Topic: GASTROENTERITIS

Reporter: ENERIO, Melanie, L.

Course & Section: BSN 3B

GASTRO – means stomach

ENTER – refers to small intestine
ITIS – means inflammation
➢ Usually refer Gastroenteritis as “Stomach flu/bug or Stomach virus”.
➢ Every year, gastroenteritis accounts for 1.7 million visits to emergency department
by children in US (S.B Freedman et al., 2018)
➢ There are 2 types of Gastroenteritis:
o Acute Gastroenteritis – usually last long about a few days to a week. Is
common in pediatric patient.
❖ Acute gastroenteritis defined as having 3 or more loose or watery
stools in 24 hours w/ or w/o vomiting and typically w/ fever.
❖ Or vomiting and or diarrhea for less than 72 hours
o Chronic Gastroenteritis – on the other hand, is persistent, last long period
of time.
➢ Signs and Symptoms include the following:
▪ Nausea/vomiting
▪ Diarrhea
▪ Abdominal pain
▪ Fever
To assess dehydration the ff. are the symptoms;
➢ A child with mild dehydration will have the ff.:
✓ Dry mucous membrane
✓ Thirst
✓ Mild tachycardia
✓ Decrease urine output
➢ Moderate dehydration has the ff. symptoms:
✓ Dry mucous membranes
✓ Sunk eyes
 ✓ Dyspnea
✓ Tachycardia
✓ Reduced skin turgor
✓ Lethargy
➢ Severe dehydration has the ff. symptoms:
✓ All symptoms mention above
✓ Altered consciousness
✓ Signs of shock
What causes Gastroenteritis?
Ordinary flu usually caused by influenza virus DOES NOT cause this disease. There are
specific infectious pathogens that can cause Gastroenteritis and these are:
o Virus:
▪ Rotavirus –
▪ Norovirus – most common virus
▪ Adenovirus
o Bacteria
▪ Enterotoxigenic E. coli
▪ Campylobacter
▪ Shigella
▪ Salmonella
o Protozoan (are the less common pathogen)
▪ Protozoa
▪ Helminths
Cause of gastroenteritis is mainly viral. More than 70% of cases cause usually is
rotavirus or norovirus while 20% is mainly bacterial cause.
How to differentiate viral gastroenteritis and gastroenteritis?
If viral gastroenteritis the diarrhea tends to be watery whereas if bacterial infection more
like a bloody diarrhea. In addition, that w/ bacterial gastroenteritis will experience more
fever.
How these pathogens get into the system?
This disease is usually transmitted through fecal and or oral transmission. The feces get
undigested doesn’t absorbed in the system an gets excreted as waste. This waste
contains pathogen and is contaminated.
Oral refers to other’s mouth. If a person with existing gastroenteritis uses the bathroom,
they may wash hands but not well enough. Their hands might be contaminated with the
pathogens such as the rotavirus or norovirus then they go in touching other objects
surfaces or food and water that you may also touch. If you touch it those with your
hands or eat the contaminated food and or water, you give the pathogens an easy
access to enter your gastrointestinal system.
What will it do?
Gastrointestinal wall - a lining extends over entire gastrointestinal tract (stomach to
small intestine). Epithelium in the gastrointestinal wall contains all cells that specialized
for digestion and absorption (Epithelial cell). Food in the stomach that is partially
digested contains pathogenic that cause Gastroenteritis then will invade Epithelium,
then this causes cells to die resulting to disfunction in absorption and digestion of food
and water that may lead to vomiting. A lot of water can’t be absorbed thus it will come
out as diarrhea. Excess loss of water and Epithelium cells dies results to dehydration.
So, as I mentioned earlier that the IT IS in gastroenteritis means inflammation so it
means the immune system response specially WBC combat against the pathogens that
causes the infection, is also the reason why you will experience fever.
For the viral gastroenteritis, the Epithelial cell encounters the virus, virus that has capsid
structure made of proteins and within the capsid is nucleic acids this can include DNA or
RNA. That virus wants to replicate but lacks of enzymes that is necessary to do the
process. What will the virus do? The cell has all the enzymes that can make more viral
protein and more viral nucleic acids. So, the virus will invade the epithelial cell. The
virus will hijack the enzymes of the cell to make its own another virus then infect another
cell. In addition, the virus will shut down the function of the cell by releasing toxins to
damage the cell it will stop the epithelial cell from absorbing the water. It can also
deactivate certain proteins that is responsible for digesting your food.
Note for Red Flags specially for pediatric patient and these are:
✓ Severe abdominal pain
✓ Blood in stool
✓ Persistent diarrhea (more than 10 days)
✓ Vomiting w/o diarrhea
✓ Very unwell appearance
How to diagnose?
The physician will order diagnostic test to verify if the patient had a Gastroenteritis and
these are:
✓ Stool sample – use to evaluate what pathogens is in the system through
evaluating it in the lab the patient feces.
 ✓ Blood Test – use not to look what kind of pathogen cause but to evaluate if the
patient is dehydrated through looking the level of sodium and creatinine (high
level indicates positive dehydration) for children that has high fever.
• Full blood count (FBC)
• Electrolytes, urea, creatinine (EUC)
• Glucose
✓ Urine analysis
How to treat?
Through:
▪ Oral rehydration therapy – patient must drink fluids that contains a lot of sugar
and salt.
▪ IV Fluid – if patient dehydration is pretty bad dehydrated.
▪ Nasogastric tube – for moderate to severe dehydration for pediatric patient.
▪ Antibiotics – this treatment depends if the pathogens that cause gastroenteritis is
bacteria. Antibiotic only works for bacteria and not for virus pathogens. Only
physician can give order what kind of antibiotic will be use as treatment.
So far, there is no medicine to treat gastroenteritis or a cure. But there’s this called
Probiotic trial conducted in children with acute gastroenteritis in the US. The bests thing
to do is to treat the symptoms and also practice good hand hygiene. Cooked food well
just to make sure it isn’t contaminated.

QUESTIONS:
1. What is the most common viral pathogen that causes Gastroenteritis?
a. Rotavirus
b. Norovirus
c. Noravirus
d. Adenovirus
2. Why is acute gastroenteritis common in children?
a. Children are weak
b. Children immune response is not yet fully developed
c. Some drugs and immunization cause the immune response to become
weak hence, once the virus invade, the body can’t fight back.
d. Gastroenteritis is the most common disease so every child will
experience it.
3. The following are the signs and symptoms of Gastroenteritis except;
a. Nausea
b. Vomiting
c. Pain
d. Fever
4. Nurse Cyril is reviewing the isolation prescription for Xyra who has
gastroenteritis. Which of the following types of isolation precautions
should Nurse Cyril implement?
a. Standard
b. Airborne
c. Droplet
d. Contact
5. Nurse Cyril complete the admission assessment of Xyra who has
gastroenteritis and is dehydrated. Which of the following is the priority
action based on the assessment?
a. Assess vital signs
b. Initiate IV access
c. Administer antibiotic
d. Call the physician