DIARRHEA

Case Presentation

Prepared by Group 4
BSN 3-4

CURTIN HEALTHCARE SERVICES

 DIARRHEA
Diarrhea is an increased frequency of bowel movement
(more than three per day), an increased amount of
stool (more than 200g/day), and altered consistency
(increased liquidity) of stool. it is usually
associated with urgency, perinal discomfort,
incontinence, or a combination of these factors.
diarrhea can be acute or chronic. acute diarrhea is
most often associated with infection and is usually
self- limiting lasting up to 7- 14 days. chronic
diarrhea persist for more than 2 to 3 weeks and ,ay
return sporadically.

 TWO TYPES OF DIARRHEA

1. Acute watery diarrhea
This term refers to diarrhea that begins acutely, lasts less than 14 days (most
episodes last less than 7 days), and involves the passage of frequent loose or watery
stools without visible blood. vomiting may occur and fever may be present. Acute watery
diarrhea causes dehydration; when food intake is reduced, it also contributes to
malnutrition.
2. Dysentery
This is diarrhea with visible blood in the feces. important effects of dysentery
include anorexia, rapid weight loss, and damage to the intestinal mucosa by the invasive
bacteria. A number of other complications may also occur. the main cause of acute
dysentery is Shigella; other causes are Campylobacterjejuni and infrequently,
enteroinvasive E. coli or Salmonella. Entamoeba histolytica can cause serious dysentery
in young adults but is rarely a causes of dysentery in young children.
3. Persistent Diarrhea
This is diarrhea that begins acutely but is of unusually long duration (at least 14
days). The episodes may begin either as watery diarrhea or as dysentery. Marked weight
loss is frequent. Diarrhea stool volume may also be great with a risk of dehydration. There
is no single microbial cause for persistent diarrhea; eneteroaggregative E. coli, Shigella
and Cryptosporidium may play a greater role than the other agents. Persistent diarrhea
should not be confused with chronic diarrhea, which is recurrent or long- lasting diarrhea
to noninfectious causes, such as sensitivity to gluten or inherited metabolic disorders.
 What Causes Diarrhea?
The most common causes of diarrhea include:
Bacteria from contaminated food or water
Viruses such as the flu, norovirus, or rotavirus. Rotavirus is the
most common cause of acute diarrhea in children
Parasites , which are tiny organisms found in contaminated food or
water
Medicines such an antibiotics, cancer drugs, and antacids that
contain magnesium
Food intolerances and sensitivities, which are problems digesting
certain ingredients or foods. An example is lactose intolerance.
Diseases that affect the stomach, small intestine, or colon, such
as Crohn's disease
Problems with how the colon functions, such as irritable bowel
syndrome.

 SIGNS AND SYMPTOMS

Patient Based:
Greenish, loose and watery stools
Abdominal Pain
Fever
Decrease Appetite

Book Based:
Distention
Borborygmus
Anorexia
Thirst
Voluminous, greasy stools
Painful Spasmadic Contractions of
Anus and Tenesmus

References: Brunner & Suddarth's textbook of Medical- Surgical Nursing 13th

Edition
 Medical Medical
management management
PHARMACOLOGICAL THERAPY
NURSING INTERVENTION
 MEDICAL MANAGEMENT
NURSING INTERVENTION

1. Weigh daily and note decreased weight. Diarrhea causes severe water loss from the body. As
a result, the body loses weight. An accurate daily weight is an important indicator of fluid
balance in the body. It has consistently been associated with decreased weight over the
short term, but the longer- term impact of diarrhea on weight has been less consistently
documented and is more controversial. Have the patient keep a diary of their bowel
movements. Stool consistency need to be evaluated, which may be accompanied by the patient
keeping a self- care log or diary. Evaluation of defecation pattern will help direct
treatment, especially for cancer- related diarrhea. Diarrhea log should include time of day
defecation occurs; as usual stimulus for defecation; consistency, amount, and frequency of
stool; type of, amount of, and time food consumed; fluid intake; history of bowel habits and
laxative use; diet; exercise patterns; obstetrical/ gynecological, medical, and surgical
histories; medication; alterations in perianal sensations; and present bowel regimen. Avoid
using medication that slow peristalsis. If an infectious process occurs, such as Clostridium
difficile infection or food poisoning, medication to slow down peristalsis should generally
not be given.
2. Provide bulk fiber (e.g., cereal, grains, psyllium) in the diet. Bulking agents and dietary
fibers absorb fluid from the stool and help thicken the stool. Psyllium is found in some
cereal products, dietary supplements, and commercial bulk fiber laxatives (e.g., Metamucil,
Konsyl generic). Provide natural bulking agents (e.g., rice, apples, matzos, cheese) in the
diet. Soluble fiber removes excess fluid, which is how it helps decrease diarrhea.
 Medical Management
Pharmacological Therapy

