Republic of the Philippines

NUEVA ECIJA UNIVERSITY OF SCIENCE AND

Cabanatuan
TECHNOLOGY City, Nueva Ecija, Philippines
ISO 9001:2015 CERTIFIED

CASE PRESENTATION :
ACUTE
GASTROENTERITIS
IN PEDIATRIC CLIENT
PREPARED BY :
Azarcon, Jamaica Jane J.
Benedicto, Andrea Lorraine G.
Berin, Lyca B.
Bocobo, Meljude D.
Bondoc, Adrian M.
Campos, Kimberly A.
Datu, Beverly Jane L.
De Lara, Bianca Jesmine A.
Del Rosario, Trixie DC.
Domingo, Precious Mae T.
BSN II-C

Ms. Golda Mir Macabitas

HEAD STUDENT NURSE
SEVILLA C. GUINTO MAN,.RN
CLINICAL INSTRUCTOR
CHAPTER 1
• GENERAL OBJECTIVES
• SPECIFIC OBJECTIVES
• INTRODUCTION
• CLIENT’S PROFILE
GENERAL OBJECTIVES :

As a level 2 NEUST-CON student nurse, the

general objective of this case study is to be able to
gain more knowledge, improved our skills and
acquire a good attitude as necessary in dealing
with different patients, perform basic nursing skills
with confidence and competence as well as
providing an appropriate nursing management to a
pediatric patient dealing with Acute
Gastroenteritis.
 SPECIFIC OBJECTIVES :
At the end of the clinical duty the student-nurses
will be able to:
1.Assess the client from head to toe, focusing on
the parts affected by the Acute Gastroenteritis;
2.Obtain, document, and present a comprehensive
medical history;
3.Explain the anatomy and physiology of Digestive
System;
4.Define the Acute Gastroenteritis, become familiar
with the important diagnostic/laboratory
examinations that will be used in the confirmatory
and management of Acute Gastroenteritis;
SPECIFIC OBJECTIVES :
5.Understand the pathophysiology of Acute
Gastroenteritis
6.Recognize the different medications used, its action,
side effect and its action in the management of Acute
Gastroenteritis;
7.Understand the suggested medical management,
employed to resolve problems;
8.Formulate appropriate Nursing Care Plan utilizing
the Nursing Process; and
9.Identify nursing priorities; provide prompt nursing
intervention that would help alleviate the condition of
the client thus increasing their capacity to function.
 INTRODUCTION
Gastroenteritis is characterized by diarrhea or
vomiting and is described as inflammation of the
mucus membranes of the gastrointestinal tract. It's a
very common childhood illness. Children in developing
countries are at a higher risk of morbidity and
mortality than children in developed countries.
Acute diarrhea is characterized by a sudden rise in
recurrence and changes in stool consistency. It's
usually caused by an infectious agent in the GI tract.
 INTRODUCTION
Incidence of diarrheal diseases is estimated to be 3.6
percent of overall Disability Adjusted Life Years
worldwide, according to the World Health Organization
(WHO). According to the most recent Department of
Health (DOH) survey, acute watery diarrhea is the
seventh leading cause of morbidity, affecting 76.3 people
per 100,000. With a prevalence of 0.5 per 1,000 live
births, Acute watery diarrhea is also the seventh leading
cause of child mortality. Diarrhea is a leading cause of
death in children under the age of five in developing
countries, with an estimated 2 million deaths per year.
DEMOGRAPHIC PROFILE :
• Name: Patient X
• Age: 6 Years Old
• Date of Birth: March 14, 2015
• Sex: Male
• Weight: 20kg
• Civil Status: Child
• Nationality: Filipino
• Religion: Roman Catholic
• Address of parents: Mabini St. Cabanatuan City
• Date of Admission: April 8, 2021
• Attending Physician: Dr. X
FAMILY HISTORY :
No family history of the disease
related to acute gastroenteritis.
HISTORY OF PAST ILLNESS :

The client had a diarrhea 3 months

ago but was treated and resolved.
 ADMITTING HISTORY
On April 8, 2021 at around 10:00 AM, a 6-year-
old male client named X is admitted in the
Pediatric ward of ELJH with his parents. According
to his mother, the client experienced diarrhea and
vomited six times. Also, the client experienced
restlessness and fever. His temperature is 38.4 C.
The client’s final diagnosis is Acute Gastroenteritis.
He is now receiving an IV fluid of D5 0.3 NaCL
500ml bottle, connected to a microset, to run for 8
hours.
ADMITTING VITAL SIGNS :
Temperature: 38.4°C
Pulse Rate: 120 bpm
Respiratory Rate: 26 cpm
Blood Pressure: 90/70 mmHg
PRELIMENARY TESTS DONE
The preliminary test that is done is
Fecalysis.
Notable observation: Yellowish and loose
watery stool.
STATUS OF PRESENT ILLNESS

