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Diarrhea: DEFINITION-Diarrhea Is Define As The Passage of Loose, Liquid or

Diarrhea is defined as loose or watery stool more than 3 times per day. It is a major cause of death in children in developing countries. Diarrhea can be acute lasting 3-7 days or chronic lasting more than 3 weeks. It is commonly caused by viruses, bacteria, parasites, and transmitted through feco-oral route or contaminated food and water. Management involves rehydration therapy with oral rehydration solution and continued feeding to prevent dehydration and malnutrition. For severe cases intravenous fluids may be needed. Nursing care focuses on restoring fluid and electrolytes, preventing spread of infection, providing nutrition, and giving health education.

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Niharika Chauhan
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147 views6 pages

Diarrhea: DEFINITION-Diarrhea Is Define As The Passage of Loose, Liquid or

Diarrhea is defined as loose or watery stool more than 3 times per day. It is a major cause of death in children in developing countries. Diarrhea can be acute lasting 3-7 days or chronic lasting more than 3 weeks. It is commonly caused by viruses, bacteria, parasites, and transmitted through feco-oral route or contaminated food and water. Management involves rehydration therapy with oral rehydration solution and continued feeding to prevent dehydration and malnutrition. For severe cases intravenous fluids may be needed. Nursing care focuses on restoring fluid and electrolytes, preventing spread of infection, providing nutrition, and giving health education.

Uploaded by

Niharika Chauhan
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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UNIT IV- DISORDERS AND HEALTH PROBLEMS OF A CHILD

DIARRHEA
DEFINITION- Diarrhea is define as the passage of loose , liquid or
watery stool more than 3 times per day.

Diarrheal diseases rank among the top 3 causes of childhood death in


the developing countries.
Acute diarrhea is term as an attack of loose motion with sudden
onset which usually last for 3-7 days and may last up to 10-14days .
Chronic diarrhea is term when the loose motion is occurring for 3
weeks or more.
Diarrhea with watery stool and visible blood in the stool is termed as
dysentery.

EPIDEMIOLOGY- Diarrhea is a major public health problem in India


among children below the age of 5year.
About 1/3 or total hospitalized children are due to diarrheal diseases
and 17% of all deaths in pediatric patient are related to this
condition.
AGENT/FACTORS-
• The infectious agents causing diarrhea with enteric infection
include viruses(rotavirus), bacteria(salmonella, cholera vibrio),
parasites(e.histolytica, malaria etc) and fungi (candida albicans)
• Environmental factors include – bacterial diarrhea is more
common in summer and rainy season whereas viral diarrhea is
found in winter. Diarrheal diseases are commonly seen
unhygienic environment.
• Host factors- the disease is most common in children specially
those between 6months to 2year.the incidence is highest
during weaning period that is 6-11 months of age.
Malnourished children are more prone to diarrhea.

MODE OF TRANSMISSION- It is mainly feco-oral route, oral route,


water borne, food borne disease or may transmit via flies, dirt.

CAUSES-
• It may occur from other infections like UTI, pneumonia etc.
• Overfeeding, food allergy
• Food poisoning
• Antibiotics
• Mal absorption syndrome
• Inappropriate used of laxatives
• Emotional stress

TYPES OF DIARRHEA-
1. SECRETORY DIARRHEA- It is caused by external or internal
secretagogues(hormones, drug sand poisons) . There is
decrease absorption and increased secretion.
2. OSMOTIC DIARRHEA – It is due to ingestion of poorly absorb
solute or maldigestion. It tends to be watery and acidic.
3. MOTILITY DIARRHEA- It is associated with increase or delayed
motility of the bowel.

CLINICAL MANIFESTATIONS-
• Dehydration
• Loose or watery stool
• Low grade fever
• Thirst
• Vomiting
• Irritability
• Weakness
• Lethargy
• Restlessness
• Loss weight
• Poor skin turgor
• Dry lips
• Sunken eyes
• Dry mucus membrane
• Low BP
• Rapid respiration
• Low or absent urinary output
• Convulsions or loss of consciousness in rare cases.

DIAGNOSTIC EVALUATION-
• History collection
• Physical examination
• Assessment of degree of dehydration
• Stool examination
• Blood examination

MANAGEMENT-
• REHYDRATION THERAPY- The management of diarrhea is best
done with ORS and continued feeding . Replacement of fluid by
rehydration therapy is the principle measure.
It can be provided by ORT or IV fluids.
The standard formulation of ORS as recommended by WHO is
Nacl-3.5g, KCL-1.5g , Sodium citrate-2.9g, Glucose- 20g/L
INSTRUCTIONS-
1. To be diluted in 1litre of portable water.
2. Mix entire content of the packet in 1litre of water.
3. ORS to be use with 24hrs of preparation.
• ORT-It means drinking of solution of portable water , sugar and
mineral salts to replace the water and salt lost from the body
during diarrhea specially when accompanied by vomiting .
ORT is beneficial in 3 stages of diarrheal disease i.e. prevention
of dehydration.
1. Rehydration of the dehydrated child
2. Maintenance of hydration after severely patient has been
rehydrated with IV fluid therapy.
3. ORT is provided with ORS and home available fluids i.e. fruit
juices, coconut water, dal soup, sherbet ect.

MANAGEMENT OF CHILD HAVING NO DEHYDRATION-


• The child with loose motion having no dehydration can be
treated at home.
• Give the child more fluids than usual to prevent dehydration
until the diarrhea stops.
• Give the child plenty of fluid to prevent undernutrition.
continue breast feeding, frequently offer food at least 6 times a
day.
• Take the child to the health worker if the child does not get
better.
MANAGEMENT OF CHILD HAVING DIARRHEA WITH SOME
DEHYDRATION-
• Management should be done under supervision of health
worker with ORS.
• After 4hrs of rehydration therapy the child should assessed for
degree of dehydration.
• If the signs of severe dehydration have appear the child should
be admitted in the hospital for IV therapy.
• During ORS therapy if the child is having puffy eyelids than ORS
should be stop and plane water and breast feeding to be given.
MANAGEMENT OF CHILD WITH SEVERE DEHYDRATION-
• The child with severe dehydration should be treated quickly.
• IV fluids to be started immediately with RL solution or if not
available NS to be used.
• The patient should be reassessed every 1-2hrs.
• More rapid IV fluid to be given if hydration is not improving.
DIETARY MANAGEMENT-
• Diet to be plan to prevent malnutrition and allow normal
nutritional requirement.
• Food items may include energy rich foods with rice, potatoes,
pulses, wheat, vegetables, fish, fruits.
• Breast feeding to be continued during diarrheal episodes along
with ors.
• Mixtures like rice milk, dahlia saag or khichri can be given to the
infants more than 6months of age.
• Hygienic measures to be followed during preparation and
serving of fruits and foods.
• Feeding to be given in small quantity every 2-3hrs.
NURSING MANAGEMENT-
• Restoring fluid and electrolyte imbalance by ORS, IV fluid
therapy, intake and output recording and checking of vital
signs.
• Prevention of spread of infection by good handwashing
practices, hygienic disposal of stools , care of dipper, and follow
universal precautions.
• Preventing skin breakdown by frequent change of diaper,
keeping the perineal area dry and clean and the use of
protective barrier cream.
• Providing adequate nutritional intake by appropriate dietary
mgmt..
• Reducing fear and anxiety by explanation , reassurance and
providing necessary information.
• Giving health education for prevention of diarrhea , home
mgmt. , importance of ORS , hygienic practices.

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