CASE SCENARIO 2

ACUTE GASTROENTERITIS

Eliz, a 9-month old baby girl, 8 kilos, She was rushed to the ER carried by her mother at 10 pm due to
severe diarrhea 2-days PTA associated with fever and non-projectile vomiting on the day of admission.
Upon interviewing, the mother verbalized it started at 1AM with a sudden onset and occurred about 7-9
times per day. The stool was watery in nature, yellowish to brown in color with no blood stains, since
then she had little to no appetite and only drinks little amount of milk. There was no history of eating
outside food and travelling.

Upon the nurse’s assessment Baby Eliz conscious, and irritable, had a fever of 39.2 degree Celsius, a
heart rate of 180bpm, a blood pressure of 100/55mmHg, an o2sat of 99% and a respiratory rate of
50cpm, abdomen was symmetrically distended and moves with respiration, depressed fontanelle,
sunken eyes, tenting skin turgor and a capillary refill time of 2 seconds.

The mother’s medical history showed that she developed GDM and was managed with insulin therapy
during her pregnancy, baby Eliz was born full term via cesarean section due to DM, birth weight was
about 6.2 kg APGAR score was 9-9 at one and five minutes, she then developed mild jaundice after 4
days of life. Baby Eliz was exclusively breastfed up to present.

Baby Eliz was placed on fluid replacement therapy, with an IVF of D5 0.3NaCl 500ML @ 40cc/hr,
hydration status is then assessed every 2 hours by the resident doctor and nurse to determine whether
to increase or decrease the cc/hr, PCM drops 100MG/ML 1.2ml orally q4 PRN for fever of 38 degree
Celsius and above, Probiotics Flotera drops, 5drops orally OD, and Metronidazole (Rodazid) 125mg/5ml
suspension 4ml TID x 7 days, Diloxinide Furoate 125mg/5ml. 2.25ml X 3x a day for 10 days, 2 hr apart
frm Metronidazole. encouraged increased oral fluid intake, replace GI loses volume per volume, with
PLR 1L, monitor I&O Qh in absolute figures was ordered. Urinalysis and stool exam was then ordered by
the doctor, urinalysis showed normal results yet the stool exam showed that it was loaded with E.
Histolytica (Cyst and Trophozoites)

Diet: Low fat

IMPRESSION: ACUTE GASTROENTERITIS WITH MODERATE DEHYDRATION, Intestinal Amoebiasis

1. What are the signs and symptoms of AGE?

2. What are the common causes of AGE?
3. Trace the pathophysiology of the disease using a schematic diagram.
4. What are the organisms associated with AGE?
5. Differentiate Viral and Bacterial gastroenteritis.
6. Baby Eliz has an IVF of D5 0.3NaCl 500ml @ 40cc/hr. How many hours would it be consumed? What is
the rate for drops/min?
7. How do we assess for hydration status in children?
8. What is the diet for AGE?
9. What are the preventive measures ans health education for Amoebiasis?