The client shows weakness of the body

due to vomiting and diarrhea. The mother
also observes that her child has an
intermittent fever. But due to multiple
defecations and vomiting the mother
decided to admit the client in the hospital to
know the proper treatment of the child’s
condition.
PHYSICAL ASSESSMENT
Body Part Normal Findings Result

Generally, round with the prominence The client’s skull is generally round
Skull in the frontal to occipital. There are no and no tenderness noted upon Normal
nodules and masses when palpated palpation

The client’s scalp has no lesions, nor

No lesions, no tenderness nor masses
Scalp masses, fontanelle is sunken noted Normal
on palpation
upon palpation

The client’s hair is black and evenly

Hair Evenly distributed, covers the scalp Normal
distributed and covers the whole scalp.

White sclera, pink conjunctiva.

Eyes The client has a sunken eyeballs. Abnormal
Clear pupils and reactive to light.

The client’s face is oval, there is no

Face Shape may be oval or rounded. involuntary muscle movement. Has Normal
facial grimace.

The client’s ears are not the same with

Color is the same with face. Clear
his face, clear hearing senses and
Ears & Hearing hearing senses. Absence of wounds Normal
absence of wounds and abnormal
and abnormal discharges.
discharge
PHYSICAL ASSESSMENT
The client’s nose has no discharges, Normal
No discharges, airways are patent. No airways are patent. No tenderness and
Nose & Sinuses
tenderness and lesions. lesions.
The client’s lips are symmetrical. His Abnormal
Normal, lips are pinkish and
Mouth lips are pale and very dry due to
symmetrical.
vomiting.
Muscles are equal in size, no inflamed The client’s neck’s muscles are equal Normal
Neck nodules, and smooth movement with in size, no inflamed nodule and neck
no discomfort. veins not dilated.
The client’s chest is symmetrical, right Normal
Symmetrical, right and left shoulders and left shoulders are aligned with the
Chest right and left hips. His breathing is
are aligned with the right and left hips.
normal. RR: 26 cpm
The client’s abdomen is normallyround.The Normal
Abdomen is normally flat to round abdomen is soft during palpation.
Abdomen
midline umbilicus
The client’s lower extremities are Normal
No presence of bone deformities, normal, no presence of bone
tenderness and swelling. Normally deformities, tenderness and swelling.
Lower Extremities
firm and movements should be Normally firm and movements are
coordinated. coordinated.
The skin is normally uniform, whitish The client’s skin is flushed and warm Abnormal
pink or brown in color defending on to touch. Skin turgor is performed
Skin Temp: 38.4 degree Celsius
the race of client, should be moist and
soft.
The client’s nails have no crack, pale Normal
Normal. No cracks. Has good capillary and capillary refill >2 seconds.
Nails
refill.
CHAPTER II
• DEFINITION OF THE CASE
• ANATOMY AND PHYSIOLOGY
• BOOK - BASED PATHOHYSIOLOGY
• CLIENT - BASED PATHOPHYSIOLOGY
• RISK FACTORS
• CLINICAL MANIFESTATION
• MEDICAL MANAGEMENT
• NURSING MANAGEMENT
DEFINITION OF THE CASE
Acute gastroenteritis (AGE) is a diarrheal disease
with a rapid onset and a variety of symptoms and
signs, including nausea, vomiting, fever, and
abdominal pain. It occurs when pathogenic
microorganisms (such as Clostridium perfringens,
Vibrio cholera, and E. Coli) or their toxins are
consumed in food or water. Nausea, vomiting,
diarrhea, and abdominal pain are some of the
symptoms. A viral or bacterial infection, as well as
a parasitic infection, is the most common causes of
gastroenteritis.
ANATOMY AND PHYSIOLOGY

Figure 1: Gastrointestinal Tract

Source: https://healthengine.com.au/info/gastrointestinal-system
ANATOMY AND PHYSIOLOGY

Liver, pancreas and gallbladder

Source: https://www.google.com.www.webmd.comdigestive-disorders
ANATOMY AND PHYSIOLOGY

