11 Geriatric Nursing Care Plans (Older Adult)

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In this nursing care plan guide are 11 nursing diagnosis for the care of the elderly (older adult) or geriatric nursing or also known as gerontological nursing. Learn about the assessment, care plan goals, and nursing interventions for gerontology nursing in this post.

Gerontology nursing or geriatric nursing specializes in the care of older or elderly adults. Geriatric nursing addresses the physiological, developmental, psychological, socio-economic, cultural and spiritual needs of an aging individual.

Since aging is a normal and fundamental part of life. Providing nursing care for elderly clients should not only be isolated to one field but is best given through a collaborative effort which includes their family, community, and other health care team. Through this, nurses may be able to use the expertise and resources of each team to improve and maintain the quality of life of the elderly.

Geriatric nursing care planning centers on the aging process, promotion, restoration, and optimization of health and functions; increased safety; prevention of illness and injury; facilitation of healing.

Nursing Care Plans

Here are 11 nursing care plans (NCP) and nursing diagnosis for geriatric nursing or nursing care of the elderly (older adult):

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  1. Risk for Falls
  2. Impaired Gas Exchange
  3. Hypothermia
  4. Disturbed Sleep Pattern
  5. Constipation
  6. Adult Failure to Thrive
  7. Risk for Aspiration
  8. Risk for Deficient Fluid Volume
  9. Risk for Injury
  10. Risk for Infection
  11. Risk for Impaired Skin Integrity
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Constipation

Nursing Diagnosis

Here are the common related factors for Disturbed Sleep Pattern that can be used for the “related to” of the nursing diagnostic statement.

  • Changes in diet, decreased activity, and psychosocial factors

Defining Characteristics

The following are the common subjective and objective data or nursing assessment cues (signs and symptoms) that could serve as your “as evidenced by” for this care plan:

  • Changes in bowel pattern; unable to pass stool
  • Atypical presentation in older adults (changes in mentation, urinary incontinence, unexplained falls)
  • Straining with defecation

Desired Outcomes

The commonly used expected outcomes or patient goals for Constipation nursing diagnosis:

  • The patient will state that his or her bowel habit has returned to normal within 3 to 4 days of this diagnosis.
  • Patient’s stool will appear soft, and the patient will not strain in passing tools.

Nursing Interventions and Rationale

The following are sample nursing interventions and rationale (or scientific explanation) for Constipation that you can use for our geriatric nursing or gerontological nursing care plans:

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Nursing InterventionsRationale
Nursing Assessment
During admission, assess and record the patient’s normal bowel elimination pattern (frequency, time of day, associated habits, and previous measures to manage constipation). Discuss with the patient’s significant others or caregiver if the patient cannot provide this information.This assessment sets a baseline and identifies the normal bowel elimination pattern of the patient.
Quantify the amount of roughage to the severity of constipation.Excessive roughage taken too rapidly can cause gas, bloating and diarrhea.
Assess hydration status for signs of dehydration. Maintain diet, fluid, activity, and continuation of routines. If there is an absence of bowel movement within 3 days, start with mild laxatives to attempt to reattain the normal bowel pattern.The use of osmotic medications can result in dehydration. Fluid volume deficit can result in hard stools, which are more difficult to pass.
Therapeutic Interventions
Inform the patient that changes happening during hospitalization may increase the risk of constipation. Allow the patient to use effective nonpharmacologic management practiced at home as this problem is observed or prophylactically as needed.Constipation is not difficult to handle preventively than it is when present or prolonged.
Educate the patient about the connection between fluid intake and constipation. Encourage fluid intake (2500 ml/day) unless contraindicated. Assess and record bowel movements (amount, date, time, consistency).Increase consumption of fluids can make the stool soft and lessens the risk of constipation. Patients with renal, cardiac, or hepatic diseases may have a fluid restriction.
Instruct the patient to include roughage in every meal when possible. For patients with low tolerance to raw foods, encourage intake of bran via cereals, bread, and muffin.Having a roughage (raw fruits and vegetables, whole grains, legumes, nuts, fruits with skin) in the diet adds bulk in the stool, therefore, minimizes episodes of constipation.
Educate the patient about the connection between activity level and constipation. Support optimal activity for all patients. Institute and build an activity program to foster participation; include devices necessary to enable independence.Regular exercise stimulates peristaltic movement thus it can reduce or prevent constipation.
Encourage the patient to use his or her gastrocolic or duodenocolic reflex to promote colonic emptying, if the usual bowel movement happens in the early morning. If the patient’s bowel movement occurs in the evening, ambulate the patient just before the right time.Scheduling interventions that correspond with the bowel habits of the patient are more likely to increase bowel movements. Taking warm liquids in the morning, for example, also promotes peristalsis. Digital stimulation of the inner anal sphincter can trigger a bowel movement.
Try to use the patient’s previously effective measures. Follow the maxim “start low, go slow” (i.e., apply the lowest level of nonnatural intervention and progress gently to a more powerful intervention).Aggressive measures done may lead to rebound constipation and can hinder with subsequent bowel movements.
When giving pharmacologic therapy to the patient, administer the more benign, oral methods firstThe following hierarchy of laxatives is recommended:

