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Questions and Answers
What percentage of cases is typically associated with dysentery?
What percentage of cases is typically associated with dysentery?
How long must diarrhea last for it to be classified as persistent diarrhea?
How long must diarrhea last for it to be classified as persistent diarrhea?
What characterizes post-infectious diarrhea?
What characterizes post-infectious diarrhea?
Which of the following symptoms are associated with dysentery?
Which of the following symptoms are associated with dysentery?
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Which statement about persistent diarrhea is true?
Which statement about persistent diarrhea is true?
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What is a primary consequence related to malnutrition?
What is a primary consequence related to malnutrition?
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Which of the following is NOT a major sequelae mentioned?
Which of the following is NOT a major sequelae mentioned?
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Which of the following best describes marked weight loss?
Which of the following best describes marked weight loss?
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What do dehydration and marked weight loss have in common?
What do dehydration and marked weight loss have in common?
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How does dehydration typically manifest in individuals?
How does dehydration typically manifest in individuals?
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What is included in the composition of Oral Rehydration Solutions (ORS)?
What is included in the composition of Oral Rehydration Solutions (ORS)?
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Which solution is known for managing dehydration effectively?
Which solution is known for managing dehydration effectively?
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What is the role of breast milk in hydration?
What is the role of breast milk in hydration?
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Which of the following fluids is generally NOT considered an ORS component?
Which of the following fluids is generally NOT considered an ORS component?
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What is another term for the fluid used in oral rehydration?
What is another term for the fluid used in oral rehydration?
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What assessment criteria indicates a condition of 'Some Dehydration'?
What assessment criteria indicates a condition of 'Some Dehydration'?
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Which option describes a severe case of dehydration according to the assessment criteria?
Which option describes a severe case of dehydration according to the assessment criteria?
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What is indicated by 'No Signs of Dehydration' in the assessment criteria?
What is indicated by 'No Signs of Dehydration' in the assessment criteria?
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In assessing for dehydration, which scenario would be classified as indicative of 'Some Dehydration'?
In assessing for dehydration, which scenario would be classified as indicative of 'Some Dehydration'?
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When assessing dehydration severity, which option does NOT classify as 'Severe'?
When assessing dehydration severity, which option does NOT classify as 'Severe'?
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What is an indication of severe dehydration in a patient?
What is an indication of severe dehydration in a patient?
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Which hydration method is appropriate for a patient with moderate dehydration?
Which hydration method is appropriate for a patient with moderate dehydration?
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What does a patient’s thirsty behavior indicate in terms of hydration status?
What does a patient’s thirsty behavior indicate in terms of hydration status?
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How would you assess skin elasticity for dehydration?
How would you assess skin elasticity for dehydration?
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Which condition is associated with a loss of more than 10% of body fluids?
Which condition is associated with a loss of more than 10% of body fluids?
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Which of the following symptoms indicates a return to normal hydration status?
Which of the following symptoms indicates a return to normal hydration status?
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What is the most critical sign of dehydration in terms of patient alertness?
What is the most critical sign of dehydration in terms of patient alertness?
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What is the primary goal of fluid therapy in managing dehydration?
What is the primary goal of fluid therapy in managing dehydration?
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What is the primary purpose of Oral Rehydration Solution (ORS)?
What is the primary purpose of Oral Rehydration Solution (ORS)?
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Which components are essential in the formulation of Oral Rehydration Solution (ORS)?
Which components are essential in the formulation of Oral Rehydration Solution (ORS)?
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In what situation is ORS typically used?
In what situation is ORS typically used?
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Which method is NOT commonly associated with the administration of ORS?
Which method is NOT commonly associated with the administration of ORS?
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What is the characteristic of ORS that allows it to effectively treat dehydration?
What is the characteristic of ORS that allows it to effectively treat dehydration?
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Study Notes
Nursing Management of Gastro-intestinal Disorders
- Acute watery diarrhea is the second leading cause of mortality in children aged 0-59 months worldwide.
Diarrheal Disorders Definition
- Diarrhea is an increase in frequency, fluidity, and volume of stools, relative to the usual habits of the child.
Importance of Diarrhea
- Diarrhea increases mortality rates, with 25-30% of infants and preschoolers dying as a result.
- Diarrhea is a leading cause of illness in developing countries, increasing morbidity.
- Diarrhea spreads through the fecal-oral route.
Types of Diarrhea
-
Acute Watery Diarrhea (80% of cases):
- Starts acutely, lasts 3-4 days, then improves over 4-5 days.
- Usually self-limiting, lasting less than 14 days.
- May include fever and vomiting.
- Watery or loose stools, no visible blood.
-
Dysentery (5-10% of cases):
- Loose stools with visible blood.
-
Persistent Diarrhea (10% of cases):
- Post-infectious diarrhea, starting acutely as watery stool or dysentery.
- Lasts at least 14 days.
