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Community Health Nursing-II Diarrhea

Diarrhea is characterized by an increased frequency and looseness of stool. It can be acute (lasting less than 21 days) or chronic. The major causes are bacteria like E. coli, viruses like rotavirus, and parasites. Risk factors include young age, poverty, and lack of sanitation. Diarrhea is transmitted through contaminated water, food, and direct contact. It causes dehydration by damaging the intestinal lining and increasing fluid secretion, leading to electrolyte and fluid loss. Treatment involves oral rehydration, appropriate feeding, and antibiotics for bacterial infections. Prevention focuses on access to clean water and improved hygiene.

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543 views4 pages

Community Health Nursing-II Diarrhea

Diarrhea is characterized by an increased frequency and looseness of stool. It can be acute (lasting less than 21 days) or chronic. The major causes are bacteria like E. coli, viruses like rotavirus, and parasites. Risk factors include young age, poverty, and lack of sanitation. Diarrhea is transmitted through contaminated water, food, and direct contact. It causes dehydration by damaging the intestinal lining and increasing fluid secretion, leading to electrolyte and fluid loss. Treatment involves oral rehydration, appropriate feeding, and antibiotics for bacterial infections. Prevention focuses on access to clean water and improved hygiene.

Uploaded by

Priya bhatti
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Community Health Nursing- II

DIARRHEA
Diarrhea is an acute or chronic intestinal disturbance characterized by increased
frequency, humidity or volume of lower movement. It has been defined as passing
of more than three loose motions in a day or 24 hours.

Types of diarrhea

 Acute diarrhea i.e. lasting for less than 21 days


 Chronic diarrhea lasting beyond 21 days, while chronic diarrhea is
responsible for the serious problem of malnutrition, acute diarrhea is responsible
for death due to dehydration.

Epidemiological triad of diarrhea

The major pathogens causing diarrhea:

1. Bacteria: Escherichia Coli (E.coli), Shigella, Salmonella, V.cholera.


Stayphlococcus
2. Virus: Rotavirus, Adenovirus, Astrovirus, and noroviruses.
3. Parasites: Entameoba histolytica (E.histolytica), Giardia lamblia(G.lamblia),
Trichuris.

Risk factor

1. Age: Under particularly 5 years childern


2. Sex: In both sexes, male and female
3. Socioeconomic factors: Poverty malnutrition, immunodeficiency, low
standards of personal hygiene soil pollution, lack of education.

Mode of transmission

1. Contaminated water
2. Contaminated food
3. Direct contact

Mechanism of dehydration in diarrhea

1
Action of microbial agent on the epithelial layer of intestine

Cause destruction of cells in intestine, toxins release from bacteria stimulates


adenylate cyclase in the intestinal epithelial cells and cause rise in cyclic adenosine
monophosphate (cAMP) which provides energy to drive fluid, and ions into the
lumen of the intestine

As intestinal secretions or isotonic with plasma, there is outpouring of fluid and


electrolytes from plasma into the lumen of the intestine to makeup the continuous
loss leads to electrolyte and fluid deficit occur (hypokalemia or sodium loss also
occur).

ASSESSMENT OF CLIENT WITH DIARRHEA

1. Ask and collect the history from the patient, and his/her relatives regarding:
 Diarrhea duration of illness (frequency of stools per day, appearance
consistency color smell presence or absence of blood/mucus).
2. Look and examine the general conditions of the patient for signs of
dehydration:

It depends upon severity of the disease. When diarrhea is severe, signs of


dehydration occur quickly, especially in children.

1. Dehydration:
 little to extreme loss of subcutaneous fat
 up to 50% total body weight loss
 urinary output decrease
 poor skin turgor dry skin and dry mouth
 sunken fontanelles and eyes
 low BP and high pulse
 collapse imminent
2. behavioral changes:
 irritability
 restlessness

2
 weakness
 Pallor
 Extreme prostration
 Convulsions
3. Respiration rapid i.e. hyper apnea
4. Stools
 Loose and fluid inconsistency
 Greenish or yellow green color (mucus or blood)
 Collect the specimen of stool for labortary problems for laborty diagnose.
5. Vomiting mild to severe(present or not)
6. Low grade fever
7. Anorexia
8. Thirst: normal or more than normal

PREVENTION & CONTROL:

SHORT TERM:

 Training of medical and paramedical persons.


 Stream production and distribution of ORS packets.
 Education of mothers and community in the formulation of proper strategies
towards continuous breast feeding, and weaning practices.

LONG TERM OBJECTIVES:

 Provision of safe drinking water supply.


 Improvement of sewage disposal system.
 Improvement of general environmental sanitation.
 Health and nutrition education of the community.

MANAGEMENT:

 Oral Rehydration Therapy


 Appropriate feeding
 In bacterial infection: Ampicillin, gentamicin, and tetracycline are used.
 In protozoan infection: metronidazole can be used.
 IV fluids maintain. The solutions for IV infusions are:

3
 Ringers lactate solution
 Diarrhea treatment solution
 Normal saline (5% dextrose should not be given) recommended dose is
11ml/kg body weight for adult children.

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