Podcast
Questions and Answers
Signs of mild dehydration include ______ and dizziness.
Signs of mild dehydration include ______ and dizziness.
apathy/tiredness
In moderate dehydration, a child may exhibit ______ and oliguria.
In moderate dehydration, a child may exhibit ______ and oliguria.
dry tongue or sunken eyes
Severe dehydration can lead to ______ and confusion leading to coma.
Severe dehydration can lead to ______ and confusion leading to coma.
shock
Children who have passed six or more diarrhoeal stools in the past 24 hours are at risk of ______.
Children who have passed six or more diarrhoeal stools in the past 24 hours are at risk of ______.
Signup and view all the answers
Oral rehydration solutions are essential for the ______ or correction of dehydration.
Oral rehydration solutions are essential for the ______ or correction of dehydration.
Signup and view all the answers
After rehydration, parents should encourage the child to drink plenty of their usual ______.
After rehydration, parents should encourage the child to drink plenty of their usual ______.
Signup and view all the answers
It is advised to avoid giving children ______ and carbonated drinks until diarrhoea has stopped.
It is advised to avoid giving children ______ and carbonated drinks until diarrhoea has stopped.
Signup and view all the answers
The risk of dehydration is particularly high in infants younger than ______ year of age.
The risk of dehydration is particularly high in infants younger than ______ year of age.
Signup and view all the answers
Fluid accumulation in the lower bowel produces ______, leading to stimulation of peristalsis.
Fluid accumulation in the lower bowel produces ______, leading to stimulation of peristalsis.
Signup and view all the answers
Lactulose takes ______ hours to work.
Lactulose takes ______ hours to work.
Signup and view all the answers
Stimulant laxatives cause peristalsis by stimulating colonic nerves such as ______.
Stimulant laxatives cause peristalsis by stimulating colonic nerves such as ______.
Signup and view all the answers
MICROLAX® is a fast-acting micro-enema that provides relief within ______ minutes.
MICROLAX® is a fast-acting micro-enema that provides relief within ______ minutes.
Signup and view all the answers
A bulk-forming laxative is ______ preferred for treatment of constipation.
A bulk-forming laxative is ______ preferred for treatment of constipation.
Signup and view all the answers
Oral Rehydration Salts (ORS) should be reconstituted with ______ ml of water.
Oral Rehydration Salts (ORS) should be reconstituted with ______ ml of water.
Signup and view all the answers
Once reconstituted, ORS should be used within ______ hour.
Once reconstituted, ORS should be used within ______ hour.
Signup and view all the answers
Loperamide works by binding to the ______ receptor in the gut wall.
Loperamide works by binding to the ______ receptor in the gut wall.
Signup and view all the answers
The usual initial dose of Loperamide for adults is ______ tablets.
The usual initial dose of Loperamide for adults is ______ tablets.
Signup and view all the answers
Loperamide is contraindicated in children under ______ years of age.
Loperamide is contraindicated in children under ______ years of age.
Signup and view all the answers
Tasectan contains the active ingredient ______ tannate.
Tasectan contains the active ingredient ______ tannate.
Signup and view all the answers
Gastroenteritis is characterized by the sudden onset of ______, with or without vomiting.
Gastroenteritis is characterized by the sudden onset of ______, with or without vomiting.
Signup and view all the answers
Gastroenteritis is a common illness in infants and young ______.
Gastroenteritis is a common illness in infants and young ______.
Signup and view all the answers
Loperamide should be discontinued if there is ______, abdominal distension, or if bowels are not moving.
Loperamide should be discontinued if there is ______, abdominal distension, or if bowels are not moving.
Signup and view all the answers
Loperamide acts by increasing the tone of the anal ______.
Loperamide acts by increasing the tone of the anal ______.
Signup and view all the answers
Encourage the child to wash their hands thoroughly after going to the ______ and before eating.
Encourage the child to wash their hands thoroughly after going to the ______ and before eating.
Signup and view all the answers
Thoroughly clean the potty or toilet using ______ after each episode of diarrhoea and vomiting.
Thoroughly clean the potty or toilet using ______ after each episode of diarrhoea and vomiting.
