Deterioration Of Intestinal Continence

Introduction

Nursing Diagnosis: Deterioration of Intestinal Continence is a nursing diagnosis used as guide while providing care to patients suffering from alteration in elimination patterns/bladder and/or bowel control. This nursing diagnosis helps in identifying the signs and symptoms, problems and other attributes of concern that need to be addressed and improved with effective nursing interventions.

Nursing Diagnosis Definition

Deterioration of Intestinal Continence: Alteration in elimination pattern/bladder and/or bowel control which is of sufficient significance to warrant nursing interventions.

Defining Characteristics

Subjectives

• Complaints of shock/pain when stool/urine is released
• Wide fluctuations in amount and frequency of stool/urine production
• Diminished knowledge about incontinence management
• Decrease in perianal sensation
• Fearfulness/embarrassment associated with urine/stool loss

Objectives

• Involuntary leakage of stool/urine
• Absence of feelings of fullness or urination
• Uncontrolled release of stool/urine
• Difficulty in delaying urination/defecation
• Presence of constipation/diarrhea

Related Factors

• Pathophysiological processes – kidney failure, spinal cord injuries, neurological disorders, metabolic disorders, dementia, stroke etc.
• Medication Side-effects – diuretics, some types of antidepressants, sedatives etc.
• Age related changes – weakened muscular layers causing sudden urge to defecate/urinate even with small bladder/bowel stretched.
• Overflow Incontinence – Reduced capacity of bladder which is unable to store the amount of urine formed.
• Fecal Impaction – accumulation of stool in rectum due to poor solid materials intake.

Risk Population

People at greater risk of developing this nursing diagnosis include patients with limited mobility, persons with history of constipation, those on certain medications, elderly people and those with urinary tract condition or any other medical disorder causing disruption of neuronal pathways influencing bladder/bowel function.

Associated Problems

This nursing diagnosis is often associated with social isolation, emotional distress, skin irritation, malnutrition, and dehydration.

Suggestions for Use

This diagnosis can be used to outline a plan of care to enhance continence, improve nutrition and eliminate problems associated with it. It can also guide nurses in providing nursing interventions such as patient teaching and interventions to reduce the impact of risk factors.

Suggested Alternative Nursing Diagnosis

• Disturbed Sensory Perception: Visual
• Impaired Physical Mobility
• Impaired Self-Care Deficit
• Ineffective Health Maintenance
• Ineffective Coping
• Risk for Injury
• Risk for Infection
• Risk for Constipation

Usage Tips

When writing this diagnosis, provide a concise explanation that concisely describes the problem, provide specifics whenever possible and include relevant associated factors. Avoid using general terms like “inability to control” and “lack of urine and stool management”.

Nursing Outcome Classification (NOC) Results

• Bladder Control – Refers to patient’s ability to maintain continence or manage an urge or desire to void.
• Bowel Control – Describes the ability of an individual to hold, expel and delay bowel movements.
• Nutritional Status – Refers to the ability of an individual to attain adequate nutrition.
• Tissue Integrity: Skin and Mucous Membranes – Refers to the ability of an individual to maintain skin integrity.
• Body Temperature Regulation – Describes the ability to maintain body temperature when environmental conditions change.
• Safety Knowledge – Refers to patient’s ability to comprehend safety information.

Nursing Interventions Classification (NIC) Interventions

• Incontinence Care – includes regular assessment of elimination patterns, instruction in methods/products to manage incontinence, assistance with positioning and stretching to elicit urge control, and assistance in toileting/cleaning routines.
• Activity Therapy – involves providing support to carry out a variety of recreational and leisure activities.
• Insensate Perineal Care – Includes selecting appropriate catheterization techniques, providing incontinence products, positioning for comfort and safety, checking for skin integrity, and providing basic hygiene care.
• Bowel Training – Includes providing specific information about food/ fluid intake, surface anatomy/muscle structure, elimination techniques, toilet posture and timing of evacuation according to individual’s needs.
• Pain Management – Involves providing comfort measures, continual observation of vital signs, early identification of abnormal responses, and prompt management of pain.

Conclusion

In conclusion, Nursing Diagnosis: Deterioration of Intestinal Continence is a useful nursing diagnosis to assist nurses with nursing interventions working towards improving the health related problems of patients.

FAQ

• What is Nursing Diagnosis?
• Nursing Diagnosis is a standard system of classifying nursing diagnoses used to help nurses plan care for the individual patient.
• What is Deterioration of Intestinal Continence?
• Deterioration of Intestinal Continence is an alteration in elimination patterns/ bladder and/or bowel control which is of sufficient significance to warrant nursing interventions.