Give antidiarrheal drugs as ordered. Most antidiarrheal drugs suppress gastrointestinal motility, thus allowing
for more fluid absorption. Supplements of beneficial bacteria (“probiotics”) or yogurt may reduce symptoms by
reestablishing normal flora in the intestine. Antidiarrheal agents are consisting of two types: those used for
mild to moderate diarrheas and those used for severe secretory diarrheas.
Pharmacologic agents that can be used for the management for chronic diarrhea include loperamide, 5-HT3
receptor antagonist, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti- inflammatory
agents. Considering their mechanisms of action, these agents should be prescribed properly.
Flotera chewable helps and improves digestion and helps enhances intestinal ecology and enhances natural
resistance to intestinal infections. Recommended dose for children 3 years old and up: Orally, 1 to 2 chewable
tablets per day, or as directed by a doctor. Use regularly for food digestive health or when temporary stomach
discomforts occurs.
Loperamide (Imodium) slows the movement of food through your intestines, which lets your body absorbs more
liquid.
Bismuth subsalicylate (Kaopectate, Pepto- Bismol) balances out how fluid moves through your digestive tract.
LABORATORY
TEST
 LABORATORY
EXAMINATION
PATIENT NAME: ROLLON, PRIME THEO NUNEZ
AGE: 3 YEARS OLD
PHYSICIAN: PECURIBOT, MICHELLE
PATIENT ID: 196757
RELEASED DATE: 3/8/2022
TIME: 9:21PM

CURTIN HEALTHCARE SERVICES

 Fecalysis
Macroscopic Description
Color: Greenish
Consistency: Loose/ Watery
Microscopic Description
Pus cells: 0-1/ hsf
Red blood cells: 0/ hsf
Yeast cells: NONE SEEN
Fat globules: NONE SEEN
Occult blood: N/A
Parasites: NO PARASITES/ OVA SEEN
Interpretation:
Fecalysis
Visual confirmation of the results shows that the
patient stool is green with loose and watery that
inidcated diarrhea. Also, there is ova presented in
the fecal, this may indicate that it is positive in
infection
 Clinical Chemistry

Test Results Units Normal rate

BUN ---------- mmol/L 3.0- 7.2

mmol/L 50-100
Creatinine ----------

Na Decreased mmol/L 135-145

K Decreased mmol/L 3.5- 5.3

Analysis:
Based on the above data, there is a decrease in Na and K since
there is an excessive fluid loss due to diarrhea.
DRUG
STUDY
 CEFUROXIME
ADVERSE
MEDICINE INDICATIONS ACTIONS SIDE EFFECTS REACTION
Generic name: Cefuroxime is used to Body as whole:
Diarrhea
Cefuroxime Cefuroxime is used to treat a wide variety of Thrombophlebitis (IV site);
pain, burning, cellulitis (IM Decreased
Trade name: Ceftin, treat certain bacterial infections. site); superinfections, hemoglobin or
Zinacef infections caused by This medication is positive Coombs' test. hematocrit
Dose for children: bacteria. This known as a
Nausea or
125mg/mL includes urinary tract cephalosporin GI: diarrhea, nausea,
vomiting
infections, gonorrhea, antibiotic. It works by
antibiotic- associated
250mg/ 5mL stopping the growth of colitis Eosinophilia
Route: Lyme disease and Diaper rash
bacteria. This antibiotic
Oral impetigo.x treats only bacterial
Skin: Rash, pruritis,
Thrombophlebitis
urticaria
Drug Classification: infections. Vaginitis
anti- bacterial, anti- Urogenital: Increased
infectives serum cretonne and BUN,
decreased creatinine
clearance
 CEFUROXIME
NURSING CONSIDERATIONS HEALTH TEACHING
Assessment: Give this drug with food

Shake well before use
Determine history of hypersensitivity reactions to cephalosporin, penicillin and Measure liquid doses carefully. Use the
history allergies particularly to drugs before therapy initiated. measuring device that comes with this drug.
Note reasons for therapy, baseline assessments If there is none, ask the pharmacist for a
Assess anemia, renal dysfunction, reduce dose with impaired renal function device to measure this drug.
Assess if the patient has taken drug that may decrease the effectiveness of the Keep giving this drug to your child as you
medication have been told by the physician or doctor,
Inform the patient the need and imprtance of the drug to him/ her even if your child feels well.