Signup and view all the answers
Do not allow the child to return to nursery or school until ______ hours have passed since their last episode of diarrhoea.
Do not allow the child to return to nursery or school until ______ hours have passed since their last episode of diarrhoea.
Signup and view all the answers
Do not allow the child to enter a ______ pool for the first two weeks after their last episode of diarrhoea.
Do not allow the child to enter a ______ pool for the first two weeks after their last episode of diarrhoea.
Signup and view all the answers
Practising good food hygiene will help children avoid getting gastroenteritis as a result of food ______.
Practising good food hygiene will help children avoid getting gastroenteritis as a result of food ______.
Signup and view all the answers
All children born on or after ______ are given rotavirus oral vaccine at 2 and 4 months of age.
All children born on or after ______ are given rotavirus oral vaccine at 2 and 4 months of age.
Signup and view all the answers
Diarrhoea in children usually lasts for ______ days and stops in most children within 2 weeks.
Diarrhoea in children usually lasts for ______ days and stops in most children within 2 weeks.
Signup and view all the answers
Recognize developing features of ______ and shock in children, such as lethargy or irritability.
Recognize developing features of ______ and shock in children, such as lethargy or irritability.
Signup and view all the answers
Do not store raw and cooked ______ together to prevent cross-contamination.
Do not store raw and cooked ______ together to prevent cross-contamination.
Signup and view all the answers
Defecation that is unsatisfactory is characterized by infrequent ______.
Defecation that is unsatisfactory is characterized by infrequent ______.
Signup and view all the answers
Difficult stool passage may lead to ______ defecation.
Difficult stool passage may lead to ______ defecation.
Signup and view all the answers
Functional constipation is chronic constipation without a known ______.
Functional constipation is chronic constipation without a known ______.
Signup and view all the answers
Specific questions to ask include changes in ______ or routine.
Specific questions to ask include changes in ______ or routine.
Signup and view all the answers
Patients aged over ______ years with sudden change in bowel habit may require referral.
Patients aged over ______ years with sudden change in bowel habit may require referral.
Signup and view all the answers
The prevalence of childhood constipation is ______–20%.
The prevalence of childhood constipation is ______–20%.
Signup and view all the answers
During treatment, adjust any constipating ______, if possible.
During treatment, adjust any constipating ______, if possible.
Signup and view all the answers
If stool remains hard, switch to an ______ laxative.
If stool remains hard, switch to an ______ laxative.
Signup and view all the answers
If constipation is due to opioid medication, advise that laxatives can be ______ once stools are soft.
If constipation is due to opioid medication, advise that laxatives can be ______ once stools are soft.
Signup and view all the answers
Parents may not be aware of the link between soiling and ______.
Parents may not be aware of the link between soiling and ______.
Signup and view all the answers
Avoid excessive doses of laxatives to prevent misuse and ______.
Avoid excessive doses of laxatives to prevent misuse and ______.
Signup and view all the answers
Study Notes
Dehydration
- Dehydration can be mild, moderate, or severe
- Signs and symptoms include:
- Lassitude
- Anorexia
- Nausea
- Lightheadedness
- Postural hypotension
- Apathy/tiredness
- Dizziness
- Muscle cramps
- Pinched face
- Dry tongue or sunken eyes
- Profound apathy
- Weakness
- Confusion leading to coma
- Shock
- Tachycardia
- Reduced skin elasticity
- Oliguria
- Peripheral vasoconstriction
- Systolic blood pressure < 90 mmHg
- Increased risk of dehydration in:
- Infants younger than 1 year of age, and especially if younger than 6 months
- Infants who were of low birthweight
- Infants who have stopped breastfeeding during their illness
- Children who have passed six or more diarrhoeal stools in the past 24 hours
- Children who have vomited three times or more in the past 24 hours
- Manage dehydration with oral rehydration solutions (ORS)
Gastroenteritis
- Common illness in infants and young children
- Transient due to enteric infection with viruses, bacteria, or parasites
- Inflammation of stomach, small and large intestines
- Characterized by sudden onset of diarrhoea, with or without vomiting
