Bowel & bladder changes — constipation, diarrhea, urination

No bowel movement for 3 or more days beyond the client's normal pattern is a reportable change — tell the client's nurse or your supervisor today. Never give laxatives, enemas, or suppositories on your own; that is a medication decision.

1. 1Know the client's normal pattern — 'regular' differs from person to person; the change from THEIR baseline is what matters.
2. 2Report the same day: no BM for 3+ days (a week is urgent — call now), pain or straining, blood in stool or urine, black/tarry stool, new diarrhea, vomiting with constipation.
3. 3Also report urination changes: burning, going much more or less often, dark or foul-smelling urine, new incontinence — these can signal a UTI.
4. 4What you CAN do within scope: encourage fluids and fiber-rich foods if the care plan allows, encourage gentle movement, respond to bathroom requests promptly, and give privacy and time.
5. 5What you CANNOT do: give laxatives, stool softeners, enemas, or suppositories without current RN delegation — even over-the-counter ones.
6. 6Document: last known BM date, what the client reports, what you observed, who you notified and when.

A full week without a bowel movement can become a medical emergency (impaction, obstruction). Severe abdominal pain, a rigid or swollen belly, or vomiting alongside constipation means call the nurse line or 911 now — do not wait.