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Bowel Incontinence Nursing Care Plan

The nursing peculiarity bowel incontinence, so unconcealed as fecal self-indulgence, is the want to pilot bowel affects, causing stool to ooze unexpectedly from the rectum. It may appear as a development of impairment to nerves or muscles and other structures associated succeeding a while cosmical extraction or as a development of diseases that transmute the cosmical power of lustration. Common factors that administer to bowel self-indulgence are an wear to rectal, anal, or resolution texture from trauma, childbirth, radiation, or surgery. Infection succeeding a while developmentant diarrhea or neurological diseases such as stroke, multiple sclerosis, and diabetes mellitus can so development in bowel self-indulgence. Bowel self-indulgence may so appear in older unrepinings succeeding a while dementia and may so appear succeeding a while age. It is essential for nurses to acquire and collect the object of bowel self-indulgence beobject its composture depends on the object. Moreover, detriment of bowel selfcontrol is an unhappy office that should be dedicated observation and concern to desert gregarious disconnection. Divert skill such as reestablishing a continent bowel extraction specimen and baring detriment of peel conscientiousness may bias the plight of the unrepining and may aid in rectification an idiosyncratic’s self-esteem.

Signs and Symptoms

Bowel Incontinence is characterized by the succeedingcited signs and symptoms:
  • Fecal seepage (undesired oozeage of stool succeeding a bowel affect succeeding a while inadequately cosmical selfcontrol and evacuation)
  • Urge self-indulgence (release of feces and evenus in malice of erratic attempts to hold these solution)
  • Passive self-indulgence (necessitated sentence of feces and evenus succeeding a whileout any awareness)
  • Encopresis (a order used for-the-most-part for fecal self-indulgence in posterity)

Goals and Outcomes

The succeedingcited are the vulgar goals and expected outcomes for Bowel Incontinence nursing peculiarity:
  • Patient is continent of stool or reports decreased episodes of bowel self-indulgence.
  • Patient participates in a daily bowel program until a bowel specimen develops.
  • Patient evacuates a gentle, formed stool.
  • Patient verbalizes feelings of self-pilot concerning bowel affects.
  • Patient verbalizes ways on how to continue bowel affects orderly by naming what aids to eat and how abundant mellifluouss to intake.

Nursing Duty For Bowel Incontinence 

Gather your intellectual and external facts succeeding a while these nursing duty pilot for the nursing peculiarity Bowel Incontinence:
Assessment Rationale
Identify the object of self-indulgence. This counsel serves as baseline facts and stipulates superscription for succeeding interventions. Other unrepinings own balance than one contributing factors.
Assess the unrepining’s cosmical bowel extraction specimen. Every idiosyncratic has a sole bowel extraction specimen. What’s “normal” for one peculiar may not be cosmical for another; some own two bowel affects per day, when-in-fact others may own a bowel affect inconstantly as total third or fourth day. Most community feel the force to tighten before-hanker succeeding the foremost unwritten intake of the day such as coffee or breakfast; this is a development of the gastrocolic reflex.
Determine the road of medications or compositions that may tend to bowel self-indulgence. Uncontrollable explosive diarrhea may be the development of hyperosmolar tube feedings, bowel making-ready agents, pelvic and abdominal irradiation, some chemosanitary agents, and stated antibiotic agents.
Perform manual checkup for fecal impaction. Liquid stool may ooze gone-by the impaction when the unrepining has rigorous, dry stool that cannot be expelled cosmically.
Assist in preparing the unrepining for different tests. These procedures are done to mention the objects of bowel self-indulgence. Tests enclose indulgent sigmoidoscopy, barium enema, colonoscopy, and anal manometry (consider to mention the power of rectal sphincters).
Assess the use of diapers, disinfectant napkins, self-indulgence briefs, fecal gathering stratagems, and belowpads. Patients or custodygivers may use well-unconcealed products such as disinfectant napkins to congregate fecal symbolical and for security from bowel oozes, chiefly at mystification.
Evaluate the power of the unrepining to go to the bathroom unconnectedly. Rearranging the environment can bar soiling accidents that can beaccident succeeding a while the unrepining’s want to get to the bathroom.
Assess mellifluous and fiber intake. Fiber and mellifluous are protracted for cosmicalizing bowel power.
Evaluate the size to which the unrepining’s daily activities are qualified by bowel self-indulgence. The fear of violent bowel extraction may development in gregarious disconnection. Individuals succeeding a while bowel self-indulgence are slight to habit soiling of drapery and tribulation.
Assess perineal peel conscientiousness. Stool can make chemical sensitivity to the peel, which may be worsened by the use of diapers, self-indulgence briefs, and belowpads.
Evaluate the verbiage for the availpower of an unsettled toilet ease. Lacking appropinquation to toileting facilities at home, in the product contrast, in the shopping mall, and the enjoy can incense the self-indulgence habit.

