Reporting Diarrhea

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8/8/2019 Reporting Diarrhea

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Definition

Increase in frequency,volume and fluid content of

A symptom rather than aprimary disorder

Acute – lasts less than a week: oftendue to infectious agent

Chronic – persists longer than 3 to 4weeks: may be caused byinflammatory bowel disorders,malabsorption and endocrine disorders

Etiology

Large volume of diarrhea is causedby increased water content of stoolfrom osmotic or secretory processes

Small volume diarrhea ischaracterized by small frequentstool: usually caused by

inflammation or diseases of thecolon

Sign & Symptoms

Affected by cause, duration,severity, area of bowel affectedand client’s general health

Varies from several large waterystools daily to very frequent small

stools containing mucus, blood orexudates.

Complications

Dehydration, especially in very young andolder or debilitated adult

Severe Diarrhea: leads to vascularcollapse, hypovolemic shock, electrolyteimbalances such as hypokalemia,hypomagnesemia, metabolic acidosis

Collaborative Care

Management focuses on identifyingand treating the cause, andpreventing complications.

A. Diagnostic Tests

Stool specimen: gross and microscopic- examination to detect WBC’s, unabsorbedfat, parasites (if parasitic infectionssuspected, usually get series of 3specimens at 2-3 day intervals.)

Stool culture: enteric pathogen

Serum electrolytes; osmolality; arterial

blood gases: to asses complications

Sigmoidoscopy: direct examinationof bowel mucosa

Tissue biopsy; identify chronicinflammatory process and infections

A. Diagnostic Tests

B. Medications:Used sparingly or not at all untilcause has been identified.

Antidiarrheal medications mayworsen disease if it slows elimination

of toxin from the bowel

Balanced electrolyte solutions, oral orintravenous potassium replacement.

B. Medications:

Antidiarrheal medicationscommonly contain opium orderivatives, anticholinergics,

absorbants and demulcents

Antibiotics should be used

cautiously since these alter thebowel’s normal bacterial flora

C. Dietary Management

Fluid replacement: oral glucose/

balanced electrolyte solution thatis commercially prepared or can

be made at homeSolid food should be withheld forthe first 24 hours to rest the

bowel; then begin frequent smallfeeding to start with soft diet

C. Dietary Management

Milk and milk products are addedlast

Foods with roughage, fried and

spicy, coffee and alcohol are avoidedin the recovery period

Clients with chronic diarrhea mayneed to eliminate specific foods foundto aggravate and cause diarrhea

Nursing Care Teaching on safe food handling andmeasures to take if travelling outsideforeign countries or without safe water

Assess information regarding durationand extent of diarrhea, risk factors,abdominal assessments and signs of dehydration

Home care: teach regardingcare including proper handwashing, introduction of foodwith constipating effect (i.e.

crackers, bananas, rice,potatoes)

Nursing Care

Diarrhea

Risk for Deficient Fluid Volume: assessfor orthostatic hypotension: drop in BP

> 10 mmHg and pulse increase of tenwhen changing from lying to sitting orstanding position

Risk for Impared Skin Integrity:provide hygiene and protectiveointment for perianal srea.

Nursing Diagnosis

Reporting Diarrhea

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