Republic of the Philippines

TARLAC STATE UNIVERSITY

COLLEGE OF SCIENCE
Department of Nursing
Lucinda Campus, Brgy. Ungot, TarlacCityPhilippines 2300
Tel.no.: (045) 493-1865 Fax: (045) 982-0110 website: www.tsu.edu.ph
Awarded Level 3-Phase II Status by the Accrediting Agency of Chartered Colleges and Universities in the Philippines Inc (AACCUP)
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NCM 112 -Communicable Diseases
CASE SCENARIO
Communicable Disease involving the Digestive System (GIT)

PATIENT PRESENTATION
A patient is 27 years old. He was infected with a bacteria V. cholerae (Cholera is caused by the
bacterium V. cholerae. (This bacterium is Gram stain-negative), by eating contaminated food and water or
uncooked food and fruits. After a 24–48 hours, some symptoms begin with the sudden onset of painless
watery diarrhea that quickly become voluminous and is often followed by vomiting. Its main symptoms are
vomiting and diarrhea, because of these, severe dehydration can occur.
He vomits every time he eats or drinks anything. After a day, his color become pale yellow and he
became weak due to dehydration by loose motions and vomiting. In the first day of infection, he drank some
rehydration solutions but no improvement observed. He also felt severe abdominal pain
He experienced accompanying abdominal cramps, probably from distention of loops of small bowel as
a result of the large volume of intestinal secretions. Fever is typically absent.

DIAGNOSIS
He went to a hospital where proper check-ups were performed. The Physician advised him for few tests
(CBC+ESR, Rapid stool test to identify cholera bacteria). Thus, confirms cholera by identifying bacteria in a
stool sample. He was then admitted for treatment and management

HISTORY
Two Days ago: Symptoms began with abdominal cramps and an intense urge to pass stool after every
meal. His symptoms started to appear after eating his dinner bought in the Carinderia and rapidly worsened
with passage of stool becoming more frequent. Within two days he was passing persistently watery diarrhea.
One Day ago: Symptoms persisted and he experienced diarrhea and vomiting after eating or drinking,
which lasted for 48 hours. He was admitted to hospital for rehydration and further investigations. No conclusive
diagnosis was made.
Currently: Patient is passing 8-10 liquid stools per day. Diarrhea is watery. Occurs day and night.
Patient complains of malaise, lethargy and anorexia. He has lost 5 kg in the past 2-3 days.
No past surgical history, and No significant medical history

FAMILY HISTORY:
Mother – type 2 Diabetes Mellitus
No other family members with chronic disease
No known allergies
Foods are bought in the Carinderia nearby and water supply from water pump being used by the whole
Barangay

EXAMINATION/ASSESSMENT
 Thin ill looking male patient, conscious and alert, in obvious discomfort.
 The Nurse weighed him and recorded 48 kgs only at that time. He became bluish and weak due to loss
of water causing dehydration.
Other findings includes:

Vital Signs:
Blood Pressure: 90/50
Cardiac Rate: 122bpm
Respiratory Rate: 28cpm
Temperature: 36.1 *C
General Appearance:
Weak, and pale looking, Eyes were sunken and with observable discomfort
Lack of sweat production, Sunken eyes, Shriveled skin, with Dark urine

Neurological:
Verbalized stress and worrying at time

Cardiovascular:
Slight Tachycardia
 Complaining of heart beats faster, increasing heart rate and causing to feel palpitations at times

Abdominal examination:
Guarding and tenderness noted in the left iliac fossa and hypogastrium.

Abdominal X-ray:
No toxic megacolon

Gastroscopy Report:
Oesophagus and gastro- oesopahageal junction were normal. Stomach mucosa was intact and normal. No
gastritis, ulceration or blood was noted. Cardia was normal. Pylorus and duodenum normal.

MANAGEMENT
After checking all aspects, the Physician ordered the following:
 Dimenhydrinate tablets for vomiting twice-a-day before the meal
 Antibacterial Medication: gramicidin, neomycin sulfate, ciprofloxacin 500 mg twice-a-day, and Flagyl
(Metronidazole) 400 mg twice-a-day and a rehydration solution (ORS).
 Intravenous Fluid to treat dehydration (Volume per Volume)

Guide Questions:
 
Note: Analyze well the case scenario given. Incorporate additional relevant data pertaining to the disease.
1. Identify and discuss briefly the disease being described.
2. Describe the current situation of the patient. Nursing Diagnosis should be prioritized based on your
assessment data.
3. Make use of your critical thinking through expanding your knowledge focusing on the clinical
manifestations/presentations you observed to your patient.

In each scenario create:

▪ Daily PA -------- (As a group)
▪ (1) Sample Charting ------ (Per student)
▪ (1) NCP ------ (Per Student)
▪ (1) Drug Study ------ (Per Student)
▪ Patient education (contents: Lifestyle, Activity/ Exercise, Diet, Follow – up check, Psychological or
Emotional or Spiritual Aspect of teaching needs) ------ (Per student))
▪ Case analysis ------ (Per Group)
▪ Journal reading ----- (Per Student))  
 
 
“Acquiring knowledge is the most fruitful effort.” ― Eraldo Banovac

 
 
                                                                            Prepared by: Bianca Camille M. Mercado, RN, MSN