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NCP Diarrhea

The patient, a child, presented with diarrhea characterized as watery stools occurring twice within 4 hours as reported by the mother. On examination, the child appeared weak and showed signs of dehydration including dry lips and oral mucosa. The nurse's plan was to monitor vital signs every 4 hours, restrict solid foods, encourage oral fluid intake with electrolytes, assist with pericare as needed, and evaluate the child's condition and diarrhea after 4 hours of nursing interventions. However, after 4 hours the child did not achieve a decrease in bowel movement frequency, indicating the goal was not met.

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Elisha Faith Sevilla Espineli
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6K views2 pages

NCP Diarrhea

The patient, a child, presented with diarrhea characterized as watery stools occurring twice within 4 hours as reported by the mother. On examination, the child appeared weak and showed signs of dehydration including dry lips and oral mucosa. The nurse's plan was to monitor vital signs every 4 hours, restrict solid foods, encourage oral fluid intake with electrolytes, assist with pericare as needed, and evaluate the child's condition and diarrhea after 4 hours of nursing interventions. However, after 4 hours the child did not achieve a decrease in bowel movement frequency, indicating the goal was not met.

Uploaded by

Elisha Faith Sevilla Espineli
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • Medical Assessment and Planning: Outlines a comprehensive medical assessment and intervention plan for a patient presenting with diarrhea, including diagnosis, interventions, and evaluation.

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTIONS RATIONALE EVALUATION

Subjective: Diarrhea Presence of After 4 hours - Establish - for easier carrying- - Goal not met
related to infectious agents of nursing rapport out of nursing
“Dalawang infectious in the body interventions, interventions After 4 hours of
beses na siya process | the patient - Monitor and nursing
dumumi secondary to Microorganisms will achieve record VS q4 - for baseline data interventions,
kaninang presence of attach and enter a decrease in the patient did
umaga, parang pathogenic mature frequency of - Restrict solid food, - to allow for bowel not achieve a
tubig” as toxin enterocytes at the bowel as indicated rest/reduced decrease in
verbalized by tips of small movement intestinal workload frequency of
the mother of intestinal villi - Limit high-fiber bowel
the patient. | foods - high-fiber foods movement.
Structural increase peristalsis,
Objective: changes to small - Encourage oral therefore
bowel mucosa intake of oral aggravating diarrhea
- two | fluids with
consecutive Inflammation of electrolytes - to maintain
watery stools lamina propria hydration/electrolyte
within 4 hours | - Assist, as needed, balance
Bacteria releases with pericare after
- weak-looking endotoxin each bowel - to maintain skin
| movement integrity
- with signs of Increased amount
dehydration (dry of diarrheal fluid - Provide prompt - skin breakdown
lips, dry oral | diaper change and can occur quickly
mucosa) Active secretion gentle cleansing when diarrhea is
of chloride and present
bicarbonate ions - Expose perineum
| or buttocks to air - to keep area dry
inhibition of and to maintain skin
sodium and - Assess for integrity
water presence of poor
reabsorption skin turgor, dry - these are signs
| mucous membranes, indicating
DIARRHEA tachycardia dehydration
- Note frequency,
consistency, and - to assess causative
appearance of stools factors of condition

- Emphasize - to prevent further


importance of hand spread of bacteria to
washing other persons

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTIONS RATIONALE EVALUATION Subjective: “Dalawang beses na siya dumumi kaninan
reabsorption | DIARRHEA skin turgor, dry mucous membranes, tachycardia - Note frequency, consistency, and appearance of stool

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