diarrhea

• Gastroenteritis


  An inflammation of the stomach and intestines that may be accompanied by vomiting and diarrhea
• Diarrhea


  A symptom that results from disorders involving digestive, absorptive, and secretory functions
• Classification of diarrhea


  • Mild (stools slightly increased in number, more liquid consistency)
  • Moderate (several loose or watery stools, irritable, anorexia, nausea and vomiting)
  • Severe (continuous watery stools, symptoms of fluid and electrolyte imbalance, camping, extremely irritable and difficult to console)
• Causes of gastroenteritis


  • Rota virus (leading cause in children <5 years of age)
  • Escherichia coli (E. Coli)
  • Salmonella
  • Shigella
• Pathophysiology of diarrhea


  1. Entry and Growth in the Intestine

  2. Osmotic Pressure Rises

  3. Hypersecretion of water and electrolytes

  4. The movement of water and electrolytes into the gut cavity

  5. Hyper-peristaltic
• The toxin can not be absorbed
• Anxiety decreases the chance intestines to absorb food
• Assessment and diagnostic studies for diarrhea

  • History
  • Physical examination
  • Stool analysis
  • Serum electrolytes
  • Urinalysis
  • ABG
• Nursing management of diarrhea

  1. Adequate hydration status

  2. Oral rehydration therapy

  3. IVF (I & O; weight)

  4. Adequate nourishment

  5. Breastfeeding (infants)

  6. Reintroduce nutrients early

  7. Prevent infection (Enteric precautions, Proper handwashing, Skin care, Expose diaper area to air, Change diaper frequently, Keep area clean and dry)
• Nursing interventions for vomiting

  1. Determine cause of vomiting

  2. Thirst: most sensitive guide to fluid needs

  3. Carbohydrates: to spare body protein and avoid ketosis

  4. Small frequent feeding

  5. Position on side or semi reclining to prevent aspiration

  6. Brush teeth rinse mouth after vomiting to dilute HCI that comes in contact with teeth
• Patho

  
• Acute diarrhea

  – Rotavirus is the most common cause of acute

  nonbacterial diarrhea (gastroenteritis)

  – Bacterial causes includes:

  • Escherichia coli (E. Coli)

  • Salmonella

  • Shigella

  – Clostridium difficile (may follow antibiotic

  therapy)

  – Other causes: URTI, UTI, over feeding,

  antibiotics, ingested toxins, irritable bowel

  syndrome, enterocolitis, and lactose intolerance
• Chronic diarrhea

  – Malabsorption syndromes

  – Anatomic defects

  – Allergic reactions

  – Lactose intolerance

  – Inflammatory response

  – Immunodeficiency

  – Motility disorders

  – Endocrine disorders

  – Parasites

  – Chronic nonspecific diarrhea