- Main sequelae include dehydration, weight loss, and malnutrition.
Causes of Diarrhea
-
Infectious Diarrhea:
- Intestinal infection caused by viruses, bacteria, and protozoa. (Specific agents are listed in the image, but can't be reliably extracted).
-
Non-Infectious Diarrhea:
- Dietary factors: Overfeeding, food allergies, and formula that is too concentrated, or unsuitable for the child's age.
- Malabsorption: Conditions like cystic fibrosis.
- Other conditions: Irritable colon, ulcerative colitis, heavy metal poisoning, Hirschsprung's disease.
- Misconception: Teething is not a cause of diarrhea.
Consequences of Diarrhea
- Dehydration: Due to loss of water and salts.
- Electrolyte disturbances.
- Metabolic acidosis: Due to reduced sodium bicarbonate.
- Malnutrition:
Dehydration
- Caused by loss of water and electrolytes in liquid stool and vomit.
- Fever can increase water loss.
- Dehydration can lead to hypovolemia (decreased blood volume) and death if untreated.
Degree of Dehydration
- Signs and symptoms appear with a 5% loss in body weight.
- Mild dehydration occurs with less than 5% loss in body weight.
- Moderate dehydration occurs with a 5-10% loss in body weight (average 7.5%).
- Severe dehydration occurs with more than a 10% loss in body weight.
Types of Dehydration
- Isotonic: Most common type, water loss proportionate to sodium loss.
- Hypertonic: Less common (10-15%), more common in young infants, water loss greater than sodium loss.
- Hypotonic: Less common (5-10%), water loss less than sodium loss.
Clinical Assessment of Diarrheal Disorders
- History: Gather information about the diarrhea's duration, stool characteristics, presence of fever, vomiting, convulsions, other problems, medications, and vaccinations (especially measles)
-
Assessment of Dehydration:
- Two or more signs indicating severe dehydration in column C in the assessment criteria
- Two or more signs in column B indicate moderate dehydration.
- Column A indicates no signs of dehydration (mild).
Assessment Criteria for Dehydration
-
Symptoms:
- General condition (Alert, lethargic, etc.).
- Eyes (Normal, sunken).
- Thirst (Normally drinks, unable to).
- Skin pinch (Quick/Slow). -Other assessments listed include the condition of the anterior fontanel (normal, sunken), moisture levels of the mouth/tongue (moist, dry, very dry), presence of tears, extremities (cool skin with cyanosed nails), pulse characteristics (weaker/more rapid), and signs of oliguria or anuria (urine output decreased).
- Further assessment
Therapeutic Management of Diarrhea (Dehydration)
-
Treatment Focus:
- Prevent dehydration (if not already present) through fluid therapy.
- Treat dehydration with fluids (hydration).
- Ensure continued feeding during and after diarrhea.
- Maintain good hygiene, especially hygiene around the buttocks and neck/ears in the case of diarrhea and vomiting.
-
Management based on the degree of dehydration.
- Three treatment plans (Plan A, Plan B, Plan C).
Management Plans
- Plan A: Treatment at home.
- Plan B: Treatment at the Out-Patient Department.
- Plan C: Treatment at the Hospital.
Management of Dehydration: Fluids
- Plan A: Give more fluids (ORS, water, home-made fluids, breast milk).
- Plan B: Give more fluids (ORS).
- Plan C: Give intravenous fluids (Pansol, Ringer's lactate, normal saline, polyelectrolytes).
How much fluid, per plan
- Plan A: Give fluids after each loose stool (dosage for infants and toddlers).
- Plan B: 75 ml/kg of body weight within 4 hours. Specific dosage guidelines for the first hour and subsequent period are provided.
- Plan C: 100 ml/kg of body weight within 3-6 hours, with 30 ml/kg during the first 1½ hours, followed by 70 ml/kg over a 2.5 - 5 hour period
- Longer time for infants less than 1 yr of age.
How to administer fluids
-
Plan A, B, and C:
- Administration methods include cup and spoon, dropper, and syringe.
- Plan C may include a nasogastric tube to administer fluids.
Feeding
- Breastfeeding: Continue breastfeeding.
- Milk or Formula: Administer milk or formula after rehydration.
- Weaned Children: Provide food after rehydration.
- Dietary Restrictions: Avoid hyperosmolar foods (high sugar) and foods with high fiber.
Further Assessment/Referral
- Reasons to return for further assessment: Frequent large stools, increased thirst, repeated vomiting, blood in stool, and lack of improvement (with fever also listed as a reason).
Oral Rehydration Solution (ORS)
- ORS is a balanced mixture of glucose and electrolytes used to prevent or treat dehydration.
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Description
Test your knowledge on dysentery, persistent diarrhea, and oral rehydration solutions. This quiz covers essential aspects such as symptoms, consequences, and management strategies related to dehydration and malnutrition. Challenge yourself with a variety of questions that assess your understanding of these critical health topics.