What is gastroenteritis? Gastroenteritis is a general term for irritation and inflammation of the gastrointestinal tract. The hallmark symptoms of gastroenteritis are nausea, vomiting and diarrhea. Gastroenteritis is quite common and can occur in any age group or population. Gastroenteritis is most frequently caused by a viral infection and is commonly referred to as viral gastroenteritis, the stomach flu, or the 24-hour or 48-hour ³bug.´ This type of infectious gastroenteritis is contagious. A bacterial infection, such as Salmonella food poisoning, can cause bacterial gastroenteritis, which is also contagious. Similar gastrointestinal symptoms can also result from a variety of other conditions that are not contagious, such as alcohol intoxication or irritable bowel syndrome. Gastroenteritis can lead to serious complications such as dehydration, especially in infants, young children, the elderly, or people with chronic diseases. The underlying disorder, disease or condition that is causing gastroenteritis can also cause complications. Seek prompt medical care if you have symptoms of gastroenteritis that do not improve after a day or two. Seek immediate medical care ( call 911) if you, your child, or someone you are with, have symptoms of gastroenteritis accompanied by lethargy, change in alertness, delirium, a seizure, rectal bleeding, or a lack of urination. What are the symptoms of gastroenteritis? The symptoms of gastroenteritis can range from mild to severe and may vary depending on the underlying cause. Symptoms of viral gastroenteritis, caused by a viral infection, generally resolve within 24 to 48 hours. Other causes of gastroenteritis can last longer.. Symptoms of gastroenteritis can include: y Abdominal gas, bloating or belching y Abdominal pain or cramps y Blood-streaked stools y Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains) Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness, or an upset stomach y Vomiting including multiple episodes y Watery diarrhea including multiple episodes y Weakness (loss of strength) Serious symptoms that might indicate a life-threatening condition Gastroenteritis can lead to serious or life-threatening complications in some cases, including dehydration and gastrointestinal bleeding. Seek immediate medical care (call 911) if you, your child, or someone you are with, are experiencing any of the following life-threatening symptoms: y Change in alertness or consciousness y Delirium y Extreme thirst y Lack of urination or fewer wet diapers in infants y Lethargy y Rectal bleeding y Seizure y Shallow, raspy, or difficulty breathing y Sunken fontanel (soft spot) in an infant¶s head y Unresponsiveness What causes gastroenteritis? Gastroenteritis is most frequently caused by a gastrointestinal viral infection. Similar symptoms can also result from a variety of other conditions including: y Alcohol intoxication y Anthrax infection y Bacterial gastrointestinal infection, such as salmonella food poisoning, campylobacter infection, or traveler¶s diarrhea y Dysentery y Indigestion y Irritable bowel syndrome y Medication side effects y Parasite infections, such as Giardia infection y Stress y Toxic ingestion, such as eating poisonous plants, mushrooms or chemicals What are the risk factors for gastroenteritis? A number of factors increase the risk of developing gastroenteritis. They include: y Close contact with a person who has viral gastroenteritis y Eating eggs or meats that are raw or undercooked y Eating excessively large meals, especially if consumed rapidly y Eating expired foods or leftovers that have been refrigerated for more than two to three days y Having a compromised immune system due to such conditions as HIV/AIDS, diabetes, kidney disease, or cancer or cancer treatment y High stress levels or anxiety

which is when contents of the stomach flow into the lungs during vomiting (a rare occurrence) y ·A rip in the esophagus (Mallory-Weiss tear) due to multiple violent episodes of retching and vomiting (a rare occurrence) y I . The risk of dehydrationincreases as symptoms are prolonged. handling reptiles. Treatment of severe gastroenteritis that does not resolve or leads to dehydration may require hospitalization and rehydration with intravenous fluids.y Not washing hands after contact with a person who has bacterial or viral gastroenteritis Not washing hands frequently. vomiting. When gastroenteritis is caused by a self-limiting condition. Infants. Food that hasspoiled may also cause illness. medicaltreatment is essential if symptoms worsen or if there are complications. gastroenteritis. especially after using the bathroom. especially after using the bathroom. but