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8/8/2019 Reporting Diarrhea
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8/8/2019 Reporting Diarrhea
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Definition
Increase in frequency,volume and fluid content of
stool
A symptom rather than aprimary disorder
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Types
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
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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
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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.
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Complications
Dehydration, especially in very young andolder or debilitated adult
Severe Diarrhea: leads to vascularcollapse, hypovolemic shock, electrolyteimbalances such as hypokalemia,hypomagnesemia, metabolic acidosis
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Collaborative Care
Management focuses on identifyingand treating the cause, andpreventing complications.
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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
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Sigmoidoscopy: direct examinationof bowel mucosa
Tissue biopsy; identify chronicinflammatory process and infections
A. Diagnostic Tests
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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.
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B. Medications:
Antidiarrheal medicationscommonly contain opium orderivatives, anticholinergics,
absorbants and demulcents
Antibiotics should be used
cautiously since these alter thebowel’s normal bacterial flora
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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
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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
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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
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Home care: teach regardingcare including proper handwashing, introduction of foodwith constipating effect (i.e.
crackers, bananas, rice,potatoes)
Nursing Care
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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