 

  • Bulk-forming additives such as bra, methylcellulose, psyllium
  • Mild laxatives (apple or prune juice, Milk of Magnesia)
  • Stool softeners (docusate calcium, docusate sodium)
  • Potent laxatives or cathartics (senna, bisacodyl, cascara sagrada)
  • Medicated suppositories (glycerin, bisacodyl)
  • Enema (tap water, saline, sodium phosphate/biphosphate)
Older persons tend to focus on the loss of habit as an indicator of constipation rather than on the number of stools. Do not intervene pharmacologically until the older adult has not had a stool for three days.
Administer laxatives as ordered after diagnostic imaging of the gastrointestinal tract with the aid of barium.Laxatives are administered to facilitate barium removal. This will prevent rebound constipation due to severe disruption of bowel habit during the preparation.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

More care plans related to basic nursing concepts:

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  1. Cancer (Oncology Nursing) | 13 Care Plans
  2. End-of-Life Care (Hospice Care or Palliative) | 4 Care Plans
  3. Geriatric Nursing (Older Adult) | 11 Care Plans
  4. Prolonged Bed Rest | 8 Care Plans
  5. Surgery (Perioperative Client) | 13 Care Plans
  6. Systemic Lupus Erythematosus | 4 Care Plans
  7. Total Parenteral Nutrition | 4 Care Plans

References and Sources

Here are the references and sources for this Geriatric Nursing Care Plan:

  • Boltz, M., Capezuti, E., Fulmer, T. T., & Zwicker, D. (Eds.). (2016). Evidence-based geriatric nursing protocols for best practice. Springer Publishing Company.[Link]
  • Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and collaborative problems. Lippincott Williams & Wilkins. [Link]
  • Gilje, F., Lacey, L., & Moore, C. (2007). Gerontology and geriatric issues and trends in US nursing programs: a national survey. Journal of Professional Nursing23(1), 21-29. [Link]
  • Mauk, K. L. (Ed.). (2010). Gerontological nursing: Competencies for care. Jones & Bartlett Publishers. [Link]
  • Wold, G. H. (2013). Basic Geriatric Nursing-E-Book. Elsevier Health Sciences. [Link]

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
  • I’m an LPN for 30 years of med surg, rehab, surg, geriatric care, addiction, and psych care. I love my career of caring for people. I want to join a team that wants to continue to improve nurse care. Please keep me a part of your network. I also like to be called Penny.

  • It is very useful lesson for improving geriatric patient health care provision.
    I like it to have more.
    Or the whole course, if possible.

  • I utilize your web page/info on all of my care plans, thank you
    I am an LVN Case Manager for mostly geriatric and disabled members in managed care.

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