you can lower your risk of developing or transmitting gastroenteritis by: y Avoiding contact with a person who has food poisoning. youngchildren. not on the counter y Drinking alcohol in moderation y Keeping poisonous or toxic plants or products out of reach of young children y Not keeping reptiles as pets in homes. or perishable food that has been sitting at room temperature for two hours or longer y Washing hands frequently during and after contact with a person who has food poisoning. certain bacteria. medications are used to treat gastroenteritis. and decreases the risk of dehydration. and anyone with an underlying disease aremore vulnerable to complications such asdehydration. such as diabetes or cancer y Small children y The elderly Reducing your risk of gastroenteritis Not all people who are at risk for gastroenteritis will develop the condition. even life threatening in some cases. low fever. but children. but some viruses may last up to a week. Antibiotics may be prescribed when gastroenteritis is caused by a bacterial infection.Gastroenteritis arises from ingestion of viruses. Leftovers from restaurants should be eaten within 24 hours. Complications can include: y Severe dehydration. minimizes the discomfort of nausea. although theinfluenzavirus is not associated with this illness. or scanty urination is experienced. or Campylobacter infection. However. Adults usuallyrecover without problem. blood in the vomit.The greatest danger presented by gastroenteritis is dehydration.9 °C] or above). Certain medications and excessive alcohol can irritate thedigestive tract to the point of inducing gastroenteritis. or symptoms such as vomiting and diarrhea y Defrosting foods in the refrigerator or microwave. such as in bacterial food poisoning due to Shigella. the symptomsof gastroenteritis include diarrhea. The loss of fluids throughdiarrhea and vomiting can upset the body's electrolyte balance.increased or excessive thirst. diarrhea. and persons with underlying disease require special attention in thisregard. or touching raw foods y Washing plates. These symptoms are sometimes also accompanied byfever and overall weakness. medical history. and abdominal cramps. especially with infants and young children y Refrigerating or freezing leftovers right away and eating them within two to three days of refrigerating. old leftovers. and cutting boards that have been exposed to raw meats or poultry in hot soapy water before reusing How is gastroenteritis treated? Treatment plans for gastroenteritis are individualized depending on the underlying cause and your age. the elderly. touching pet feces. I N T R O D U C T I O N Acute Gastroenteritis (AGE)Gastroenteritis is a catchall term for infection or irritation of the digestive tract. Typically. or parasites. such as Pedialyte) to ensure adequate hydration In some cases. touching pet feces. treatment includes: y Not eating solid foods to rest the stomach and intestines until symptoms have passed y Drinking plenty of fluids (water or rehydrating fluid. and abdominal painand cramps. the elderly. y Throwing out expired food.If symptoms do not resolve within a week. such as viral gastroenteritis. What are the possible complications of gastroenteritis? Complications of gastroenteritis can be serious.Sufferers may also experience bloating.A usual bout of gastroenteritis shouldn't require a visit to the doctor. blood or mucus in the diarrhea. Major symptoms includenausea andvomiting.Salmonella. nausea and vomiting. thesymptoms last only two to three days. particularly thestomach and intestine. such as antibiotics and chemotherapy Gastroenteritis can lead to the serious complication of dehydration in some cases. Treatment generally involves a multifaceted plan that addresses the cause. or symptoms such as vomiting and diarrhea y Washing hands frequently. and overall tiredness. Dehydration should be suspected if adry mouth. Symptoms of great concern include a high fever (102 ° F[38. changing diapers. which can lead to an electrolyte imbalance and shock y Aspiration. or touching raw foods or foods potentially contaminated with bacteria or parasites or viruses y Taking certain medications. handling reptiles. Gastroenteritis typically lasts about three days. gastroenteritis. Regardless of the cause. utensils. and severe . an infection or disorder more serious thangastroenteritis may be involved. It is frequently referred to as the stomach or intestinal flu. leading to potentially life-threatening problems such as heart beat abnormalities (arrhythmia). People most at risk for dehydration include: y Infants y People with chronic illnesses. and any other conditions you may have. and diarrhea.

