University:
American Career College
Course:
NURS112 | Fundamentals of Nursing
Academic year:

2020
Views:

282

Pages:

40
Author:

TwelveAlemat7c

Definition : Diarrhea is defined as passage of watery stools more than 3 times a day, diarrhea lasting less than 14 days is said to be acute diarrhea and lasting more than or equal to 14 days is said to be chronic diarrhea ( WHO) . WHAT IS THE PROBLEME STATEMENT The problem of diarrheal disease is next only to acute respiratory infection with about 3million children under 5 years dying every year due to diarrhea . Oral rehydration therapy is now preventing an estimated 3 million diarrhea related deaths every year .  In developing countries children under 5 years have an average (3-5 ) episodes of diarrhea each year  In tropical countries ( 15 – 40 % ) of all under 5 deaths are diarrheal related . Malnutrition – Predisposing factors: poverty –lack of personal hygiene Family size – standard of living – quality of life Illiteracy ---- malnutrition---- Ill health Mode Of Transmission Fe co-oral route through Remember 5 F’s food – fluid (milk –water ) –fingers – fomites – flies . EPIDEMIOLOGICAL FACTORS : 1- Agent factors : Viruses : Rota , Astro , Entero, Measles .  Bacterial : Campylobacter jejuni , typhoid , E.coli , Shigella , salmonella. Food poisoning. Parasites : E. histolytica , Giardia lamblia .  2- Host factors :  6 months of age up to 2 years is the  most susceptible especially (6-11 months) period 3- Environmental factors : In temperate regions , bacterial diarrhea is more common in warm seasons and viral diarrhea during winter . In the tropical regions , viral diarrhea occurs throughout the year , whereas bacterial diarrhea Is commoner in the warm , rainy season Classification Of child With Diarrhea  into categories Of dehydration : 1 – sever dehydration . 2- moderate dehydration . 3- Mild dehydration . Two of the following signs :  1- sever dehydration Lethargic or un conscious Sunken eyes Not able to drink or drink poorly . Skin pinch goes back very slowly . Sunken eyes lethargic or un conscious Skin Turgor Signs of dehydration Not able to drink 2- Moderate dehydration  : Restless – irritable.  Sunken eyes .  Drinks eagerly (thirsty) .  Skin pinch goes back slowly .  Dry mouth –dry mucous membrane – No tears on  crying Dry mouth -Dry mucus membrane Sunken eyes Dry mouth Irritable or restless child Restless child Irritable and restless NO Tears On Crying SIGNS OF DEHYDRATION Drinks eagerly 3- Mild dehydration  Or no dehydration only clinically a child  diarrhea with no signs of having dehydration Plan A Is treating a child having diarrhea with no dehydration  using home available fluid like Fruit juice- light yogurt –gruel  Give as much as the child needs  Advice mother to continue breast feeding  if no improvement follow up .  Plan A management Plan B A child having diarrhea with moderate signs of dehydration using oral rehydration solutions(ORS) and reassess degree of dehydration after giving ORS and treat accordingly . Plan C Is a child having diarrhea with sever dehydration using  IV fluids Fluid of choice is Ringer’s lactate give 100ml/kg  Sever dehydration Not able to drink or poorly drink IV FLUID Prevention and control of diarrheal disease Short term management: 1-using Oral rehydration therapy or IV fluids as  indicated according to WHO guidelines 2- Educating the mother to continue breast feeding  during diarrhea , in children with moderate to sever dehydration once the rehydration phase is over , breast feeding can be continued . 3- Avoidance of use of antibiotics except in case of  infective diarrheas (typhoid, cholera, shigellosis etc ). Long term management Better Maternal and Child care practice  : 1- Improving prenatal maternal nutrition to reduce low  birth weight problem and improve quality of breast milk. 2- Promoting exclusive breast feeding and weaning at  appropriate age with supplementary feeding. Preventive strategies : 1- Improved sanitation : promoting hand washing , proper  disposal of human waste , supply of safe drinking water. 2- Health education regarding hygiene and breast feeding.  3-Immunization against measles can prevent up to 25% of  diarrheal episodes by preventing post measles immune suppression and post measles malnutrition . 4- Control of fly breeding . 

Epidemiology of Acute Diarrhoeal Diseases

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