Use this nursing diagnosis guide to help you create nursing interventions for diarrhea nursing care plan. Show What is Diarrhea?Diarrhea is defined as an increase in the frequency of bowel movements and the water content and volume of the waste. It may arise from various factors, including malabsorption disorders, increased secretion of fluid by the intestinal mucosa, and hypermotility of the intestine. It may also be due to infection, inflammatory bowel diseases, side effects of drugs, increased osmotic loads, radiation, or increased intestinal motility. Diarrhea can be an acute or severe problem. Mild diarrhea cases can recover in a few days. However, severe diarrhea can lead to dehydration or severe nutritional problems. Problems associated with diarrhea include fluid and electrolyte imbalances, impaired nutrition, and altered skin integrity. Additionally, nurses and the healthcare team members must take precautions to prevent transmission of infection associated with some causes of diarrhea. CausesThe following are the common causes of diarrhea:
Signs and SymptomsA patient with diarrhea may report the following signs and symptoms:
Goals and OutcomesThe following are the common goals and expected outcomes for Diarrhea:
Nursing Assessment and RationalesA thorough assessment is important to ascertain potential problems that may have led to diarrhea and handle any conflict that may appear during nursing care. 1. Assess for abdominal discomfort, pain, cramping, frequency, urgency, loose or liquid stools, and hyperactive bowel sensations. 2. Evaluate the pattern of defecation. 3. Culture stool. 4. Determine tolerance to milk and other dairy products. 5. Determine intolerances to food. 6. Determine methods of food
preparation. 7. Review the
medications the patient is or has been taking. 8. Assess changes in eating habits and behaviors.
9. Review osmolality of tube feedings. 10. Assess stress levels. 11. Assess for fecal impaction. 12. Determine hydration status by assessing
input and output. 13. Assess moisture of mucous membranes. 14. Assess skin turgor. 15. Assess for other signs of dehydration. 16. Assess history for gastrointestinal
diseases. 17. Assess history for abdominal radiation therapy. 18. Use the Common Toxicity Criteria (CTC) to grade chemotherapy-related diarrhea.
19. Assess history for previous gastrointestinal surgery. 20. Assess history of foreign travel, ingestion of unpasteurized dairy products, or drinking untreated water. 21. Determine the type of stools using the Bristol Stool Chart.
22. Assess the condition of the perianal skin. 23. Examine the emotional impact of illness, hospitalization, and soiling accidents. Nursing Interventions and RationalesThe following are the therapeutic nursing interventions for diarrhea: 1. Weigh daily and note decreased weight. 2. Have the patient keep a diary of their bowel movements. 3. Avoid using medications that slow peristalsis. If an infectious process occurs, such as Clostridium difficile infection or food poisoning, medication to slow down peristalsis should
generally not be given. 4. Give antidiarrheal drugs as ordered. 5. Provide bulk fiber (e.g., cereal, grains, psyllium) in the diet. 6. Provide “Natural” bulking agents (e.g., rice, apples, matzos, cheese) in the diet. 7. Explain the need to avoid stimulants (e.g., caffeine, carbonated beverages, artificial sweeteners) 8. Record the number and consistency of stools per day; if desired, use a fecal incontinence collector for accurate measurement of
output. 9. Evaluate dehydration by observing skin turgor over the
sternum and inspecting for longitudinal furrows of the tongue. Watch for excessive thirst, fever, dizziness, lightheadedness, palpitations, excessive cramping, bloody stools, hypotension, and symptoms of shock. 10. Encourage intake of fluids 1.5 to 2 L/24 hr plus 200 mL for each loose stool in adults unless contraindicated; consider nutritional support. 11. Encourage to take oral rehydration solution. For adults
For children
12. Monitor and record intake and output; note oliguria and dark, concentrated urine. Measure the specific gravity of urine if possible. 13.
Evaluate the appropriateness of protocols for bowel preparation based on age, weight, condition, disease, and other therapies. 14. Provide perianal care after each bowel movement. 15. Avoid the use of rectal Foley catheters. 16. If diarrhea is associated with cancer or cancer treatment, once the infectious cause of diarrhea is ruled out, provide medications as ordered to stop diarrhea. 17. For patients with enteral tube feeding, employ the following interventions:
18.
If diarrhea is chronic and there is an indication of malnutrition, discuss with the primary care practitioner for a dietary consult and possible use of a hydrolyzed formula to maintain nutrition while the gastrointestinal system heals. 19. Encourage the patient to eat small, frequent meals and to consume foods that normally cause constipation and are easy to digest. 20. Educate patient not to eat only bland foods. 21. Educate patient or caregiver about dietary measures to control diarrhea. 22. Remind the
patient of the importance of diet modification. 23. Allow patient to communicate with nurse or caregiver if
diarrhea occurs with prescription drugs. 24. Educate patient or caregiver on the proper use of antidiarrheal medications as ordered. 25. Discuss the importance of fluid replacement during diarrheal episodes. 26. Impart to the patient the importance of good perianal hygiene. 27. Educate patient and significant other (SO) on preparing food properly and the importance of good food
sanitation practices and handwashing. 28. Provide tips on how to manage stress. 29. Allow the patient to use free time to relax, meditate, read a book, or listen to music. 30. Provide emotional support for patients who have trouble controlling unpredictable episodes of diarrhea. Recommended ResourcesRecommended nursing diagnosis and nursing care plan books and resources. Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.
See alsoOther recommended site resources for this nursing care plan:
References and SourcesReferences and sources you can use to further your research for diarrhea.
|