She has lots of energy but cries when shedoesn¶t like something. S. distress or feelings. Q says ³ eto first time nya ma-admit after nya ipanganak.Family Health History No one in the family had any respiratory illness or allergies.Q. M. she usually cries when something is wrong about her. Activity-ExerciseS. Sexual-ReproductionPrior to age.Q. These medications work by altering the ability of the intestine to move or secrete spontaneously.´S. H e a d . She changes diaper 3-5times in a day when full or had defecated.Q. is a female. Someover-the-counter medicines use more than one element to treat symptoms. and Bonagua. EliminationShe defecates once or twice a day in her usual days. has a mannerism of sticking anything on her mouth. Her coordination.I I I . ± 8 A. she doesn¶t practice hand washing every nowand then. Once one is sick in thefamily. neatInitial Vital Sign: T=36. Napuntatalaga kami kay Dra.Their whole family is Born Again in religion.Q. is a very playful and active girl.4°C RR=27 PR=11 .Present IllnessS. balance isnot yet stable due to age. She response well to verbal stimulus by looking atyou or having facial expressions. no other disease or complication was seen or diagnosed. Her daily living activities were provided by her parents. Forms words like dede and dada .. They regularly attend church together with all themembers of the family. and born at Calamba. residing at P2 Blk1 L38 Pabahay Nanadero. for comfort andconvenience. ³lagi naman kami nagpapacheck up ni stephani. On her father¶s side. She smiles and laughs a lot. She weighs 8.7 kg. gets seasonalcough and colds at times but never serious because it usually last only for a few days. S. 11/12 months old. Self-PerceptionS. factory worker. Sleep-RestShe sleeps at 8 P.Q.Past Health HistoryMrs. Cognitive PerceptualS. She is friendly and is easy toaccommodate.M. She has straight undisturbed sleep atnight.Q. Value-Belief The family is Born Again.Q. ³Bibo nga yan bata nay an.She drinks formula milk. After playing or eating she takes a nap. a person may use over-the-counter medications such as Pepto Bismol to relievethe symptoms.´ S. in themorning. Simple smile or cry is a sign of her comfort. Angelie.Q. is not yet oriented with any sexual matters Coping StressIn her age. She is complete in her vaccinations except those whichwould be taken on her 1 year of age. Q provides her daughter milk and food in accordance to age and doctor¶s advise. G o r d o n ¶ s P a t t e r n Health PerceptionAs Mrs Q. I I .M. pedia ward with chief complaint of high fever for 2 days with emesis and has a diagnosis of Acute Gastroenteritis. And she wasdischarged on January 6. She was advise to use Lactacid for her perennial wash and calmoseptin ointment on her diaper rash. M. absorbing toxins and water. Filipino in nationality. stated. Theyalways consult their doctor once sick. Malikot lang talaga yan pero inaalagaan yan sa bahay. has no sensory deficits.T o e A s s e s s m e n t General Assessment: Playful and active.Q. Role-RelationshipShe doesn t know the concept of death yet due to age.. 2010 at room 103-C. V . They don t usually believe in hilot .Q.almost all have hypertension. Aireen. I V . works part time in a shop and her father is R. She stop being breastfed when she was 10 ½ moths. She drinks 6-7 bottles of milk in a day. 2010.D .t o . Their attending physicianswere Campos. was only admitted to the hospital due to gastrointestinal problem now and was alsosuspected of urinary tract infection by Dra.Q. However. Nutritional-MetabolicS. She hasno allergy. Aside from the diagnosis. Her mother is J.7 kg. Laguna. gait. She usually plays after she wakes up in the morning. There are some medications she takes easily but there are also thosemedications which is hard for her because of the taste. Although. One member of their family died on a heart attack. 2009. weighs 8. 3 years old. P a t i e n t ¶ s P r o f i l e S.Calamba City. is not afraid of new people around her. in the evening and usually gets up 7 A. Laguna.Gastroenteritis is a self-limiting illness which will resolve by itself.. Campos. Thereis no musculoskeletal impairment. K. She¶s admitted onJanuary 30.was born on March 6. Whatever she touches shedirects it toward her mouth. She knows her family members and can easily familiarize the peoplearound her.abdominal pain or swelling. makulit pero mabilis monaman makuha attention. She eats soft foods.M. they go immediately to the hospital or for check-up.Q. She is familiarized to her familymembers and long for them when she doesn t want the situation like giving of medications or other procedures. or altering intestinal microflora. Campos.Mrs. These symptoms require prompt medical attention.´ as her mother stated. Saturday at 1:30 pm.D.Q. H e a l t h H i s t o r y & C h i e f C o m p l a i n Chief ComplaintShe was admitted for having high fever for 2 days with vomiting. She has one sibling older than her.