Nursing Interventions For Bowel Incontinence

The succeedingcited are the sanitary nursing interventions for Bowel Incontinence nursing peculiarity:
Nursing Interventions Rationale
Provide a high-fiber nutriment below the superscription of a registered nutrimentician, original contraindicated. Insoluble archearchetype of fiber promotes the affect of symbolical through the digestive system and increases stool magnitude, so it can be of service to those who labor succeeding a while irorderly stools. Cumbrous stool incenses peristalsis and persecution of stool from the bowel.
Ensure mellifluous waste of at last 3000 mL/day, original contraindicated. This bars impaction beobject a fresh stool can affect through the bowel balance largely. If the unrepining has diarrhea, mellifluous therapy is essential for magnitude renovation.
Perform analysis of fecal impaction manually, if requisite. Presence of fecal impaction can quarrel succeeding a while the literature of a orderly bowel system.
Keep bedlaterality commode and assistive stratagem on visibility. Immediate appropinquation to divert toileting facilities reduces unrequisite “accidents.”
Encourage the intake of cosmical magnitudeing agents to condense stools, for issue, aids such as banana, rice, and yogurt. These aids acceleration stipulate magnitude to the stool by absorbing mellifluouss from the stool.
Assist unrepining for disturbance or practice, if tolerated. Movement and practice incense peristalsis and aid in bowel affect.
Create a bowel program. Promoting orderly interval for bowel extraction bars the bowel from emptying sporadically.
  • Encourage bowel extraction at the corresponding interval each day.
Soon succeeding breakfast is the best interval beobject the gastrocolic reflex is incensed by aid or mellifluous intake.
  • After breakfast or a fervent absorb, administer a suppository and execute digital stimulation total 10 to 15
For some cases, straightforward stimulation of the rectal sphincter and inferior colon may be needed to originate peristalsis.
  • Place the unrepining in an erect posture for lustration.
Sitting erect succeeding a while feet even on the base promotes robust affect that aids in lustration.
Discourage the use of pads, diapers, or gathering stratagems for hanker-order skill of bowel self-indulgence. These products can be used on a short-order reason to bar soiling but may exasperate the peel in the hanker run.
Use fecal gathering systems selectively balance pads and diapers. These stratagems grant for gathering and dispensation of stool succeeding a whileout exposing the perianal peel to stool; scent and tribulation are pilotled beobject the stool is contained.
  • External anal pouch
This consists of a bendable wafer which has an start at its core. One succeedingality of the wafer adheres to the peel environing the anus and the other succeedingality is alike to a gathering bag.
  • Intra anal stool bag
This is made of latex (20cm non-extended, 26cm abundant) that is inserted into the anus and an retentive affection (10cm in transversion) applied environing the anus to protect it in posture.
  • Rectal tubes and catheters
These are inserted into the rectum to straightforward vague stool into a gathering bag. A balloon neighboring the tip of the catheter (inlaterality the collectiveness) can be joyed once the catheter is in posture to fill oozeage of stool environing the catheter and to bar the tube from hence out throughout a bowel affect.
  • Rectal flourishs
The flourish is made up of a nasopharyngeal airway alike to a drainage bag. The flange (wide) end of the flourish is inserted into the rectum. A flourish is shorter than a rectal tube so there is near accident of noxious the coating of the rectum. The other slender end of the flourish can be alike to a drainage bag.
Wash the perineal area succeeding each extraction succeeding a while soap and introduce. Apply a freshure division ointment. Any fecal symbolical left on the peel may object childishness, peel excoriation, and pain. This self-denial may development in dismay of defecating and object the unrepining to delayhold the force to tighten. This may development in impaction and ultimately bowel self-indulgence.
Educate the unrepining and custodygiver the concern of mellifluous and fiber in maintaining gentle, magnitudey stool. This improves peculiaral efficiency and can repair yielding and partnership succeeding a while the sanitary nutriment.
Educate the custodygiver the use of a fecal stratagem, if requisite. This may be challenging but the custodygiver has the accident to acquire to administer the stratagem succeeding a while divert control and feedback.
Educate the unrepining environing suitable hygiene and the use of soap and introduce and freshure division containing zinc oxide or dimethicone. These bar peel childishness and self-denial that may administer to fecal impaction and ultimately bowel self-indulgence.
Educate the unrepining on the concern of establishing a orderly register for bowel extraction. Knowledge accelerations the unrepining and race collect the rationale for composture and assists the unrepining in sumptuous service for self-care succeeding.

References and Sources

Additional references and exalt lection for Bowel Self-indulgence nursing peculiarity:
  • Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., & Zanotti, M. (2019). Nursing Peculiarity Handbook E-Book: An Evidence-Based Pilot to Planning Care. Mosby. [Link]
  • Carpenito-Moyet, L. J. (2006). Handbook of nursing peculiarity. Lippincott Williams & Wilkins. [Link]
  • Fisher, M. E., Moxham, P. A., & Bradshaw, B. W. (1989). U.S. Patent No. 4,813,422. Washington, DC: U.S. Patent and Trademark Office. [Link]
  • Urden, L. D., Stacy, K. M., & Lough, M. E. (2006). Thelan’s censorious custody nursing: peculiarity and skill (pp. 918-966). Maryland Heights, MO: Mosby.
  • Wong, W. D., Congliosi, S. M., Spencer, M. P., Corman, M. L., Tan, P., Opelka, F. G., … & Fry, R. D. (2002). The security and efficiency of the unnatural bowel sphincter for fecal self-indulgence. Diseases of the colon & rectum45(9), 1139-1153. [Link]

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