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Constipation is the condition of the digestive system of having less than three bowl movements in a week. On this basis therefore, chronic constipation is a long term complexity of the digestive system which occurs as a constituent of the Irritable Bowel Movement (IRB); thus imposing an ailment in the intestines. More specifically, victims of chronic constipation usually have irregularities in the bowl passages as bowl responds rarely to the normal stimuli. As reported in various cases, many individuals who were born with perforated anus, even if corrected at birth, usually have reversed colostomy at their early ages which may yield to chronic constipation. More so, other characteristics associated with Irritable Bowel Movement are spastic colitis and convulsive colon which revokes the general sensitivity to stimuli associated with bowel movements. This paper presents a case where a four year old female has been admitted in a ward in which she has been reported to be having chronic constipation from the time of her admission, throughout her nursing management till she would be discharged (Connect, 2003).
Perhaps, Molly who is only four years having admitted in a ward as a result of chronic constipation calls for special attention so as to save her from her current ailments. Having only three months to attend schooling, urgent medication processes ought to be arranged for her so as to give her ample time to attend school being relieved. As reported by her carers, Molly eats fruits and vegetables a lot which makes her to be in a better position of not to lose her sight as frequently reported in many chronic constipation cases. As a matter of fact, the main cause of bowel movement failure is the inability of the Central Nervous System (CNS) to control the involuntary movement of bowel along the alimentary canal. Considering the current Molly’s condition of being behaviorally abnormal, where she takes dexamphetamine two times daily so as to be manageable; an immediate response is necessary in her situation (Troponin, (2000).
Certainly, on arriving at the ward, Molly should be administered with muscle relaxants so as to accelerate the process of bottle emptying. In this case, the best medication to be prescribed to Molly is the Amtizas; which have been well known to increase the secretion of fluids on the walls of the alimentary canal. More specifically, the specific version of Amtiza is the drug referred to as lubiprostone; which is the most commonly used antispasmodic as it has very few side effects associated. As a matter of fact, the Amtiza capsules should be administered together with food to the young girl as at times they are known to bring nausea. By so doing the young girl would be relieved of using laxatives and enemas as this medication would suffice for the purpose played by the enemas and the laxatives (Jay, 2005).
On being received in the ward, Molly should first be administered to a lot of fluids including water and include a lot of fibrous food in her diet. As she is still a young girl, Molly should be exposed to natural wheat bran, dried fruits and vegetables among others. As her current situation depict, the frequently used laxatives and enemas previously seem to have interfered with the normal functioning of the colon in which the condition of constipation is worsened. As it has been revealed, the laxatives and enemas used to soften the stool by many victims of chronic constipation tend to damage the wall of the alimentary canal which may further worsen the condition currently diagnosed. In this case therefore, as soon as Molly is received in the ward, she ought to be put under a lot of fluids like what and be given a lot of bulk forming natural laxatives (Walsh & Crumbie, 2004).
As molly’s current situation reveal, her neuromuscular control system has been impaired; and thus she needs a proper attention so as to eliminate the laxatives and enemas used, successfully. In this case, a call for stimulation of the impaired intestinal walls ought to be established so as to peristalsis movement of the stool along the gut. In this case therefore, in the first day at the ward, the girl should be administered with a lot of water followed by a number of fibrous food materials at regular intervals. In this case, the regularity of the intervals at which the fibrous foods would be administered is of great significance in physically stimulating the walls of the alimentary canal to allow for peristalsis movements of stool and other gut materials (Troponin, (2000).
Soon after the girl has been put into proper drink intake and regular intake of fibrous food materials, a glycerine suppository may be administered after one or two days. By so doing, the enhancement of further stimulation of defeacation is enhanced; which would facilitate the regular and free stool movement along the bowels. Throughout all these processes, a very high degree of personal hygiene on the girl should be maintained so as to ensure that, she undergoes the least irritations on her skin. This would be necessary because, any impairment on the central nervous system would interfere with the normal sustenance of the peristalsis movement even after a physical stimulation. More specifically, some protective ointments ought to be applied on molly’s skin after bathing so as to enhance comfort; thus reducing chances of itching (Jay, 2005).