Digestive system hollow organs

Source: https://www.google.comanatomyhelp.weebly.comdigestive-system.
ANATOMY AND PHYSIOLOGY

Stable organs of digestive system

Source:. https://www.google.com/url?sa=i&url=https%3A%2F
%2Fwww.aboutkidshealth.
BOOK - BASED PATHOPHYSIOLOGY
Toxicogenic agents
*E.coli Pathogenic agents
*Shigella strains *Rotaviruses
*Salmonella species

Toxicogenic agents penetrate the mucosa Attached to the mucosal

of the small bowel wall

Release an exotoxin
Destroy cells in the
intestinal villa

Impairs intestinal
absorption
malabsorption of
electrolytes

Cause cellular destruction, necrosis,

ulceration, bleeding, and exudation
of protein-rich fluid.

Increased Gastrointestinal Increased secretion of fluid

motility electrolytes

Fig 2: Pathophysiology of AGE

Source: Mosby’s Handbook of Diseases pg. 263
• CLIENT - BASED PATHOPHYSIOLOGY
Modifiable Factors
*Poor Hygiene Non- Modifiable Factors
*Poor Sanitation (Contaminated foods and water)  *Age
*Presence of Bacterial Infection (E.coli, Shigella and Salmonella)
 

Ingestion of contaminated food and

water

Direct invasion of the bowel wall

Destruction of the mucosal lining in the

bowel wall

Digestive and absorptive

Increase peristaltic movement
malfunctioning

• DIARRHEA
• VOMITING
Fluid and Electrolyte
• FEVER Dehydration
Imbalance
• RESTLESSNESS
• POOR APPETITE
RISK FACTORS
People who may be more susceptible to
gastroenteritis include:
• Young children
• Older adults
• Anyone with a weakened immune system
CLINICAL MANIFESTATION
• Book-based • Client-based

• Dehydration (mild, moderate, • Diarrhea

severe) • Fever
• Electrolyte disturbances • Poor appetite
• Abdominal cramps • Vomiting
Malnutrition • Restlessness
• Nausea and Vomiting
• Diarrhea with or without blood and
mucus
• Anorexia
• General Malaise
• Muscle ache

Source : Mosby’s Handbook of Diseases page.263

MEDICAL MANAGEMENT
Medical treatment for gastroenteritis include:

• Oral rehydration solution (ORS) is the treatment of

choice for children with mild-to-moderate
gastroenteritis in both developed and developing
countries, according to the World Health
Organization (WHO).
 MEDICAL MANAGEMENT
• IV rehydration. In extreme dehydration, IV
access should be provided, and patients
should receive 200 ml of Lactated Ringer (LR)
or Normal Saline (NS) solution connected into
microset to run for 2 hours.
• Diet. Brat diet which stands for Banana, Rice,
Apples and Toast is suggested if experiencing
diarrhea as it may help to solidify stools.
 NURSING MANAGEMENT
• Reduce infection transmission. All caregivers must
wear gowns; when handling feces-contaminated
articles, gloves must be worn; contaminated linens
and garments must be placed in specially designated
containers to be handled according to facility policy;
guests are restricted to family members only; teach
and follow the principles of aseptic technique; and
good hand washing must be practiced.
NURSING MANAGEMENT
• Prevent dehydration. Keep track of the number and
type of stools, as well as the volume and type of
vomitus.

• Maintain body temperature. If there is a fever,

monitor vital signs at least every 2 hours, follow
effective fever-reduction protocols, and administer
antipyretics and antibiotics as prescribed.
NURSING MANAGEMENT
• Maintain adequate nutrition. Weigh the child on the
same scale every day; take measurements in the
early morning before the morning feeding; and keep
a close eye on his intake and production. When a
child is NPO, good oral hygiene is essential. Also, the
child is given oral replacement solution.
NURSING MANAGEMENT
• Promote skin integrity. Cleanse the buttocks
and genital region regularly and apply a calming
protective preparation such as lanolin A or D
ointment to minimize itching and excoriation.
CHAPTER III
• LABORATORY RESULTS
 LABORATORY RESULTS
Fecalysis

Result Interpretation

Color Yellowish Normal

Consistency Loose watery Abnormal

Presence of some bacteria

Bacteria Abnormal
(Salmonella & E.coli)
 LABORATORY RESULTS
Hematology
Results Normal Value Interpretation