The liver produces bile .Q. This area allows food to pass from the smallintestine to the large intestine. Undigested material travels next to the large intestine. a muscular tube that is about10 inches long. A digestiveenzyme(calledamylase) in the saliva begins to break down thecarbohydrates(starches and sugars). Saliva or spit.which is why it takes hours to fully digest food. She was seen andexamined by Dra. IVF was changed to #2 D5 INM 500 ml x 10cc/hr at 9:50 am.The villi arecovered with even tinier projections called microvilli. The combination of villi andmicrovilli increase the surface area of the small intestine greatly. The last part of the large intestine is the rectum. It begins at thelower right-hand side of the body and ends on the lower left-hand side. 1 st dose is given at 8:00 am the next morning. produced by the salivary glands (located under thetongueand near the lower jaw). where chemical andmechanical digestion occurs. the smallintestine absorbs the nutrients from the digestive process. it squeezes shut to prevent food and fluid fromgoing back up the esophagus. the jejunum (thecoiled midsection). The esophagus is located between the throat and the stomach. January 31. and digestive juices produced by the stomach. then. The cecum is a pouch at the beginning of the large intestine. gall bladder . The main job of the large intestine is to remove water and salts (electrolytes) from the undigestedmaterial and to form solid waste that can be excreted. and pancreas. Medications were Paracetamol drops 1ml every 4 hours for fever. Bile helps to make fat molecules (which otherwise arenot soluble in water) soluble.forms an upside down U over the coiled small intestine. 2010.Mouth and Salivary GlandsDigestion . is released into the mouth. together with theliver . The large intestineis about 5-6 feet long.The digestive system is made up of the digestive tract.6 ml)once daily was ordered. Second. and. allowing absorption of nutrients to occur. The laboratoty results was followed up. Oneof the most important functions of the mouth is chewing.Large intestine . so they can be absorbed by the body. 2010. the pancreas. at 8:40 am S. she was crying when received. 2010. Also. The remaining contents of the large intestine aremoved toward the rectum. She hasfever of 37. where feces are stored until they leave the body through theanus as a bowelmovement V I I I . An IVF D5 INM500 ml x 10cc/hr is hooked and CBC was done. Saliva begins to break downthe food. She was brought to pedia ward ataround 11:00 am and received by nurse on charge. The pancreas secretes enzymes into the smallintestine that help breakdown carbohydrates. stomach. February 1. and the chemical breakdown of larger molecules into smaller molecules. Campos and was advised to be admitted for further test and treatmentdue to suspected UTI. Muscular wavelike contractions known as peristalsis push the food down through the esophagus tothe stomach. Campos. She was diagnosed with Acute Gastroenteritis. Glands in the intestine walls secreteenzymes that breakdown starches and sugars. First. its movement through the digestive tract (also known as thealimentarycanal). The inner wall of the smallintestine is covered by millions of tiny fingerlike projections called villi . Every piece of food we eat has to be broken down into smaller nutrients that the body canabsorb.which is stored in the gallbladder . which produce important secretions for digestion thatdraininto the small intestine.Esophagus . All laboratory results . and wasrefered to Dr. thecolon. She was playful all throughout the day. It has 3 parts: thececum. fats . She was prescribed with Omeprazole (Omepron) 5mg IV once a day. This consists of a long tube of organs that runs from themouthto theanusand includes the esophagus.begins in the mouth.Bacteriain the large intestine help to break down the undigested materials. and the liver. examined S. She was seen by Dra. is for check up with her attending physician due to high fever for 2 days associated with vomiting. moistening it and making it easier to swallow. The digestivetract in an adult is about 30 feet long. Zablan due to decreased results of urinalysis.and therectum. liquid. which iswherefeces(waste material) is stored before leaving the body through the anus. Her fever decreases gradually unitl there administration of paracetamol every 4 hours for fever was discontinued. 