Diarrheal Diseases in Children PDF

Diarrhea and dehydration in children Done By: Marwa Abd Elkreem  INTRODUCTION Diarrhea and dehydration are a life threatening emergency. There are many causes lead to Diarrhea and dehydration in children.  Diarrhea is a symptom that can result from disorders....

Diarrhea and dehydration in children Done By: Marwa Abd Elkreem  INTRODUCTION Diarrhea and dehydration are a life threatening emergency. There are many causes lead to Diarrhea and dehydration in children.  Diarrhea is a symptom that can result from disorders. Dehydration is classified as mild, moderate or severe based on how much body fluid is lost. Diarrhea is Sudden increase in the frequency of stools. Change in stool consistency with an increase in fluid content. Tendency of stool to be greenish in color and contain mucous or blood. Factors that predispose the child to diarrhea: Age socio-economic status Overcrowding environmental sanitation Nutrition personal hygiene Parent’s education Chronictability Emotional disturbance Why children are more susceptible to DDs & Dehydration? -Electrolyte system of infants and young children is less adjustable to the disturbances in fluids and electrolytes. - About 50% of the body fluids found in the extracellular fluids until the age of 2 years, so fluids are more rapidly lost. -In dehydration 60% of loosed fluid from extracellular and 40% from intracellular fluids. Why children are more susceptible to DDs & Dehydration? -The basal metabolic rate (BMR) is higher to support child's growth. Increase BMR produces more heat that needs more water consumption. -The kidney is relatively immature in function, has less ability to concentrate urine. So the child is more difficult to handle over or under amounts of fluids. -They need more fluids intake than older children and adults.  Causes In most cases, children dehydration is from fluid losses from vomiting or diarrhea. Diarrhea may be caused by any of the following systems or processes: CNS (eg, infections) GI (eg, gastroenteritis, obstruction, hepatitis, intussusception, pyloric stenosis, toxicity [ingestion, overdose, drug effects]) Endocrine (eg, diabetic ketoacidosis) Renal (eg, infection, renal failure) Consequences or outcomes of diarrheal diseases in children depend on: Severity of illness The cause Types Duration of diarrhea Associated symptoms Child's age Child's nutritional status  Types of diarrhea Acute: – Is a leading cause of illness in children under five years of age. – Dehydration is the fatal complications of acute diarrhea. – It is usually self-limited. Chronic – The passage of loose stool with increased frequency that lasts for more than 2 weeks. Acute diarrhea: It commonly results from 1-Acute invasion of the GIT by microorganisms. 2-Infections in outside of GIT as, communicable diseases. 3-Antibiotic misuse. 4-Food poisoning. Chronic diarrhea: it usually associated with: 1-Faulty preparation of infant formula. 2-Over feeding and imbalanced diet. 3-Malabsorption disorders. 4-Intestinal obstruction. 5-Anatomical defects. 6-Allergic reactions (Food & drugs). Signs and symptoms of diarrhea: Mild diarrhea *Change in nature and frequency of defecation (2- 5 /day), fluidity in consistency. *3 %-5% of body weight may be lost. *Low grade fever, possibly vomiting. *Irritability and disturbed sleep. Moderate diarrhea *frequency of defecation (6-9/day) 6%-9% of body weight may be lost Moderate grade fever. *Child may be drowsy , have reduced tearing, dry skin, and decreased urinary output. Severe diarrhea Frequency of defecation (more than 10 times). more 10% of body weight is lost. Child has altered mental status. Rapid pulse Delayed capillary refill. Rapid respiration  Nursing Management of Diarrhea  Nursing Assessment ► Measuring weight and vital signs  Assessing the child's for: Degree of diarrhea and dehydration Frequency, color, odor and consistency of stool Presence or absence of mucus, pus or blood in stool Duration of diarrhea and number of episodes\day Child's ability to drink and or presence of thirst Presence of vomiting, fever or other problems (cough otitis media). Last time urine passed. Feeding practices before and during illness. Treatment during this episode (ORS, drugs)  Nursing Interventions ►Monitor child's vital signs, child's weight ►Monitor the character, amount, and frequency of diarrhea ►Monitor fluid intake and output ►Instruct the parents about the effective hygienic strategies when dealing with the child ►Apply dipper care frequently. ►Monitor for signs and symptoms of dehydration ►Encourage the mother to continue breast feeding for breastfeed children ►Teach the mother to offer the child food braced fluids as soup, rice and wheat water – potato etc…..  Foods should be avoided during diarrhea ►Foods rich with fat ►Junk foods ►Spicy foods ►Carbonated fluids ►Foods rich with sugar & glucose Prevention of Diarrhea Promotes of breast feeding. Improve weaning practices. Proper use of water drinking. Personal hygiene. Safe disposal of stools of young children. Dehydration Dehydration is a common body fluid and electrolytes disturbance in infants and children and occurs whenever the total output of fluid exceeds the total intake regardless the underlying cause.  Dehydration Dehydration is common body fluid and electrolytes disturbance in infants and children which occurs when the total fluid output is higher than the total fluid intake due to the underlying cause. It is one of the consequences loss of water and electrolytes through diarrhea, and vomiting. Causes of dehydration Dehydration can be caused by losing too much fluid, not drinking enough water or fluids, or both. Vomiting and diarrhea are common causes for dehydration. based on how much body's fluid is lost. 1-Increased loss from GIT, UT, the skin and respiratory tract. 2-Lack of oral intake 3-Excessive vomiting and repeated diarrhea. 4-Burns Types of Dehydration 1- Isotonic Loss of water & salt Shock is fatal Types of Dehydration 2- Hypotonic Loss of salt is less than water loss Shock may find Types of Dehydration 3- Hypertonic Loss of salt is more than water loss Shock is less freq.  Signs and Symptoms Symptom Mild Moderate Severe Apathetic, Restless or Mental status Normal lethargic, fatigued, irritable unconscious Normal to Heart rate Normal Tachycardia increased Quality of Normal to Weak, thready, Normal pulse decreased impalpable Normal to Breathing Normal Tachypnea increased Eyes Normal Slightly sunken Deeply sunken Fontanelles Normal Slightly sunken Deeply sunken Normal to Tears Normal Absent decreased Mucous Moist Dry Parched membranes