Gastroenteritis Nursing Notes PDF

Gastroente ritis Presented by: Dr/Rasha Helmy Lecturer of pediatrics, Cairo University Gastroenteritis: acute infective diarrhea. Diarrhea: frequency, fluidity or volume of stool deviated from the normal habit. Age Normal frequency 0-4 months 1-7 motio...

Gastroente ritis Presented by: Dr/Rasha Helmy Lecturer of pediatrics, Cairo University Gastroenteritis: acute infective diarrhea. Diarrhea: frequency, fluidity or volume of stool deviated from the normal habit. Age Normal frequency 0-4 months 1-7 motions/day 5-15 months 1-3 motions/day >1 year 1-2 motions/day  Infective diarrhea Bacteri Parasiti Viral al c  Bacterial Viral Parasitic Salmonella Rota virus Giardia lamblia Shigella Adenovirus Entameba Ecoli histolytica Campylobacter jejuni Yersinia enterocolitica Staph Cholera Clinical evaluation: 1. Severity of diarrhea: Mild Moderate Severe 3-6 motions/d 6-10 motions/d >10motions/d 2. Associated symptoms: fever, vomiting, abdominal pain. 3. Signs of dehydration: Signs and Grades of Dehydration Mild Moderate Severe/ Shock Shocked Baby 4-Causative organism: Watery Bloody Bacterial Enterotoxic EC EnteroInvasive EC Staph Samonella Cholera Shigella Yersinia Campyelobacter jejuni Viral Rota Parasitic Giardia E.histolytica Notes  The most frequent cause is rotavirus.  60% of cases in children < 2 yr.  More during the winter & early spring. Complications: Dehydration. Metabolic acidosis. Hypokalemia. Hypocalcemia. Acute renal failure. Shock. Convulsions. Bleeding. Persistent diarrhea (>2weeks). Malnutrition. Investigations: To detect the causative organism:  Stool analysis ± stool C&S.  CBC & CRP (if suspecting bacterial infection) To detect complications:  ABG.  Kidney functions.  Electrolytes. Treatment:  Correction of dehydration:  ORS or IV fluids.  Feeding: Avoid sugary juices and fatty meals  Symptomatic treatment:  For vomiting: metoclopramide or domperidone.  For fever: fomentations & antipyretics.  Specific treatment:  Antibiotics, antiprotozoal therapy.  Zinc supplentation:  Treatment of complications: Metabolic acidosis: correction of dehydration & shock, NaHco3. Renal failure: fluid balance ± dialysis. Convulsions: correction of electrolytes, diazepam. Bleeding: vit K. Septicemia: antibiotics. Persistent diarrhea. Questions  Q1) Signs of dehydration are all except  Reduced Skin turgor  Prolonged capillary refill  Sunken eyes  Normal breathing  Q2)The most common cause of GE is  Viral  Bacterial  Mycobacterial  fungal  And the most common organism is ……  Klebsillea  Candida  Pseudomonus  Rotavirus  Q3) In shocked baby Capillary refill time is ……  30 minutes  1 second  60 seconds  >2 seconds  Q4) All of the following are complications of GE except  Dehydration.  Metabolic acidosis.  Renal Failure  Q5)All are investigations for GE except  CBC  ABG  Electrolytes  EEG  Q6)Correction of dehydration & shock, NaHco3. is the treatment of metabolic acidosis (T ) Q7) Correction of dehydration is through all except : ORS IV fluids Antibiotics Q8) Zinc supplementation is important for patients with GE ( T ) Q9) Sugary juices is good for patients with GE ( F ) Q10) All of the following is management of GE except  Correction of dehydration:  Antiprotozoal therapy.  Zinc supplantation  Steroids