Etiology
hemorrhage. Certain laxatives such as
Diarrhea is an increased frequency of bowel
movements (more than 3 per day), an increased
amount of stool (more than 200 g/day), and
altered consistency (loose-watery) of stools.
The organisms most frequently associated with
diarrhea are Rotavirus, Enterotoxigenic
Escherichia coli, Shigella, Campylobacter jejuni,
Cryptosporidium. In 2019, 203 thousand cases
of diarrhea were recorded.
Predisposing factors
 Age
 Seasonality
 Asymptomatic infections
 Epidemics
 Poor sanitation
 Poor hygiene
 Diet
 Undernutrition
 Current or recent measles
 Underlying conditions
Precipitating factors
 Ingestion of contaminated food and
water
 Contact with an infected person
 Unwashed hands
 Dirty utensils
 Failure to dispose feces
 Storing of food in room temperature
Pathophysiology
 Secretory diarrhea is usually high-
volume diarrhea. Often associated with
bacterial toxins and neoplasms, it is
caused by increased production and
secretion of water and electrolytes by
the intestinal mucosa into the intestinal
lumen.
 Osmotic diarrhea occurs when water is
pulled into the intestines by the osmotic
pressure of unabsorbed particles,
slowing the reabsorption of water. It
can be caused by lactase deficiency,
pancreatic dysfunction, or intestinal
lactulose and citrate of magnesia or
maldigestion of certain food substances
such as milk are common causes of
osmotic diarrhea
 Malabsorptive diarrhea combines
mechanical and biochemical actions,
inhibiting effective absorption of
nutrients manifested by the markers of
malnutrition that include
hypoalbuminemia which happens when
the level of albumin in the blood is low
and which is also a feature of chronic
and advances hepatic cirrhosis. Low
serum albumin levels lead to intestinal
mucosa swelling and liquid stool.
 Infectious diarrhea results from
infectious agents invading the intestinal
mucosa. Initially, after ingestion,
organisms colonize the intestinal
mucosa and invade the ileal and colonic
mucosa or secrete a noxious cytotoxin
intramurally.
 In exudative diarrhea, it happens when
there is a damage to the intestinal
mucosa, be it changes in mucosal
integrity, epithelial loss, or tissue
destruction by radiation or
chemotherapy. which then releases the
presence of mucus, blood, and plasma
proteins from cells as result of the
inflammation or the injury. Through
that, it increases the content of the fluid
present in the feces. This is usually
associated with patients who have
ulcerative colitis, Chron’s disease, or
radiation enteritis.
Symptomatology
Abdominal cramps
Diagnostic tool/s:
*Verbalized and manifested by the
patient (pain scale)
 *Physical assessment *Maintain a pleasant and relaxed
1. Nursing management atmosphere for eating
*Dietary and nutritional counseling 3.Pharmacologic management
*Increased hydration of water or clear *Administer antiemetics as ordered
fluids *Prescribed IV fluids
*Provide CBT 4. Nursing diagnosis
2. Health teaching *RISK FOR INJURY
* Small amounts of clear fluids and
foods Vomiting
*Avoid greasy, fried, and high-fat foods Diagnostic tool/s:
*Avoid food that give gas *Verbalized and/or manifested by the
3.Pharmacologic management patient
*Provide loperamide as ordered
4. Nursing diagnosis 1. Nursing management
*ACUTE PAIN *Nutrition and hydration counseling
*Monitor I&O
Abdominal distension *Provide CBT
Diagnostic tool/s: 2. Health teaching
*Verbalized and manifested by the *Practice deep breathing and voluntary
patient (pain scale) swallowing
*Physical assessment *Eat smaller meals and eat slowly
1. Nursing management *Small amounts of clear fluids and
*Dietary and nutritional intervention foods with ginger
*Maintain rest 3.Pharmacologic management
*Provide CBT *Administer antiemetics as ordered
2.Health teaching *Prescribed IV fluids
*Encourage a low-spice, low-fat diet 4. Nursing diagnosis
*Avoid sleeping supine *DEFICIENT FLUID VOLUME
*Low-fiber diet
3.Pharmacologic management Fever
*Provide simethicone as ordered43. Diagnostic tool/s:
Nursing diagnosis *Physical assessment
*ACUTE PAIN 1. Nursing management
*Monitor vital signs
Nausea *Encourage adequate hydration
Diagnostic tool/s: *Assess for signs of dehydration
*Verbalized and/or manifested by the 2. Health teaching
patient *Avoid coffee, tea, grapefruit juice,
1. Nursing management sugared drinks, and alcohol
*Promote comfort during nausea and *Need to increase fluids
vomiting *Teach the individual/family how to
*Reduce or eliminate noxious stimuli observe for dehydration
*Decrease stimulation of the vomiting 3. Pharmacologic management
center *Provide antipyretic as ordered
2. Health teaching 4. Nursing diagnosis
*Apply cool, damp cloth to the patient’s *DEFICIENT FLUID VOLUME
forehead, neck, and wrists
*Rest before meals Mucus in the stool
Diagnostic tool/s: Prognosis
*Stool examination and blood tests
1. Nursing management If treated, the patient will recover from bouts of
*Dietary and nutritional counseling and diarrhea within few days with no lasting
management complications. If left untreated, it can lead to
*Maintain skin integrity severe dehydration and cause fits (seizures),
*Increase fiber intake brain damage, and even death.
2. Health teaching
*Clean the anal area after bowel
movement; lubricant can protect the
skin
*Dietetic food containing sugar can
cause diarrhea
*Apply lotion or ointment as skin
barrier
3.Pharmacologic management
*Taking probiotics
*Provide antidiarrheal as prescribed
4. Nursing diagnosis
*DEFICIENT FLUID VOLUME

Blood in the stool (hematochezia)

Diagnostic tool/s:
*Stool examination and blood tests
1. Nursing management
*Monitor Hct and Hgb
*Dietary and nutritional counseling and
management
*Encourage adequate fluid intake
2. Health teaching
*Provide information to the client or
family about hereditary or familial
problems that predispose to the
bleeding complications
*Instruct at-risk client and family
regarding specific signs of bleeding
*Dietary measures to improve blood
clotting, such as vitamin K-rich foods
3. Pharmacologic management
*NSAIDs, anticoagulants,
corticosteroids, and certain herbals
*Hemostatic agents
4. Nursing diagnosis
*RISK FOR BLEEDING