Children

Diarrhea

Emmi Valentina PardedePo.71.20.1.11.020IIB.1

Definition

• Diarrhea is a bowel movement (defecation) by the number of stools more than normal (normal 100-200 cc / hr feces). With the stool is liquid / solid half, may be accompanied by an increased frequency.

• WHO (1980)

Diarrhea is watery bowel movements more than 3 times a day

• Mansjoer (1999)

Diarrhea is divided into two based on the onset and duration, namely acute and chronic diarrhea

Etiology

1. Infection factor: bacteria (Shigella, Shalmonella, Vibrio cholera), virus

(enterovirus), parasites (worms), Candida (Candida Albicans).

2. Parenteral factors: infections of other parts of the body (OMA often

occurs in children).

3. Malabsorption factors: Carbohydrates, fats, proteins.

4. Dietary factors: Food stale, poisonous, too much fat, cooked vegetables

underdone.

5. Psychological factors: Fear, anxiety.

Pathophysiology

Infection factors

Malabsorption Factors carbohydrates, proteins, fats

Food Factors

Psychological Factors

Entry and growth in the intestine

Osmotic Pressure Rises

The toxin can not be abscebed

Anxiety

Hyperecretion of water and electrolytes

The movement of water and and electrolytes into the gut cavity

Hyper-peristaltic decrease the chance intestines to absorb food

Diarrhea

Nursing Assessment Nursing Care Plan Children with Diarrhea

Identity

• Noteworthy is the age. Episodes of diarrhea occurred in the first 2 years of

life. The incidence is highest age group 6-11 months.

• Most intestinal bacteria stimulate the immune response to infection, it

helps explain the decreased incidence of disease in older children.

• At the age of 2 years or more active immunity begins to form.

• Most cases are due to asymptomatic intestinal infection and enteric

bacteria spread mainly clients are not aware of the infection.

• Economic status are also influential, especially from diet and treatment.

Main complaint

Defecate more than 3 times

Disease History Now

Defecation: greenish yellow color, mixed with mucus and blood or mucus only. Watery consistency, frequency of more than 3 times, spending time: 3-5 days (acute diarrhea), more than 7 days (persistent diarrhea), more than 14 days (chronic diarrhea).

In the past history of disease

Previous history of diarrhea, use of antibiotics or corticosteroids long term (changes in Candida albicans from saprophyte to parasites), food allergy, respiratory infection, UTI, OMA, measles.

History of Nutrition

In children ages toddler foods given as in adults, the share of a given 3 times per day with additional fruit and milk. Malnutrition in children toddler age are particularly vulnerable. Good food management, food hygiene and sanitation, hand washing habits.

Family Health History

There was one family who had diarrhea.

Environmental Health History

Food storage at room temperature, lack of hygiene, neighborhood.

Nursing DiagnosisNursing Interventions

1. Fluid And Electrolyte Imbalances related to fluid loss secondary to diarrhea.Objectives : after nursing action for 3 x 24 hours, fluid and electrolyte balance is maintained to the fullest.Expected outcomes:- Vital signs are within normal limits- Turgor elastic, mucous membranes moist lips, the eyes do not cowong, the crown is not concave.- Consistency of bowel movements soft, frequency 1 time per day

Interventions Rational

1. Monitor signs and symptoms of fluid and electrolyte

2. Monitor intake and output3. Measure weight every day4. Encourage the family to drink lots of

2-3 liters / day

1. decrease the volume of fluid circulation causing mucosal dryness and urinary concentration. Early detection allows immediate fluid replacement therapy to correct the deficit

2. Dehydration can increase the glomerular filtration rate was adequate to make the output to remove the waste.

3. Detecting loss of fluid, decrease of 1 kg of body weight equal to 1 liter of fluid loss

4. Replacing the lost fluids and electrolytes orally

2. Imbalanced Nutrition Less Than Body Requirements related to diarrhea or excessive output and intake of less. Objectives: after the action at home on hospital care for nutritional needs are met Expected Outcomes: - Increased appetite - Increased body weight, or normal according to age

Interventions Rational

1. Discuss and explain about the restriction diet (high fiber foods, fatty foods and water is too hot or cold)

2. Create a clean environment, away from the smell that odor or waste, serve food in warm

3. Give the patient time to rest - sleep and reduce the excessive activity

4. Monitor intake and output in 24 hours

1. high fiber, fat, water is too hot / cold can stimulate irritate the stomach and intestinal tract.

2. situation a comfortable, relaxed will stimulate the appetite.

3. Reduce excessive energy consumption4. Knowing the amount of output can plan

the amount of food

3. Risk for Imbalanced Body Temperature related to the process of infection secondary to diarrhea. Objectives : After making maintenance actions performed for 3 x 24 hours, there was no increase in body temperature Expected outcomes: - Body temperature within normal limits (36 to 37.5 C) - There is no sign of infection (rubur, dolor, color, tumors, fungtio leasa)

Interventions Rational

1. Monitor the body temperature every 2 hours

2. Give a warm compress3. Collaboration of antipirektik

1. Early detection of abnormal changes in body function (an infection)

2. stimulates the central thermostat to lower the body's heat production

3. Stimulate the central thermostat in the brain

4. Risk for impaired skin integrity related to increased frequency of diarrhea. Objectives : after nursing actions while in hospital, skin integrity is not compromised Expected outcomes: - No irritation: redness, abrasions, cleanliness maintained - Families are able demonstrate perianal care properly

Interventions Rational

1. Discuss and explain the importance of maintaining a bed

2. Demonstrate and involve the family in caring for perianal (if wet clothing and replace the bottom and base)

3. Adjust bed or seated position with an interval of 2-3 hours

1. hygiene prevents germs breeding2. Prevent the occurrence of skin irritation is

not expected, because of humidity and acidity of the stool

3. Smooth vascularization, reducing the emphasis of the old so that does not happen ischemia and irritation.

Thank You..