Hemorrhoids are varicosities in the superior or inferior hemorrhoidal venous plexus. Internal hemorrhoids result from the dilation and enlargement of the superior plexus while external hemorrhoids result from the enlargement and dilation of the inferior plexus. Hemorrhoids are considered to be caused by increased venous pressure in the hemorrhoidal plexus.
- First-degree hemorrhoids may itch because of poor anal hygiene.
- Second-degree hemorrhoids are usually painless and spontaneously return to the anal canal following defecation.
- Third-degree hemorrhoids cause constant discomfort and prolapse in response to an increase in intra-abdominal pressure. They must be manually reduced.
Nursing Care Plans
Nursing management of hemorrhoids depends on the type and severity of hemorrhoid and on the patient’s overall condition. Treatment includes measures to ease pain, combat swelling and congestion, and regulation of the patient’s bowel habits. Patient care includes preoperative and postoperative support.
May be related to
- Low residue diet
- Lack of dietary bulk
- Hemorrhoidal pain
Possibly evidenced by
- Passage of hard, formed stool
- Decreased bowel sounds
- Inability to evacuate stool
- Severe, exquisite rectal pain
- Abdominal pain
- Abdominal distention
- Absent bowel sounds
- Frequency of stool is less than normal
- Less than the usual amount of stool
- Palpable mass
- A feeling of rectal fullness
- Patient will have normal elimination pattern reestablished and maintained.
|Determine the patient’s bowel habits, lifestyle, ability to sense an urge to defecate, painful hemorrhoids, and history of constipation.||Assists with the identification of an effective bowel regimen and/or impairment, and need for assistance. GI function may be decreased as a result of decreased digestion. Functional impairment related to muscular weakness and immobility may result in decreased abdominal peristalsis and difficulty with the identification of the urge to defecate.|
|Assess patient’s stool frequency, characteristics, presence of flatulence, abdominal discomfort or distension, and straining at stool.||Aging, such as decreased rectal compliance, pain, impairment of rectal sensation can lead to constipation.|
|Auscultate bowel sounds of presence and quality.||Abnormal sounds, such as high-pitched tinkles, suggests complications like ileus.|
|Monitor diet and fluid intake.||Adequate amounts of fiber and roughage provide bulk and adequate fluid intake of at least 2 L per day is important in keeping the stool soft.|
|Monitor for complaints of abdominal pain and abdominal distention.||Gas, abdominal distention, or ileus, could be a factor. Lack of peristalsis from impaired digestion can create bowel distention and worse to the point of ileus.|
|Monitor patient’s mental status, syncope, chest pain, or any transient ischemic attacks. Notify the physician if these symptoms occur.||Undue straining may have harmful effects on arterial circulation that can result in cardiac, cerebral, or peripheral ischemia.|
|Assess for rectal bleeding.||Excessive straining may produce hemorrhoids, rectal prolapse, or anal fissures, with resultant pain and bleeding.|
|Provide bulk, stool softeners, laxatives, suppositories, or enemas as warranted.||May be used to stimulation evacuation of stool.|
|Provide a high-fiber diet, whole grain cereals, bread, and fresh fruits.||Improves peristalsis and promotes elimination.|
|Monitor medications that may predispose patient to constipation.||Analgesics, anesthetics, anticholinergics, diuretics, and other drugs are some medications that are known to cause constipation.|
|Instruct patient in activity or exercise programs within limits of the disease process.||Activity promotes peristalsis and stimulates defecation. Exercises help to strengthen the abdominal muscles that aid in defecation.|
You may also like the following posts and care plans:
- Nursing Care Plan: The Ultimate Guide and Database – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- Nursing Diagnosis: The Complete Guide and List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
Gastrointestinal Care Plans
Care plans covering the disorders of the gastrointestinal and digestive system:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans