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14a Gastroenteritis (GE) 肠胃炎, : - Coggle Diagram
14a Gastroenteritis (GE) 肠胃炎
What is GE?
Present with
diarrhoea, abdominal cramps and vomiting
fecal-oral route
: through contaminated food / water
person to person
: close contact
def: acute inflammation of the lining of the stomach and intestines caused by viruses, bacteria and parasites.
Clinical manifestations
diarrhoea, listlessness, weight loss, irritability, abdominal pain, dehydration, poor skin turgor, nausea and vomiting
Pathophysiology
invasion pathogens into GI tract ->
increased
intestinal
secretion
inflammation ->
decrease
in the intestinal
absorption
the organism remains attached to the cell surface, penetrates the mucosa
Diagnostic Evaluations
History taking
find possible cause of diarrhoea
assess severity of symptoms & risk of complications
Lab tests
Blood for electrolytes (children who are severely dehydrated and receiving IV therapy)
stool specimen - if inflammation present, further test particularly for bacterial & parasitic infection
Complications
loss of fluid and electrolytes, acid-base imbalance, severe dehydration, hypovolemic shock, death
Medical Treatment
(ORS) Oral Rehydration Solutions
: contain carbohydrate (glucose/ rice syrup) & electrolytes (Na, K, Cl, HCO-3)
Infants & Children
Mild dehydration
: ORS + encourage feeding
Moderate to Severe dehydration
: IV fluids at hospital
AVOID
caffeine (diuretic)
& lactose containing product
virus or bacteria infection
(cases of
diarrhoea
): NOT using antibiotics or antiviral medications
parasitic infection
: anti-parasitic medicine
ANTIBIOTICS: given to very young children with
weak immune system
Nursing Diagnosis
RISK FOR IMPAIRED SKIN INTEGRITY
related to frequent passing of watery stool
Cleanse perineal area with warm water using wipes that is free of any alcohol.
(R) the longer the stool is in contact with the child’s skin, the greater risk of excoriated tissue脱落组织. Alcohol can be painful on impaired skin.
Change diapers as soon as stooling occurs.
(R) liquid stools generally contain high amount of acids which at greater risk of excoriated tissue.
Apply soothing balm香脂/ ointment to affected area.
(R) a balm/ ointment is a protective barrier on the child’s skin.
Leave buttocks exposed to air whenever if possible.
(R) air helps to keep the skin dry & free from any irritation such as from diaper or napkin rubbing on the skin.
RISK FOR FLUID VOLUME DEFICIT
related to frequent passing of watery stool and vomiting
Weight infant/ child daily. (R) daily accurate weight are necessary to ascertain the amount of fluids lost through watery stool and vomiting.
Monitor vital signs and temperature hourly. (R) helps to determine if the infant/ child responding appropriately to medical & nursing intervention.
Record I/O accurately. (R) to dertermine the amount of fluid replacement required.
Observe & monitor IV fluid administration. (R) fluid depletion occurs very rapidly in infants & small children.
Obtain fresh stool specimen if ordered. (R) to determine if there are any ova / parasites in the stool.
Resume oral liquids & foods gradually starting with rehydration fluids as ordered. (R) rehydration helps to decrease the mobility of the colon, rest the intestinal tract & decrease the risk of water toxicity.
PARENTERAL KNOWLEDGE DEFICIT
related to home care management of gastroenteritis
Instruct parents on proper methods of storing & preparation of milk formulas or food.
(R) improper handling/ storing of food products can increase the risk of future GE.
Teach proper hand washing techniques,
especially handling of soil diapers before preparing or eating a meal
(R) hand washing is the first line of defence in preventing the spread of infection.
Educate parent on sign & symptoms of dehydration & seek treatment early as it occurs rapidly in infant & small children.
(R) early detection prevent more severe complications from the dehydration.
Educate parents that some over-the-counter remedies for vomiting & diarrhoea can be harmful to infant & small children.
(R) absorbents such as kaolin and pectin may alter the consistency and appearance of stools, decrease the frequency of evaluation.
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