Do not give antacids at the same time as this
Implementation: drug. Ask the doctor if you have a question
Administer medication with food to hasten absorption about how to give antacids with this drug.
if patient has difficulty swallowing, tell him that it may be crushed or dissolved Store liquid (suspension) in a refrigerator. Do
but warm him about its bitter taste that is hard to mask, even with food. not freeze. Throw away any part not used
Inspect IM and IV injection sites frequently for sign of phlebitis. after 10 days.

Keep all drugs in a safe place. keep all drugs

out of the reach of children.
Monitoring: If your child's symptoms or health problems
1. Repost loose stools or diarrhea promptly. Instruct patient not to breast feed while do not get better or if they become worse,
taking this drug call the doctor of go to the hospital
2. Educate patient of the possible adverse reactions of the drug

3. Tell patient to notfy prescriber if rash, chills of fever develops

4. Document drug's name, time and date of administration on the patients chart
 Flotera Chewable Tab
ADVERSE
MEDICINE INDICATIONS ACTIONS SIDE EFFECTS REACTION
Trade Name: Biogaia Flotera
Flotera has a probiotic rash
Flotera contains 100 (live micro-organisms Gas
Generic Name: Flotera hives
million CFU of that keep the body Upset
itching
Dose: 1-2 chewable Lactobacillus reuteri healthy) that helps to stomach or
tablets/day difficulty
(L. reuteri ) which is restore good bacteria in
the intestines. Thereby,
throwing up breathing
Form: Tablet (chewable) used for enhancing
it prevents diarrhoea Not hungry tightness in the
Route: PO
intestinal ecology,
improving digestion
and loss of beneficial Stomach chest
bacteria due to swelling of the
Drug Classification:
and helping enhance prolonged intake of cramps
antidiarrheal
Dry mouth mouth, face, lips,
natural resistance to antibiotics or due to
or tongue
Safe Dose Range:
intestinal infections infections in the Headache
4 years old and up: Orally, 1 to
2 chewable tablets per day, or
intestine.
as directed by a doctor.
 FLOTERA CHEWABLE TAB
NURSING CONSIDERATIONS HEALTH TEACHING
Assessment:
Ask a doctor before use: If patient

History: Allergy to some inactive ingredient which can cause allergic reactions or
has a short bowel syndrome, must
other problems. Talk to your pharmacist for more details. last more than 2 days before taking

this
Implementation: If patient has a weakened immune

system (e.g., patients with HIV/AIDS

Flotera is recommended to be taken 2 to 4 hours in between antibiotic intake
during the entire course of treatment duration plus 3 to 7 additional days for or lymphoma, patients on long-term
probiotic restoration. corticosteroid treatment, patients

undergoing cancer treatment,
Children 4 years old up give 1-2 chewable tablet/day
patients taking medications that

Monitoring:
weaken the immune system).

Antibiotic medicines may reduce the
Monitor patient for hypersensitivity reactions, GI reaction especially if drug effect of probiotics in the body. Take
previously taken. Keep supportive equipment and emergency drugs readily probiotics at least 2 hours before or
available in case of serious allergic response.
after antibiotics.

Evaluation: Report to SO if there’s any adverse

effect
Patient now enhances her intestinal ecology and improves her digestion.

 Folvite (Folic Acid)

ADVERSE
MEDICINE INDICATIONS ACTIONS SIDE EFFECTS REACTION
Trade Name:
Folic acid, whether given by
Folvite, Folacin-800, FA-8, There is damage to the mouth or parenterally, rash, nausea, loss of
FaLessa appetite;
intestinal mucosa in stimulates the production of itching,
most diarrhea cases; red blood cells, white blood swelling bloating, gas,
Generic Name: Folvite
therefore, the role of cells, and platelets in (especially of the stomach pain;
Dose: persons suffering from bitter or
folic acid has been face, tongue, or
2.5mg/5ml Oral Solution certain megaloblastic unpleasant taste
studied as adjuvant anemias.
throat),
in your mouth;
Form: syrup therapy for diarrhea dizziness, and
confusion, trouble
since folic acid plays an If we do not have enough trouble
Route: PO folic acid, the body can concentrating;
important role in the breathing
make abnormally large red sleep problems;
synthesis of DNA
Drug Classification: Vitamins, blood cells that do not work depression; or.
Water-Soluble. especially in rapidly
properly. feeling excited or
regenerating cells. This causes folate deficiency irritable.
Safe Dose Range:
anaemia, which can cause
1-4 years, 300 mcg/day PO; 4-8
tiredness and other
years, 400 mcg/day PO
symptoms.
 Folvite (Folic Acid)
NURSING CONSIDERATIONS HEALTH TEACHING
Assessment:

Take folic acid exactly as

History: Allergy to folic acid preparations; pernicious, aplastic, normocytic anemias; prescribed by your doctor.
lactation

Do not take it in larger

Physical: Skin lesions, color; R, adventitious sounds; CBC, Hgb, Hct, serum folate levels, amounts or for longer than
serum vitamin B12 levels, Schilling test

recommended.
Implementation: Follow the directions on your
Children (persons aged 12 years and younger):

prescription label. Folic acid
May be given 5 mg to 15 mg daily, in divided doses, according to the severity of the oral is taken by mouth.
deficiency state

Report to SO if there’s adverse
Monitoring: effect

Monitor patient for hypersensitivity reactions, especially if drug previously taken.

Keep supportive equipment and emergency drugs readily available in case of serious
allergic response.

Evaluation:

Folic acid usually starts to work in a few hours. But if you're taking it for folate
deficiency anaemia, it may be a few weeks before you start to feel better.

 ZINC SULFATE SYRUP

MEDICINE INDICATIONS ACTIONS SIDE EFFECTS ADVERSE REACTION
Trade Name: Multitrace-4
Zinc sulfate is given Zinc is important for Nausea Nausea
Neonatal, Peditrace, Conte-Pak-4,
growth and for the
Neotrace-4 as an adjunct to oral stomach stomach upset,
rehydration therapy development and
Generic Name:
health of body upset, vomiting
zinc sulfate - oral, Orazinc, in order to reduce
Zincate. tissues. Zinc sulfate vomiting metallic taste
the duration and
Dose: Children older than 10 years: severity of
is used to treat and metallic taste heartburn
25 mg orally three times daily, to prevent zinc heartburn
diarrhoea, as well as
deficiency.
Form: Syrup to prevent further
Route: PO occurrences in the 2
Zinc facilitates
to 3 months after
Drug Classification: wound healing, helps
Mineral/electrolyte replacement treatment.
,inorganic compound. It is used as
maintain normal
a dietary supplement growth rates, normal
Safe Dose Range: skin hydration and
Children older than 10 years: 25 the senses of taste
mg orally three times daily, may
increase to 50 mg three times a and smell.
day
 ZINC SULFATE SYRUP
NURSING CONSIDERATIONS HEALTH TEACHING
Assessment:

Take this medication 1 hour
History: Allergy to some inactive ingredient which can cause allergic reactions before or 2 hours after meals.
or other problems. Talk to your pharmacist for more details.

May be taken with food if it

Implementation: upsets your stomach.

·Avoid milk, bran, grains, or

Give to children older than 10 years: 25 mg orally three times daily,

cereals within 2 hours of
Monitoring: taking this medicine.

Monitor Patients on parenteral nutrition or chronic therapy should have

Tell your doctor and SO, right
periodic serum copper and serum zinc levels; alkaline phosphatase, taste away if any of these unlikely
acuity, mental depression but serious side effects occur:
Evaluation: fever, chills, sore throat, sores

in mouth, unusual tiredness,
Patient now develop a healthy body tissues that reduces the duration of
weakness.
diarrhea.


MEDICINE INDICATIONS
Trade Name:
Biogesic, Panadol, Tylenol
Generic Name:
Paracetamol,
Acetaminophen
Dose: 120 mg q4h
Form: Vial
Route: Intravenous
Drug Classification: Non-
narcotic analgesic,
Antipyretic
Safe Dose Range:
A: 500 to 1000mg q4h- q6h
C: 120mg q4h- q6h
PARACETAMOL
ACTIONS SIDE EFFECTS
Decrease fever by a Common: Sore throat (not present
Paracetamol is
hypothalamic effect Nausea before treatment and not
indicated for
leading to sweating Vomiting caused by the condition
fever, common and vasodilation Constipation being treated)
Injection site pain Sores, ulcers, or white spots
cold, influenza, Inhibits pyrogen
Rare: on the lips or in the mouth
headache, effect on the
Bloody or black, tarry ·Sudden decrease in the
inflammatory hypothalamic- heat- tools amount of urine
pain, post- regulating centers Bloody or cloudy urine Unusual bleeding or
Inhibits CNS Fever with or without bruising
vaccination pain Unusual tiredness or
prostaglandin chills (not present
in children, synthesis with before treatment and weakness
sprains and etc. not caused by the Yellow eyes or skin
minimal impact on
condition being treated
Reduce fever in peripheral Severe: Overdose symptoms
Pain in the lower back
prostaglandin
viral and bacterial and/ or side (severe Diarrhea
synthesis Increased sweating
infections and/ or sharp)
It does not cause Pinpoint red spots on Loss of appetite
Temporary relief Nausea or vomiting
ulceration of the GI the skin
of mild to Skin rash, hives, or Stomach cramps and pain
tract and causes no
moderate pain. itching Swelling, pain or
anticoagulant action tenderness in the upper
abdomen or stomach area

 PARACETAMOL
NURSING CONSIDERATIONS
Assessment:
·Check the patient is not taking any other medication containing
paracetamol
·Check for the allergies to acetaminophen
products containing paracetamol and they should
Implementation:
·For children who may refuse medicine off a spoon try using a medicine
syringe to squirt liquid slowly into the side of the child’s mouth or use
soluble paracetamol mixed with a drink.
·Avoid using OTC drugs with Acetaminophen
·Do not exceed 4gm/ 24 hr. in adult and 75 mg/kg/ day in children
·Do not take 5 days for pain in children, 10 days for pain in adults, or more
than 3 days for fever in adults
Monitoring:
·Monitor CBC, liver and renal functions
·Monitor for S&S of: hepatotoxicity, even with moderate acetaminophen
doses, especially in individuals with poor nutrition or who have ingested
alcohol over prolonged periods; poisoning, usually from accidental ingestion
or suicide attempts; potential abuse from psychological dependence
(withdrawal has been associated with restless and excited responses.
Keep all paracetamol well out of the reach of
Evaluation:
Evaluate therapeutic response
HEALTH TEACHING
If symptoms persist for more than three days,
patients should consult the prescribing
practitioner.
Patients should be cautioned not to take any other
read the label of all other medication carefully to
ensure that it does not contain paracetamol.
Make sure patients are aware they must not
exceed the recommended dose. Do not give
children more than 5 doses in 24 h unless
prescribed by physician
Immediate medical advice should be sought in the
event of an overdose, even if patients feel well,
because of the risk of delayed, serious liver
damage.
Paracetamol for children comes in different
strengths. Parents should take care they give their
child the correct dose.
Paracetamol can be taken on an empty stomach
Do not drink excessive quantities of alcohol while
taking paracetamol
children
 PRIORITY NURSING DIAGNOSIS LIST

1
HYPERTHERMIA
2
FLUID VOLUME
3
ACUTE PAIN RELATED
RELATED TO DEFICIT
TO DIARRHEA
PATHOGENIC AGENTS

CURTIN HEALTHCARE SERVICES

 RANK 1 HYPERTHEMIA
NURSING This nursing diagnosis is the patient's physiologic needs that deals with the patient's
homeostasis and must be the highest priority to render nursing interventions. Hyperthermia is
DIAGNOSIS a condition in which the body's temperature rises as a result of a breakdown in
thermoregulation, which occurs when the body creates or absorbs more heat than it can
dissipate. It should be the main priority since the temperature that exceeds more than 39
RANKING 1-3 degrees Celsius is considered dangerous to the toddler that may cause severe complications.

RANK 2 FLUID VOLUME

DEFICIT
This nursing diagnosis is the patient's physiological needs that deals with the patient's homeostasis
and is the 2nd priority to render nursing interventions. Increase in the frequency of bowel movements
may cause deficient fluid volume as the fluid output exceeds the fluid intake. Fluid volume deficit is
often used interchangeably with the term "dehydration," and it occurs when the body loses both
water and electrolytes from the ECF in similar proportions. Appropriate management is vital to
prevent potentially life- threatening complications.
RANK 3 ACUTE PAIN
This nursing diagnosis is the patient's physiologic needed to be dealt with to not cause change
to the patient's homeostasis and is the 3rd priority to render nursing interventions. Acute pain is
when the patient reports or complaints about it. It is also the most common chief complaint that
brings patients to their health care providers. Manifestations of acute pain can be determined
by subjective and objective data from the patient. Patient P showed clinical manifestation
include pain specifically the abdominal region which was a symptom of diarrhea. the next
CURTIN HEALTHCARE SERVICES priority of nursing diagnosis after fluid volume deficits is to assess patient's pain symptoms
status and to administer intervention and medication to relieve the sign and symptom that the
patient manifest.
NURSING CARE
PLAN

CURTIN HEALTHCARE SERVICES

RANK 1
HYPERTHERMIA RELATED TO PATHOGENIC AGENTS
(PRESENCE OF OVA IN STOOL)

Patient's Name: Prime Theo Rollon

Age: 3 years old
Weight: 12 kg
Diagnosis: Diarrhea

Date: March 10, 2022

 NURSING INTERVENTIONS
ASSESSMENT OBJECTIVES
DIAGNOSIS
·Subjective Hyperthermia Long term: After 3 days of Independent
N/A related to nursing intervention the 1.Monitor vital signs
pathogenic
·Objective patient will:
agents 2.Assess for signs of dehydration as a result of
(presence of hyperthermia.
Ova seen (+) 1.Maintain core
OVA in stool)
Fever: 41.4̊C
temperature within 3.Monitor fluid intake and urine output.
normal range and
4.Provide a tepid bath or sponge bath.
Warm to touch presence of ova will not
be seen Dependent
Vital signs:
Temp: 36.3
Short term: After 8 hours
1.Paracetamol 120mg IV PRN for fever
PR: 90 bpm of intervention the
RR: 22 patient is able to: 2.Flotera chewable tab, 1 tab BID
Oxygen
Saturation: 98 Collaborative
1.Demonstrate stabilized
temperature 1.Monitor lab results, specifically fecalysis for presence
of Ova.
 RATIONALE EVALUATION
1.To observe patient’s health status.

2.Look for signs of dehydration, including thirst, furrowed tongue, dry lips,
dry oral membranes, poor skin turgor, decreased urine output, increased
After 8 hours of intervention the patient
concentration of urine, and weak, fast pulse.

was:
3.Fluid resuscitation may be required to correct dehydration. The Able to demonstrate stabilized
significantly dehydrated patient is no longer able to sweat, which is temperature as evidenced by
necessary for evaporative cooling.
normothermia.

4. A tepid sponge bath is a non-pharmacological measure to allow

evaporative cooling. Do not use alcohol as it can cool the skin rapidly and
may cause shivering.

1.Help treat pain and reduce a high temperature

2.Treat diarrhea and used for enhancing intestinal ecology, improving
digestion and helping enhance natural resistance to intestinal infections.

1.Ensure that the regression of Ova in stool is met.

 Patient's Name: Prime Theo Rollon

Age: 3 years old
Weight: 12 kg
RANK 2

FLUID VOLUME DEFICIT

Diagnosis: Diarrhea
Date: March 8- 2022

CURTIN HEALTHCARE SERVICES

 NURSING
ASSESSMENT OBJECTIVES
DIAGNOSIS
Subjective: Deficient fluid volume Long term goals:
The mother verbalizes “ related to diarrhea Within 24 hours of nursing intervention the patient will be
Masakit ang tiyan nya able to reestablishes and maintains a normal pattern of
madalas at palagi rin bowel functioning and signs of adequate hydration.
siyang dumudumi”

Short-term goals:
After 8 hours of nursing interventions the patient pain scale
Objective:
is lower than before.
Facial grimace

- Na (Decreased)
- K (Decreased)
- Loose and water stool
-Abdominal Pain
INTERVENTIONS RATIONALE EVALUATION
Independent: Independent:
Long term goals:
Strictly monitor input and To calculate fluid retention in
Within 24 hours of nursing intervention
output. the body and the effectiveness
the patient has reestablished and
of the intervention
maintains a normal pattern of bowel

functioning and signs of adequate

Daily weight the child To check the hydration status
hydration.

and assess the amount of weight

loss

Dependent: Dependent:

Administer antibiotics as To treat diarrhea causing

prescribed microorganism
Short-term goals:

After 8 hours of nursing interventions

Administer medication as To decrease infectious process,
patient pain scale is lowered than
ordered decrease motility and/ or absorb
before.

