Nursing Interventions to Promote Normal Bowel Elimination Heather Nelson, RN

Promoting Regular Defecation The nurse can help the patient achieve regular defecation by attending to: Privacy Timing Nutrition and fluids Exercise Positioning

Privacy The nurse should provide as much privacy as possible to patients to whom privacy during defecation is important. Provide patient with water, washcloth, or towel if the patient desires to clean himself after defecating.

Timing Patients should be encouraged to defecate when the urge to defecate is recognized. Provide time for the patient to defecate. Do not interfere with defecation time with other activities. Do not hurry patients. Give patients adequate time to defecate.

Nutrition and Fluids The diet a patient needs for regular defecation varies.

Nutrition and Fluids For constipated patients: Increase fluid intake. Instruct the patient to drink fruit juices, especially prune juice. Include fiber in the diet with foods such as prunes, raw fruit, bran products, and whole-grain cereals and bread.

Nutrition and Fluids For patients with diarrhea: Encourage intake of fluids and food. Eating small amounts of bland foods can be helpful, since they are more easily absorbed. Encourage the ingestion of food or fluids containing potassium, since diarrhea can lead to great potassium losses. Avoid excessively hot or cold fluids and highly spiced foods and high fiber foods that can aggravate diarrhea.

Exercise Regular exercise helps clients develop a regular defecation pattern and normal feces. Ambulation helps to stimulate normal motility, and therefore should be encouraged in post-surgical patients.

Positioning Patients who are confined to bed may need assistance to sit on a bedpan. Assist patients to the bedside commode or toilet if needed. Use elevated toilet seats to help patients who have difficulty in raising themselves from the toilet. Make sure that the patient has the call light accessible so he or she can call for assistance.