DAY 2

Focus: Dysfunctional Gastrointestinal Motility/ Constipation related to atonic bowel

Data: Received lying on bed with an IVF of PNSS 1 liter x KVO @ 800cc level infusing
well at the right hand . “nahihirapan akong tumae” as verbalized by the patient.

Action: Assessed overall status; monitored vital signs; Assessed the patient’s bowel
function by auscultating for bowel sounds;inspected for the presence of abdominal
distention; and monitored for nausea, vomiting, and fecal impaction. Notified the health
care provider of significant findings; taught the patient to attempt bowel movement 30
min after a meal or warm drink; Taught the patient to sit, bear down, bend forward, or
apply manual pressure to the abdomen. If allowed, provide a bedside commode. Checked
the patient’s ability to maintain balance on a commode; Promoted adequate fluid intake
(more than 2500 mL/day) and use of stool softeners and high-fiber diet.

Response; Patient identifies measures that prevent or treat constipation.