 RANK 3
ACUTE PAIN RELATED TO
DIARRHEA
Patient's Name: Prime Theo Rollon
Age: 3 years old
Weight: 12 kg

Diagnosis: Diarrhea
Date: March 8 2022
 NURSING
ASSESSMENT OBJECTIVES
DIAGNOSIS
Subjective Acute Pain related to SHORT TERM:
The mother verbalizes “ Diarrhea After 2-3 hours of nursing interventions, the patient’s
masakit ang tiyan nya mother will gain knowledge about diarrhea.
madalas at palaga rin
siyang dumudumi “ Expected Outcome:

Objective - Verbalize
Loosed bowel movement Understanding of causative factor.
- Verbalize the rationale for treatment regimen.
with greenish watery
stool.
Long Term:
- After 1-2 days of nursing interventions, the patient will be
Abdominal cramping
free of diarrhea.

Increased bowel sounds/

Expected Outcome:
peristalsis -Re-establish and maintain normal bowel movement.
-Reduction in frequency of stool.
-Return of the stool to the normal consistency
 INTERVENTIONS EVALUATION
Assess for abdominal discomfort, pain, cramping, frequency, urgency, After 2-3 hours of nursing interventions,
loose or liquid stools, and hyperactive bowel sensations the patient’s mother shall gain

knowledge about diarrhea and
Assess general condition closely assess periorbital area, skin turgor, verbalized understanding of causative
weight, presence of edema, etc. factors of diarrhea and rationale for

treatment regimen.
Determine tolerance to milk and other dairy products.

Long Term:
Determine methods of food preparation. - After 1-2 days of nursing interventions,

the patient shall be
Review the medications the patient is or has been taking. free of diarrhea as evidenced by re-

established and maintained normal
Assess for other signs of dehydration. bowel movement, reduced in frequency

of stools and stool
Administer antidiarrheal medication as indicated. returned to its normal

consistency
Administer medication as ordered.
DISCHARGE
PLAN
 1. OBJECTIVE
LIST AT LEAST 3 OBJECTIVES FOR THIS
PATIENTS FOR HOME CARE

1.To promote the client’s optimal level of

wellbeing.
2.To ensure continuity of care.
3.Helps regain his strength and to strengthen
his immunity.
4.The mother and the patient will be able to
follow instructions throughout the home
management care, such as prescribed
medications, functional/physical limitation,
treatments, including diet, and follow-up care,
as well as the critical health education.
 HOME
2. MANAGEMENT
DISCHARGE PLAN

1. MEDICATIONS
NAME OF DOSAGE AND CURRATIVE SIDE
DRUG
ROUTE
FREQUENCY EFFECTS EFFECTS

5 mL syrup (1 Treat moderate Nausea, vomiting

teaspoon)
Oral Stomach pain,
PACETAMOL pain and to
loss of appetite,
every 4 hours, reduce fever. dark urine
As Needed
5mL (1 - Adjunct in the management of
ZINC acute diarrhea. Nausea,
teaspoonful) Oral - to help boost immune
SULFATE function. stomach
SYRUP syrup, Once a -to help support optimum upset,
physical growth and
day. development. heartburn

Used as Adjunct in
FOLIC
5 mL. (1 GI
Oral the management of disturbances,
ACID teaspoonful) malabsorption in hypersensitivit
SYRUP Once a day. diarrhea. y reaction
(Rare).
 HOME
2. MANAGEMENT
DISCHARGE PLAN

1. MEDICATIONS
NAME OF DOSAGE AND ROUTE CURRATIVE SIDE
DRUG FREQUENCY EFFECTS EFFECTS

26.5 mg per Flotera 26.5 mg per Tablet,

Oral Twice a day.
*No data
Tablet, Twice Oral Used for enhancing found for
FLOTERA a day instestinal ecology, improving
side effects.
digestion and helping natural
resistance to intestinal
infections.
*No data found for side effects.