1 dose was given on admission and following doses for every 4 hours was given.Stomach .a J-shapedorganthat lies between the esophagus and the small intestine in theupper abdomen. the digestive process is completed here by enzymes and other substancesmade by intestinal cells.9 °C and administration of Paracetamol drops 1 ml every 4 hours wasresumed. Thesmall intestine is a narrow.Small Intestine Most digestion and absorption of food occurs in the small intestine. The small intestine has 2 importantfunctions. and to slowlyempty its contents into the small intestine. and the ileum (the last section). and proteins . Monitoring of input and output wasordered by the doctor with increase fluid intake. January 30. and large intestine.Once food is swallowed. It extends about 20 feet in length.A n a t o m y & P h y s i o l o g y Digestion is the process by which food is broken down into smaller pieces so that the bodycan use them to build and nourish cells and to provide energy. The colon is where fluids and salts are absorbed and extendsfrom the cecum to the rectum. Chewing allows food to bemashed into a soft mass that is easier to swallow and digest later. The stomach has 3 main functions: to store the swallowed food and liquid to mix up the food. C o u r s e i n t h e W a r d On day 1.Q. 10:40 am Dra. Campos at 10:15 am and given an order of urinalysisand fecalysis. smallintestine. Monday. it enters the esophagus. Thesmall intestine consists of 3 parts: the duodenum (the C-shaped part). She has been irritable all day. twisting tube that occupies most of the lower abdomen betweenthe stomach and the beginning of the large intestine. Zinc Sulfate (E-Zinc) drops (0. Digestion involves themixing of food.On the third day. A muscular ring (called the cardiac sphincter) at the end of the esophagusallows food to enter the stomach. She is being given Ceftriaxone(Xtenda) 750 mg IV once a day side drip every 12 noon.On the second day.

Dra Campos ordered continue allmedeications and treatments. Friday. Repeat urinalysis and notify him when WBC is 1-3. advised that they may go home. Allmorning medications were given. S. IVF wasregulated.On the fourth day. February 3. Follow up urine culture and sensitivity. she has no fever.Q. He ordered followup of urine culture and sensitivity and advised periodic complete emptying of urinary bladder. Saturday. S.Q.Dra. February 6. Campos had her round at 4:50 pm and checked S.Q. 2010. Campos ordered continue allmedications and follow order of Dr. IVF #4 D5 INM500 ml x 10 cc/hr was hooked at 11:30 am. Dr. all findings were on normal range. was discharge at 1:30 pm . Dr. decrease laboratory results and afebrile. 2010. IVF #3 D5INM 500 ml x 10 cc/hr was hooked at 1:00 pm. Dra. Campos. is taking a bath. Zablan saw laboratory results and advise client to increase fluidintake and replace loses with PLRS. Wednesday. February 2. All medications weregiven on time. S. and was active and playful.wereseen by Dra. Tueasday. Proceed to Dr. February 5. Dra.On the eighth day. He said all test were now stabilized and normal. he checked S.is afebrile. andthe laboratory test. Zablan had his round at 11:45. no vomiting. playful but cries at times. 2010. Zablan had his round at 11:30 am. is received active.On the seventh day.On the fifth day. He ordered repeat UA from AM (clear catch). IVF #9 imb ½ l X 20 cc/hr was hooked at 10:45 am. IVF #6 INM 500 ml x 10cc/hr was hookedat 11:00 am. negative vomiting and playful. Zablan. IVF #8 IMB ½ L x 20cc/hr was hooked at 11:30 am. During the afternoon. novomiting.On the sixth day. Thursday.Findings were with positive diaper rash. February 4. Dr. she ondered continueall medications and treatment and wait for Dr. IVF #7 INM 500 ml x 10cc/hr was hookedat 1:00am. S. Zablan¶s assessment. 2010.Q.Q. Campos. All 8:00 am medicationswere given.Q. IVF #5 INM 500 ml x 10cc/hr was hooked at 12:15 nn. urine culture and sensitivity. IVF was ordered to shift to D5 IMB ½ L x 20 cc/hr.use of Lactacid pink for perennial wash. playful and laughing when received. her fever subsides to 37. 2010. and apply Calmoseptin ointment to diaper rash3x a day. Zablan s orders. All medications were given. diminished diaper rash.2 °C .

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