common sign & symptoms of diseases. and its nursing care.

1. Mr.Veerabhadra B Badiger
Asst Professor
Dept of Medical Surgical Nsg
CONSTIPATION

2. CONSTIPATION
 Constipation
accompanied by
difficult or incomplete
passage
of stool and/or passage
of excessively hard, dry
stool.
 Constipation occurs
when a person has
difficulty emptying the
large bowel.

3. CAUSES FOR CONSTIPATION
Common lifestyle causes of constipation
include:
 Low in fibre diet.
 Dehydration
 Lack of exercise.
 Sedentary lifestyle & travelling.
 Eating large amounts of milk or cheese.
 Stress.
 Resisting the urge to have a bowel
movement.
 Oldage

4. CONT…..
 Medications : Ex:- Nonsteroidal anti-inflammatory
drugs, Antidepressants, Antacids , Iron pills.
 Underlying diseases condition:-
Endocrine problems, like underactive thyroid gland
(hypothyroidism), diabetes, Uremia, Hypercalcemia.
 Colorectal cancer.
 Irritable bowel syndrome (IBS).
 Diverticular disease
 Tumor
 Neurogenic disorders

5. SIGN & SYMPTOMS OF CONSTIPATION
Pain and cramping in the abdomen
Feeling bloated
Nausea
A loss of appetite
Difficulty passing stool
Straining when passing stool
Abdominal distention
Dull headache

6. COMPLICATION OF CONSTIPATION
 Rectal bleeding after straining
 Anal fissure, which is a small tear around the
anus.
 Symptomatic hemorrhoids (piles), which are
swollen, inflamed blood vessels in the anus
 Fecal impaction

7. ASSESSMENT AND DIAGNOSTIC FINDINGS
 Diagnosis is based on history, physical
examination.
 A barium enema or sigmoidoscopy
 Stool for occult blood
 Anorectal manometry (pressure studies)
 Defecography, and colonic transit studies
 Newer tests such as pelvic floor MRI may
identify occult pelvic floor defects

8. BARIUM ENEMA

9. SIGMOIDOSCOPY

10. ANORECTAL MANOMETRY

11. PELVIC FLOOR MRI

12. MANAGEMENT
Medical Management
 Laxatives: Methyl Cellulose
 Stool softner: Docusate Calcium, Docusate
potassium
 Stimulants:- Bisacodyl, Castor oil
 Fibre rich diet: Beans, Avocados, Broccoli Whole
Grains, Nuts, Potatoes
 Increasing fluid intake:
 Regular exercises.
 Regular monitoring of bowel pattern.

13. NURSING MANAGEMENT
 Collect complete history & perform physical
assessment
 Assess the bowel pattern including frequency and
consistency of stool.
 Check out usual dietary habits, schedule, and liquid
intake.
 Assess the patient’s activity level.
 Current medications usage that may lead to
constipation.
 Administer drug as ordered & check for side effects.

14. CONTINUED....
 Encourage the fluid intake of 2500 to 3000 mL/day
 Assist patient to take at least 20 g of dietary fiber
(e.g., raw fruits, fresh vegetable, whole grains) per
day.
 Advice the patient for some physical activity and
exercise.
 Monitor bowel pattern

15. DIARRHEA

16. DIARRHEA
Diarrhea is a condition charecterised by
 Increased frequency of bowel movements (more than
three per day).
 The frequent passage of larger-than-normal amounts of
liquid or semiliquid stool.
 It results from increased peristalsis.
 It is usually associated with urgency, perianal
discomfort, incontinence, or a combination of these
factors.

17. CAUSES
 infections : Bacterial , Viral & Parasite affecting
the intestine
 lactose intolerance
 food allergies or intolerance
 uremia
 Intestinal disease: such as Diverticulitis,
ulcerative colitis, malabsorption, or intestinal
obstruction

18. CAUSES CONTINUED….
 Fiber rich diet consumption
 Highly spiced or seasoned food
 Overuse of laxatives
 Adverse effects of drugs, especially
antibiotics or
 Concentrated tube-feeding formulas.

19. CLINICAL MANIFESTATION
 Stools are watery and frequent. In severe cases,
blood and mucus present.
 Urgency and abdominal discomfort.
 Abdominal cramps
 Distention, intestinal rumbling (ie borborygmus),
 Anorexia, and thirst.

20. C/M CONTINUED…
 Painful spasmodic contractions of the anus.
 Bowel sounds are hyperactive.
 Skin around the anus may become excoriated
 Fever may be present.
 Generalized malaise.

21.  Cardiac arrhythmia(Hypokalemia) includes
VT,VF, SVT
 Dehydration
 Electrolyte imbalances
 Vitamin deficiencies.
 Nutritional imbalance.
 Paresthesia
 Hypotension
 Drowsiness
COMPLICATIONS OF DIARRHEA

22. DIAGNOSTIC STUDIES.
 History collection & Physical examination.
 Complete blood cell count.(Hb, TLC DLC)
 Chemical profile. ( RFT,LFT)
 Urinalysis.
 Stool for occult blood.
 Stool examinations & culture for infectious or
parasitic organisms.
 Endoscopy or barium enema may assist in
identifying the cause.
 Proctosigmoidoscopy or colonoscopy
 Ultrasound abdomen.

23. MANAGEMENT OF DIARRHEA
 Antidiarrheal agent
 Diphenoxylate hydrochloride with atropine sulfate (Lomotil)
 Loperamide hydrochloride (Imodium), or a combination
 Fluid and electrolyte replacement
 Oral Rehydration Salt.
 Zinc supplementation:
 To reduce the duration and severity of diarrhoea,
 To prevent subsequent episodes

24. CONTINUED…..
 Dietary adjustments. Vitamin supplements.
 Total Parenteral Nutrition (TPN) if diarrhea is
severe and/ or patient is NBM.
 Antibiotic:
Olfaxcin , Ciproflaxin, Oridazole,
Metronidazole
Total Parenteral Nutrition(TPN)

25. NURSING DIAGNOSIS
 Risk for Deficient Fluid Volume related to frequent
passage of watery stools.
 Imbalanced Nutrition: Less than Body
Requirements related to anorexia and frequent
passage of stool.
 Impaired Skin Integrity related to mechanical and
chemical trauma to the rectum.
 Abdomen pain related to cramps .

26. NURSING INTERVENTION
 Assess the general condition , bowel pattern.
 Administer drug as ordered ex: Antidiarrhea,ORS.
 Provide nutritional balanced diet.
 Start IV fluids if patient avoid oral fluids.
 Monitor vital signs regularly.
 Consider the stool examination to check for blood /
parasite.
 Provide privacy.
 Educate patient about personal hygiene , nutritional food
& follow up care.