Hemoglobin 12.5 g/dL 11.3 – 14.1 g/dL Normal

Hematocrit 0.45% 0.31 – 0.41% Increased, dehydration

RBC 4.98 m/mm3 4.6 – 5.2 m/mm3 Normal

WBC 19.1 mm3 5 – 10 x 10 mm3 Increased, Infection

Increased, acute bacterial
Neutrophils 9000 mm3 1500-8500 mm3
infection
Lymphocytes 9700 mm3 3000-9500 mm3 Increased, Infection

Platelets 297 k/uL 140 – 340 x 10 k/uL Normal

MCV 77.3 fl 86 – 100 fl Normal

MCH 26.7 pg 26 – 31 pg Normal

MCHC 31.9 g/dL 31 – 37 g/dL Normal

CHAPTER IV
• NURSING CARE PLAN
 Outcome
Assessment Diagnosis Identification
Planning Intervention Evaluation

Subjective data: Fluid volume After 30 Short term: Independent: After 8 hours
After 8 hours of of nursing
“Naka-anim na beses na deficit related minutes of Establish rapport intervention
siyang sumuka ng may to vomiting as nursing nursing
-to gain trust and the client
kanin-kanin at may evidenced by intervention intervention,
participation from the client exhibited
the client will
halong laway na may dry lips the client’s exhibit moist
moist mucous
sukat na halos kalahating , restlessness mother will Assess vital signs. membrane.
mucous -Fever that occurs with
tasa kada suka” as , sunken report absence membrane. gastroenteritis increases fluid After 2 days of
verbalized by the client’s eyeballs and of vomiting. loss through perspiration and nursing
mother. poor skin Long term: increased respiration. The intervention
turgor After 2 days of change in HR is a the client
nursing compensatory mechanism to showed no
Objective data: maintain cardiac output. signs of
Dry lips intervention no Usually, the pulse is weak and dehydration.
signs of
Restlessness may be irregular if electrolyte
dehydration imbalance also Goal was met.
Sunken eyeballs will be noted. occurs. Hypotension is
Poor skin turgor evident in hypovolemia
Vital signs:
Temp: 38.4 °C
PR:100 bpm
RR: 23 cpm
BP: 90/70 mmHg
 Avoid spicy foods, food that
contains fats/oils, milk and citrus
juice.
-it can irritate your stomach or
may be difficult to digest.

Assess intake and output every

shift and assess the color and
amount of urine.
-A decrease in urine volume and
concentrated urine, as evidenced
by a darker urine color, denotes
fluid deficit.

Provide the client with a well-

ventilated room
-a well-ventilated room promote
easier breathing and relaxation .

Dependent:
Administer parenteral fluids as
prescribed.
- if vomiting persists, IV infusion
is used to achieve rehydration.

Administer anti emetic as

ordered
-these drugs will reduce vomiting
and the risk for fluid volume
deficit.
Assess skin turgor
-Fluid loss occurs first in
extracellular spaces, resulting in
poor skin turgor and dry mucous
membrane

Place the client in a position of

comfort upright or lateral
position
-to prevent aspiration

Do not give the client any food

or drinks for several hours of
vomiting
-foods or drinks will trigger the
stomach and make the client
throw up again.

Instruct the client to sip small

amounts of water or suck ice
chips every 15 mins for 3-4
hours. Next, sip clear liquids
every 15 mins for 3-4 hours.
Examples include water, clear
broth, gelatin and apple juice.
-drinking too much water or any
fluids can make the client to vomit
more.
 Outcome
Assessment Diagnosis Planning Intervention Evaluation
Identification
Subjective: Diarrhea After 1-2 days Short term: Independent: After 8 hours
Establish rapport of nursing
“Tatlong beses ng related to of nursing After 8 hours -to gain trust and promote
dumudumi ang anak presence of intervention, of nursing intervention
cooperation with the client
ko ng lusaw” as toxin as client will intervention the client’s
mother
verbalized by the evidenced by maintain the client’s Assess for abdominal pain,
reported
client’s mother. frequent normal bowel mother will abdominal cramping, hyperactive
bowel sounds. decrease in
elimination of functioning report -These assessment findings are elimination
watery stools, and will decrease in commonly connected with diarrhea of watery
Objective: sunken defecate elimination of stools.
-Sunken eyeballs eyeballs and formed stool. watery stools. Observe and record the frequency,
amount, time and characteristics of After 2 days
-Restlessness restlessness. stool.
Vital Signs taken as: Long term: -It could help to determine the of nursing
intervention,
T: 38.4 °C After 2 days causative factor and the need for
hydration replacement the client
PR: 100 bpm of nursing defecate
RR: 23 cpm intervention, Give the client BRAT formed stool.
BP: 90/70 mmHg the client will (bananas,rice,apples,and toast) diet and
emphasize the increase of fluid intake
defecate especially containing electrolytes. Goal was
formed stool. -It helps to solidify stools and met.
increase of fluid intake to prevent
dehydration.
Educate the client’s mother
on how to prepare food
properly and the importance
of good food sanitation.
- To prevent outbreaks and
spread of infectious diseases
transmitted through fecal-oral
route

Teach the mother about the

importance of hand washing
after each bowel movement
and before preparing food
for others.
-Handwashing is the most
efficient way to prevent the
transmission of infection to
others.

