Acute Gastroenteritis

Case Review:

Acute Gastroenteritis (also called Stomach Flu)

• Acute gastroenteritis is a sudden condition that causes irritation and inflammation of the
stomach and intestines or the gastrointestinal tract.
• Viral infection is the most common cause of gastroenteritis but bacteria, parasites, and food-
borne illness (such as shellfish) can also cause acute gastroenteritis.
• Fifty to seventy percent of cases of gastroenteritis in adults are caused by the noroviruses
while rotavirus is the leading cause of infection in children. Staphylococcus aureus can form a
toxin that cause food poisoning while the resident Escherichia coli can also cause significant
problems.
• Many people who experience symptoms of vomiting and diarrhea, which develop from these
types of infections or irritations believe they have food poisoning, and they indeed have a
food-borne illness.
• The severity of gastroenteritis depends on the immune system’s ability to resist and fight the
infection. Electrolytes, especially sodium and potassium may be lost if the client continue to
vomit and experience diarrhea.
• Most people recover easily from a short course of vomiting and diarrhea by drinking lots of
fluids and resuming a typical diet. But for some, especially the young and the old, loss of body
fluids with gastroenteritis can cause dehydration, which is a life-threatening condition unless it
is treated and fluids are replaced.

Pathophysiology
The mechanisms potentially responsible for viral diarrhea include lysis of enterocytes,
interference with the brush border function that leads to malabsorption of electrolytes,
stimulation of cyclic adenosine monophosphate (cAMP), and carbohydrate malabsorption. For
bacterial gastroenteritis, the pathophysiology involves the elaboration of toxin by enterotoxigenic
pathogens and the invasion and inflammation of mucosa by invasive pathogens. Parasitic
organisms invade epithelial cells and cause villus atrophy and eventual malabsorption.

Clinical Manifestations:
• Low grade fever to 100°F (37.8°C)
• Nausea with or without vomiting
• Mild to moderate diarrhea
• Crampy and painful abdominal bloating
• More serious symptoms include:
• Blood in vomit or stool
• Vomiting more than 48 hours
• Fever higher than 101°F (40°C)
• Swollen abdomen or abdominal pain
• Dehydration that is manifested by weakness, lightheadedness, decreased and concentrated
urination, dry skin and poor turgor, and dry lips and mouth

Diagnostic Tests:
• Blood test
• Analysis of stool samples
• Electrolyte tests
• Physical examination to rule other existing conditions such as appendicitis
Medical Management:

Home care:

• Clear fluids are appropriate for the first 24 hours to maintain adequate hydration.
• They should be given oral rehydration solutions such as Pedialyte for pediatric patients or
commercially prepared oral rehydration solution. For homemade ORS, mix 2 tablespoons of
sugar (or honey) with ¼ teaspoon of table salt in 1 liter (1 qt) of clean or previously boiled
water.
• After 24 hours without vomiting , begin to offer soft bland foods such as the BRAT diet, which
includes bananas, rice, applesauce without sugar, toast, pasta, and potatoes.

Hospitalization:

• Hydration through intravenous line.

• Replacement of fluid losses volume per volume.
• Encourage small, frequent feedings.

Prevention:

• Always wash your hands before eating and after using the comfort room.
• Eat only properly cooked and stored food.
• Bleach soiled linens used.
• Have vaccinations for salmonella typhi, vibrio cholerae, and rotavirus.

Nursing Diagnosis and Intervention:

A. Deficient fluid Volume r/t dehydration

B. Activity Intolerance r/t generalized weakness

C. Diarrhea