Study of Clinical Management of Opoid induced constipation

Study of Clinical Management of Opoid induced constipation

Opoid induced constipation. This case study outlines the clinical management of a client with a problem Opoid induced constipation. Throughout the analysis the anonymity and confidentiality of this patient will be protected as outlined by the Nursing and Midwifery Council (2008) therefore the patient will be referred to as Mark Scott. Additionally consent was gained by Mark to allow the author to use his case for my assessment.
History of present illness

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Mark Scott is a 64 year old gentleman who is 2 days post op following a Right Total Hip Replacement (RTHR). Total hip replacement involves removal of a diseased hip joint and replacement with a prosthetic joint.

Whilst doing the medications Mark confided in the nurse that he may have a problem with his bowels and that he may be constipated. He asked if there was anything she could give him. Mark has presented with a new problem with the possibility of him needing medicaion. Before considering this the nurse would first need to undertake a holistic assessment of Mark. The purpose of assessment is to allow the nurse to examine all relevant factors of the problem and allow her to make the decision of whether prescribing a patient group directive (PGD) is an appropriate intervention (Humphries 2002).

When Mark stated he thought he was constipated it was important to ascertain his own interpretation of what this meant. For example, Wondergerm (2005) states that for some, constipation may mean opening their bowels less than three times a day. On the other hand constipation may mean opening of the bowels less than three times a week. There appears to be a general consensus that the range for normal bowel activity lies somewhere between three bowel motions daily to one bowel motion every three days. However, it is important to remember that a change from three bowel motions a day to one every three days may represent a significant change for the patient, despite remaining within the normal limits (Peate 2003).

Mark felt he was constipated because he hadn’t had a bowel movement in the last five days. On further questioning it emerged that these symptoms had been going on approximately 4 days before his surgery and when he did have a bowel move………………………..