- Control infection by:
- Thorough hand washing
- Cleaning toilet/potty with disinfectant
- Not sharing towels, flannels, cutlery, or eating utensils
- Preventing children from returning to nursery/school for 48 hours after last episode of diarrhoea and vomiting
- Prevent from swimming for the first 2 weeks after last episode of diarrhoea
- Prevent gastroenteritis by:
- Practicing good food hygiene
- Regularly washing hands, surfaces, and utensils with hot, soapy water
- Never storing raw and cooked foods together
- Making sure food is kept properly refrigerated
- Always cooking food thoroughly
- Never eating food that is past its expiry date
- Practicing good food hygiene
- Rotavirus vaccine:
- Prevents Rotavirus disease
- All children born on or after 1 October 2016 are given rotavirus oral vaccine at 2 and 4 months of age
Constipation
- Prevalence of childhood constipation is 1-20%
- ~5% will have constipation lasting more than 6 months
- Peak incidence of constipation is at the time of toilet training (typically around 2-3 years of age)
- Can also occur at weaning and at school age
- Signs and symptoms include:
- Infrequent stools
- Excessive straining
- Difficult stool passage
- Incomplete defecation
- Stools are often dry and hard
- Stools may be abnormally large or abnormally small
- Functional constipation is chronic constipation without a known cause
- Secondary constipation is constipation caused by a drug or medical condition
- Referral required if:
- Pain on defecation causing the patient to suppress defecation reflex
- Patients aged over 40 years with sudden change in bowel habit with no obvious cause
- Greater than 14 days with no identifiable cause
- Recurrent abdominal pain
- Mucus in stool
- Tiredness
- Dark blood in stools
- Unexplained Weight loss
- Fever
- Nocturnal Symptoms
- Children for longer than 7 days
- Watch for abuse/misuse
- Treatment Failure
Constipation Treatment
- Aim to restore normal bowel function
- Adjust any constipating medication, if possible
- Do not take laxatives if obstruction is suspected
- Advise the person about increasing dietary fiber, adequate fluid intake, and exercise
- Offer oral laxatives if dietary measures are ineffective, or while waiting for them to take effect
- Start treatment with a bulk-forming laxative (adequate fluid intake is important), then add or switch to an osmotic laxative if stool is still hard
- If stools are soft but the person still finds them difficult to pass or complains of inadequate emptying, add a stimulant laxative
- If constipation due to opioid medication? Advise the person that laxatives can be stopped once the stools become soft and easily passed again
- Avoid excessive doses of laxatives - subject to misuse and abuse, can lead to diarrhoea and electrolyte disturbances
Stimulant Laxatives
- Cause peristalsis by stimulating colonic nerves (senna) or colonic and rectal nerves (bisacodyl)
- e.g. bisacodyl (Dulcolax®), senna (Senokot®), glycerol suppositories
Haemorrhoids
- Referral Required if:
- Over 40 yrs and persistent change in bowel habit
- Unexplained bleeding
- Severe pain associated with defecation
- Blood mixed in the stool
- Fever
- Treatment failure > 7 days.
Haemorrhoid Treatment
- Provide lifestyle advice to minimize constipation and straining
- Recommend a laxative if needed
- A bulk-forming laxative is preferred
- Lactulose alternative
- Stimulant laxatives without stool softening activity (e.g. senna) are less preferred - do not soften stools & stimulant effect may worsen symptoms
- Provide symptomatic relief with analgesia e.g. paracetamol
- Topical products - Soothing preparations containing mild astringents, emollients or lubricants are usually preferred
- Topical preparations containing corticosteroid &/or local anaesthetic may be considered for treating perianal inflammation and pain.
OTC - Treatment Options
- Anaesthetics e.g. lidocaine, benzocaine - numb the area, provide short term relief from itching and pain
- Astringents e.g. zinc, bismuth – produce a protective coating over the haemorrhoid. Also have antiseptic properties
- Anti-inflammatory e.g. hydrocortisone – steroid, which reduces swelling of the haemorrhoid.
- Referrals - sclerotherapy, rubber band ligation or a haemorrhoidectomy
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on dehydration and gastroenteritis, including their signs, symptoms, and management strategies. This quiz covers important information regarding the risks, especially in vulnerable populations like infants and children. Assess what you know about effective treatment methods, including oral rehydration solutions.