Dependent:
Administer antidiarrheal
medications as prescribed:
Erceflora
-These agents could help halt
diarrhea and the progression
of condition to dehydration.
 ASSESSMENT DIAGNOSIS OUTCOME PLANNING INTERVENTION EVALUATION
IDENTIFICATIO
N
Subjective: Hyperthermia After 1 hour of Short term: Independent: After 1 hour of
Establish rapport nursing
related to nursing After 1 hour of To gain trust and promote cooperation with the
“Pagkagising ng intervention nursing intervention,
dehydration as client.
the client’s
anak ko ay mainit evidenced by the client will intervention, the Monitor client’s temperature
To provide more accurate indication of core temperature
na siya” as maintain client’s
verbalized by the
elevated body normal body temperature will
temperature. decreased from
Provide tepid sponge bath. 38.4 C to
client’s mother. temperature, temperature. decrease from TSB helps in lowering the client’s body 37.5 C.
flushed and 38.4 C to 37.5 temperature.
warm to touch Remove excess clothing, blankets and linens
Objective: C. To facilitate the body in cooling down and to
After 4 hours
 flushed skin skin. provide comfort of nursing
 skin is warm to Long term: Advice the client’s mother to use cotton clothes intervention,
touch After 4 hours of for her child the client’s
Cotton is a strong water absorber helps absorb the temperature
nursing sweat and to make client comfortable. returned to
Vital signs: intervention, the Encourage the client to drink plenty of water. normal.
Temp: 38.4 °C client’s the client is dehydrated , therefore fluid loss
contributes to fever.
PR: 120bpm temperature will Promote a well-ventilated room The goal was
RR; 26cpm return to normal Opening the window can supply fresh air for the met.
BP: 90/70mmHg range of client that can help them to improve their health.
36.0 C - 37.0 C.
Dependent:
Administer anti-pyretic medication as
prescribed by the physician.
Antipyretic medication are used to treat fever by
reducing body temperature.
CHAPTER V
• DRUG STUDY
 NAME OF THE MECHANISM OF
DOSAGE INDICATIONS CONTRAINDICATIONS
ADVERSE NURSING
DRUG ACTION CONSIDERATION
EFFECT
Generic name: Acts as antiemetic Dose: Specifically, to treat Metoclopramide is Drowsiness Before:
Metoclopramide by blocking 5-9 years: nausea/ vomiting contraindicated in Restlessness • Observe the 12 rights
dopamine receptors 10 mg/ampule children aged less than Rash of drug administration
Brand name: and promotes GI 1 year) due to an Seizures
Reglan motility by Route: IV increased risk of Swelling (especially During:
enhancing the extrapyramidal hands and feet) • For IV infusion, give
Classification: response to Frequency: disorders Constipation or over at least 15
Antiemetic GI stimulant acetylcholine of TID (PRN) diarrhea minutes.
tissue in upper GI
tract causing After:
enhanced motility • Dispose the used
and accelerated materials properly
gastric emptying • Advice the client’s
without stimulating mother to keep the
gastric, biliary, or client stay on bed after
pancreatic drug administartion.
secretions and
increases lower
esophageal
sphincter tone
 Mechanism of
Name of Drug Action Dosage Indication Contraindication Adverse Effects Nursing Consideration
Generic Name: Contributes to Dosage: Acute diarrhea Ascertained No known Before:
Bacillus Clausii the recovery of Children 2-11 years: with duration of hypersensitivity adverse effects. • Observe the 12 rights of drug
the intestinal 1-2 nebule per day <14 days due to towards the administration
Brand Name: microbial flora infection, drugs or components of • Shake drug well before
Erceflora altered during Route: Oral poisons. Chronic the product. administration.
the course of or persistent
Classification: microbial Frequency: OD diarrhea with During:
Anti-diarrheal disorders of duration of >14 • Administer drug after opening
diverse origin. It days. container.
produces various • Administer drug orally.
vitamins, • Ensure that the client will drink his
particularly medication.
group B vitamins
thus contributing After:
to correction of • Dispose the container of drug
vitamin properly.
disorders caused
by antibiotics &
chemotherapeuti
c agents.
Promotes
normalization of
intestinal flora.
NAME OF THE DRUG MECHANISMS OF DOSAGE INDICATION CONTRAINDICATION ADVERSE NURSING CONSIDERATION
ACTION REACTION

