Assessment Nursing Background Planning Intervention Rationale

Subjective/ Diagnosis knowledge
Objective

Constipati Within 8 hours Independent

on r/t low of accurate
fiber- diet and 1.)Discuss usual 1.)Helps to ident
appropriate elimination habits and clarify clien
nursing (e.g. normal urge perception
interventions, time) and problems problem.
the patient will (e.g. client unable to
establish and eliminate unless in
demonstrate own home, passing
the following: hard stool after
prolonged effort, or
●Chan anal pain).
ges
in beha 2.)Note color, odor, 2.)This provides
vior as consistency , amount, baseline
necessi and frequency of comparison a
tated b stool. promotes
y recognition
causati changes.
ve and
contrib 3.)Determine 3.)It will let t
uting presence of hardened patient becom
factors stools which will not comfortable
●Maint let the patient helping him/her
ains defecate easily. removing t
passag Determine measures impacted stools.
e of of removing the
soft, stools if needed.
formed
stool at 4.)Auscultate bowel 4.)Bowel soun
a sounds. are genera
freque decreased
ncy constipation.
perceiv 5.)Encourage the
ed as patient to take in 5.)Sufficient flu
“norma fluid 2000 to 3000 is needed to ke
l” by mL/day, if not the fecal mass so
the contraindicated But take note
patient. medically. some patients
●Relie older patie
f from having
discom cardiovascular
fort of limitations
 6.)Encourage daily requiring less flu
constip activity and exercise intake.
ation. within limits of
●Preve individual activity. 6.)Lack of physi
nt or activity or regu
treat exercise is often
constip 7.)Encourage a factor
ation. regular period for constipation.
elimination.
7.)Most peop
defecate followi
the first daily m
or coffee, as
8.)Discuss laxative result of t
and enema use. Note gastrocolic reflex
signs or reports of
laxative abuse or 8.)This is m
overuse of stimulant common amo
laxatives. older adu
preoccupied w
having daily bow
Dependent movement.

1.)Discuss client’s
current medication
regime with
physician 1.)To determine
drugs that m
contribute
constipation can
discontinued
2.)Administer changed.
medications (e.g.
stool-softeners, mild 2.)They work
stimulants, or bulk- softening stools
forming agents) as make them easier
ordered or routinely pass.
when appropriate.

3.)Discuss with a
dietitian about
dietary sources of 3.)Fiber helps fo
fiber. to move throu
your digestive tr
more quickly
healthy eliminati
so encoura
Joseph to have
balanced diet th
rich in fiber. Fib
 rich foods a
whole foods, fru
and vegetables.
4.)Encourage sitz
bath before stools 4.)To rel
and after stools if sphincter (befo
indicated. stools).
For cleansing a
soothing effect
rectal area (aft
stools).
5.)Refer to primary
care provider for 5.)To best tr
medical therapies acute situation.
(e.g. added
emollient, saline, or
hyperosmolar
laxatives, enemas, or
suppositories).

carefully know
what is “normal”
for each patient.
The normal
frequency of stool
passage ranges
from twice daily to
once every third or
fourth day. Dry and
hard feces are
common
characteristics of
constipation.