Further, molly should be helped to contract the abdominal muscles by being stimulated carefully; which would further increase the chances of defeacation. In this case, the physical stimulation of abdominal muscles of the girl may be done through pressure application within the abdominal region which in turn encourages peristaltic movement of stool towards the anus. In this way the girl would be relieved of the regular use of laxatives and enemas which in the long-run have been revealed to cause discomfort in the abdominal region and that one cannot do without; once the body gets used to. It is of great importance to note that, all these processes ought to be integrated so as to come up with a substantial level of satisfactory results. More specifically, the dietary, fluid intake, high level of hygiene and ensuring regular contraction of abdominal muscles should be integrated so as to bring into effect positive outcomes (Jay, 2005).
As the girl seems to be having normal conditions in her vitals and urinalysis are normal, the possibility of the girl having normal muscle regulatory system in her central nervous system is there. In this case therefore, the only observed problem may be the failure of some receptors organs within the anatomy of the girl, in which muscle relaxatives are necessary in this case so as to increase sensitivity of the girl’s muscles within her digestive track (Connect, 2003).
More so, physical exercise should be administered to Molly in which; she should be involved in regular body physical activities like walking among others. By so doing, the Central Nervous System would be physically stimulated to effect the processes of peristalsis which would in turn result into the movement of stool within the alimentary canal. In this case, physical body exercise activities should be administered as soon as the girl gets into the ward; in which the previously used laxatives and enemas would be of less significant as the Central Nervous System would be stimulated to effectively enhance defeacation by initiating peristalsis movements. As the conditions of defeacation are being monitored day after a day, this regular body activities to the girl should be directed in which she should in most cases move the pelvic girdle, where the abdominal region is found, which would further result into the stimulation of rectum muscles to allow easier defeacation. In this case, the use of muscle relaxants may be necessary so as to increase efficiency in the process of stimulating rectal muscles to enhance peristalsis (Jay, 2005).
More so, a program should be developed so as to promote elimination of bowel regularly by modifying various conditions within the girl’s environment. In this program, a more detailed plan on how the process of defeacation should be increased is of great significance. The defeacation program aims at ensuring that; the patient’s alimentary canal develops a self mechanism of enhancing the passage of stool regularly without any associated stimulation. According to the program, the nurse should lubricate his/her finger in gloves and then insert it into the girl’s rectum. The essence of this program is to loosen any compacted faeces within the rectal region as well as stimulating the peristaltic movement physically (Connect, 2003).
As Molly’s conditions get better from day to day, other antispasmodics should be administered in addition to amtizas like dicyclomine and hyoscyamine among others; so as to help in the production of intestinal fluids which would enhance easy movement of stool along the alimentary canal. More so, on the time of being released from the ward, Molly should be put on metoclopramide for up to around three months which would help her in elimination of delayed gastric emptying. More specifically, this medication is meant to completely replace the previously used enemas and laxatives by treating gastroesophageal disease accompanying the chronic constipation (Barrett, 2000).
As per the current situation facing Molly, once she gets admitted in the ward, she should be administered with emtizas, a lot of fluids and roughages in her food which would be very crucial first aid for the girl. Further, the girl should be exposed to very clean conditions to reduce any chances of itching as well as being put in a lot of exercise. More so, the girl should be given a lot of fruits so as to reduce the chances of gastroesophageal. Perhaps, glycerine should be applied on the girl’s skin to increase her comfort and reduce her chances of irritations. On being released from the hospital, the girl should be put under antispasmodics like dicyclomine, metoclopramide and hyoscyamine among others so as to replace the use of laxatives and enemas.
Barrett, S. (2000). Gastrointestinal Quackery: Colonics, Laxatives, and More. Web.
Connect, P. (2003). Constipation: eMedicine Gastroenterology. Web.
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Jay, M. (2005). Chronic Constipation. Web.
Troponin, T. (2000). Patients prefer enemas to laxatives for bowel preparation. New York: Prentice Hall Publishers.
Walsh, M. & Crumbie, L. (2004). Clinical Nursing and related sciences. New York: Harcourt Publishers.