Use to treat Severe Stomach

5mL (1
CEFUROXIM Oral bacterial Pain Diarrhea
teaspoon) infection Fever, chills
W
syrup, Twice headache and
a day for 7 muscle pain
days Lightheadedness
Jaundice
 ENCOURAGE THE CHILD
TO LET HAVE FREQUENT
EXERCISE SUCH AS
WALKING, ARM RAISING.
2. EXERCISE /
ADVICE THE MOTHER TO
ACTIVITY
BALANCE THE CHILD’S DAILY Types of activities allowed/
PHYSICAL ACTIVITIES AND
to be continued:
PROVIDE ADEQUATE REST
PERIODS.
ENCOURAGE THE MOTHER TO
REPOSITION THE CHILD FROM
SIDE TO SIDE TURNING INTO A
FAVOURABLE AND
COMFORTABLE POSITION

MAINTAIN A QUIET,
PLEASANT, ENVIRONMENT TO
PROMOTE RELAXATION.

CURTIN HEALTHCARE SERVICES

 AVOID STRENUOUS
ACTIVITIES SUCH AS
RUNNING. 2. EXERCISE /
LIMIT PLAYING OR ACTIVITY
SOCIALIZING WITH OTHER
Types of activities not
PEOPLE WHILE ON
RECOVER. allowed/ to be continued:
AVOID EATING OR TOUCHING
THE CHILD WITHOUT WASHING
HANDS FIRST.

AVOID SKIPPING THE

MEDICINE

AVOID FOOD SUCH AS SODA,

CURTIN HEALTHCARE SERVICES JUICES AND CHOCOLATE MILK.
 3. TREATMENT
PERFORM ORAL
USE OF PRESCRIBE DRUGS
REHYDRATION THERAPY
(OTP)

DIET:
THE PATIENT SHOULD BE
GIVEN SEVERAL SMALL
MEALS THROUGHOUT THE
DAY INSTEAD OF 3 DAYS.
ENCOURAGE THE PATIENT
FAMILY TO EAT NUTRITIOUS
FOODS SUCH AS FRUITS AND
VEGETABLES.
CURTIN HEALTHCARE SERVICES
PARENT SHOULD SERVE CHILDREN A
BALANCED NUTRITIOUS FOOD,
INCLUDING STAPLE FOODS (RICE,
NOODLES AND RICE NOODLES), SIDE
DISHES (MEAT, FISH CHICKEN, TUFO
AND TEMPE), VEGETABLES AND
FRUITS EVERY DAY.
ADEQUATE FLUID INTAKE.
 WHEN TO SEEK
FOLLOW UP CARE MEDICAL CARE
BLOODY DIARRHEA
INSTRUCT THE PATIENT’S
MOTHER TO CONTINUE REFUSAL TO EAT OR DRINK
FOLLOW-UP CHECK UP TO ANYTHING FOR THAN EIGHT
THE DOCTOR, 1 WEEK AFTER HOURS IN CHILDREN.
DISCHARGED.
MODERATE TO SEVERE
DEHYDRATION.

ABDOMINAL PAIN THAT

COMES AND GOES OR IS
SEVERE.

INTENSE, REPEATED
CURTIN HEALTHCARE SERVICES VOMITING.
 4. HEALTH TEACHINGS
(LIST AT LEAST 5):
Instruct the patient’s mother to take all prescribed home
medications on time according to the schedule. Explain to
the mother each medication uses.
Instruct the patient’s mother to always do hand washing with
running water and using soap.
Instruct the mother to use clean water and clean latrines
for daily needs.
Instruct the parents to consume nutritious foods such as
vegetable and fruits. Especially, properly cooked foods.
Advice the patient to have fluid intake or adequate
hydration.
Advice the mother to maintain environmental cleanliness.
Instruct the mother to seek medical advice if signs and
symptoms will be severe.
 THANK
GROUP 4
MEMBERS:

Abegail Tenido
Andrea Pamonag
YOU
Angeli Kate Valdez
Ephraim Quicho
Ethel Satina
Josh Villanuava
Junie Tucay
Jusrin Reynos
Nica Pacho
Tyron Verano