Generic Name: Paracetamol is an Dosage: Used in the relief of Contraindicated in Thrombocytopaenia, Before:
Paracetamol analgesic and 2-6 years old: mild to moderate client with known anaphylaxis, and • Observe the 12 rights of drug
antipyretic. It’s 5 ml fever. hypersensitivity to skin rashes. administration
Brand Name: mechanism of paracetamol or any • Check that the client is not
Calpol action is believed Route: other components of taking any other medication
to include Oral the formulation. containing paracetamol.
Classification: inhibition of • Shake well before use.
Antipyretic and prostaglandin Frequency:
Analgesic synthesis, primarily q4h During:
within the central • Ensure that the client will drink
nervous system. his medication.
• Make sure that the client must
not exceed the recommended
dose.

After:.
• Monitor any adverse reaction
towards medication
• Stores at temperature not
exceeding 30C. Keep out of
direct light exposure.
• Keep out of reach of children.
CHAPTER VI
• EVALUATION AND FINDINGS
• RECOMMENDATION
 EVALUATION AND FINDINGS
After conducting the study, the student-nurses
were able to appreciate more the essence of
utilizing the nursing process by providing clinical
care and management for the pediatric client.
Acute diarrhea is an abrupt increase in
recurrence and changes in consistency of stools.
Infants and children are in danger or at risk for
the development of dehydration and
malnutrition which is two significant outcomes
of the diarrhea.
EVALUATION AND FINDINGS
Early accurate detection is important to
improve client outcomes. This study provides the
student-nurses a huge knowledge and
understanding with regards on taking good care
of a pediatric client in the real clinical setting and
taught the student-nurses to provide client’s care
more efficiently and competently to achieve an
effective and quality nursing care.
RECOMMENDATION
Medication
• The parents should be informed that the diarrhea
in children should not be treated with loperamide
because of the high potential for toxic side effects.
• Antidiarrheal medications also have the potential
to worsen the course of inflammatory bacterial
enteritis, leading to toxic megacolon and colonic
hemorrhage.
RECOMMENDATION
Environment/Exercise

• Avoid physical activities that can cause fatigue

because the client needs plenty of rest to be able
to recover with his condition.
• Avoid activities outside because the client will be
more susceptible for having bacteria that can
cause gastroenteritis.
RECOMMENDATION
Treatment
• The client’s parent must comply with the
doctor’s order and instructions to prevent
different complications that will lead to
severe condition.
• The mother must admit the client
immediately to receive an intravenous fluid
replacement to avoid severity of the
condition.
RECOMMENDATION
Health teaching
• Educate the client’s mother about the
importance of proper hygiene to prevent
gastroenteritis.
• Discuss with the client’s mother the importance
of washing all fruits and vegetables before
peeling and eating, to avoid ingestion of
contaminated food.
RECOMMENDATION
Health teaching (continuation)

• Advice the mother to regularly cut the client’s

fingernails and avoid nail biting.
• Teach about the proper hand washing after
defecating.
RECOMMENDATION
Output Referral OPD Check Up

• The client must attend a follow-up check up for the

physical examination such as observation of skin
turgor and condition, including vomiting, lips and
mucous membranes of the mouth, eyes, and any
notable physical signs. It will help to evaluate the
client’s condition.
RECOMMENDATION
Diet

• Advise the mother about the bland diet because

when the client can tolerate bland food, client will be
able to resume to normal diet.
• In children with diarrhea who are not dehydrated, an
age-appropriate diet should be continued, and in
children with mild to moderate dehydration, an age-
appropriate diet should be resumed as soon as
rehydration is achieved.
RECOMMENDATION
Diet (Continuation)

• Instruct the mother about providing low fat diet to

the client for 1 week to help the digestive system
function normally and to prevent diarrhea.
RECOMMENDATION
Spiritual
• Encourage to pray for healing and
recovery, during the times of doubts and
sufferings, it will provide a sense of calm,
hope, and balance in one’s life.
THANK YOU
for
listening! :)