INFECTIOUS GASTROENTERITIS

Tamara FulkersonAllison Geary

Infectious gastroenteritis is caused by a group of viruses, bacteria and parasites capable of causing serious communicable diarrhea, massive fluid and electrolyte loss, sepsis and death.

ETIOLOGY

Ingestion of contaminated food or water and person-to-person contamination are the most frequent causes of infectious gastroenteritis in the United States.

Electron Micrographs of viruses that cause gastroenteritis in humans. A = rotavirus, B = adenovirus, C = norovirus and D = astrovirus. They are shown at the same magnification of approximately x 200,000

*Rotavirus is the most common cause of gastroenteritis in children

SIGNS AND SYMPTOMS

DiarrheaAnorexia, Nausea and VomitingAbdominal painTenesmus – cramping and rectal painFeverDehydration in extreme cases

DIAGNOSISStool culture to identify pathogenExpensive and commonly result in false- negative

findingsPresence of WBCs and blood in stool

Supports presumptive diagnosisBlood cultures

May be needed in acutely ill infant or young childSigmoidoscopy

To determine amount of mucosal involvement, obtain more reliable sample for culture and diagnose the disease

TREATMENT IV fluids or PO electrolyte replacement liquids Used for water Used for water replacement and correcting fluid and

disturbances

Hospitalization is common in infants and small children Allows for continued assessment and management of symptoms or sepsis Antimicrobial therapy

Used for treatment of Shigella, Giardia and in some cases of C. diff and E. coli

Rotavirus vaccine

An oral vaccine for babies that protects against rotavirus infection, a common cause of diarrhea and

sickness

ROTAVIRUS VACCINE

In 2006, the first vaccine for rotavirus become available.

Rotavirus vaccination is recommended for all children, starting at two months of age in a two- or three-dose series spread over many weeks, to be completed by the time the infant is four months old (for the two-dose series) or six months old (for the three-dose series).

Vaccines against rotavirus prevented more than 176,000 hospitalizations, 242,000 emergency department visits, and 1.1 million doctor's visits in the first four years they were available. Study authors estimate that this resulted in a cost savings of $924 million.

NURSING DIAGNOSIS

Deficient Fluid Volume related to severe diarrhea

Interventions Administer oral or parenteral rehydration to replace fluid

and electrolyte losses

Monitor pulse, respirations, blood pressure, skin turgor

and capillary refill

Monitor total fluid intake and output

Weigh daily and watch for sudden decreases

Monitor serum electrolytes

Provide frequent oral care

References

McKinney, E.S., James, S.R., Murry, S.S., Nelson, K. A., & Ashwill, J.W. (2013). Maternal-Child Nursing. St.

Louis: Elsevier.World Health Organization. Rotovirus. Retrieved (10 March 2015) from Http://www.who.int/biologicals/areas/

vaccines/rotavirus/background/en/The History of Vaccines. Rotovirus. Retrieved (19 March 2015) from http://www.historyofvaccines.org/

content/articles/rotavirus