ACUTE INFECTIOUS GI DISORDERS Flashcards
what are clinical manifestations of celiac disease?
- steatorrhea
- abdominal bloating/cramping
- diarrhea
- anemia/vitamin B12 and A deficiencies
- vision problems from vitamin A deficiency
what type of foods should children with celiacs disease avoid?
wheat, barley, and rye should be avoided
what type of diet should a child with celiacs disease be put on?
gluten free diet
what is meckel diverticulum?
this is a complication resulting from failure of duct to fuse during embryonic development
what are clinical manifestations of meckel diverticulum?
- painless rectal bleeding
2. bloody, mucous stools
what is the main nursing intervention to perform with a patient who has meckel diverticulum?
prep this patient for surgery–> surgical removal of the diverticulum is the intervention for these patients
what are preop care interventions to perform for a patient with meckel diverticulum before surgery?
provide blood transfusions to correct the hypovolemia due to the blood loss and provide bed rest
what are post op care interventions to perform for a patient with meckel diverticulum after surgery?
maintain NPO and maintain NG tube to low, continuous suction
what does rotavirus cause?
rotavirus is the most common cause of diarrhea in children less than 5 years of age
what are clinical manifestations of rotavirus?
- fever
- foul smelling diarrhea for 5-7 days
- vomiting for about 2 days
what type of precautions will a patient with rotavirus be place on?
contact precautions
what are nursing interventions to practice with a patient who has rotavirus?
- avoid rectal temperatures (due to contact precautions)
- complete oral rehydration therapy of 75-90 Na at 40-50 mL/kg over 4 hours
- replace each diarrheal stool with 10 mL/kg of ORS for ongoing diarrhea
- notify school of infection because rotavirus has 48 hour incubation period
what nutritional guidelines should a patient with rotavirus follow?
avoid-
- fruit juices and gelatin
- caffeine
- chicken or beef broth (too much sodium)
- bananas, rice, applesauce, and toast (BRAT diet) because it has a high carb content and low electrolytes
what is isotonic dehydration?
- sodium levels are within normal ranges
- major loss of fluid from extracellular fluid which leads to hypovolemic shock
- these patients will be bleeding or have diarrhea
- usually is LR or 0.9% NS or NaCl
what is hypotonic dehydration?
- electrolyte loss > water loss
- shock and seizures are likely to occur
- sodium is < 130
what is hypertonic dehydration?
- water loss > electrolyte loss
- sodium is >150
- neurological changes can occur such as changes in LOC, cerebral edema, or confusion
what does mild dehydration consist of?
- weight loss of 3-5 % which can lead to behavior changes
- manifestations include slight thirst
- replace fluids with 50 m/kg every 4-6 hours
what does moderate dehydration consist of?
- weight loss of 6-9%
2. replace fluids with 100 mL/kg every 4-6 hours
what are manifestations of moderate dehydration?
- slight elevation in HR and slight tachypnea
- dry mucous membranes and decreased tears/ skin turgor
- normal to orthostatic BP
what does severe dehydration consist of?
weight loss of >10 % and give these patients a bolus of 20 m/kg
what are manifestations of severe dehydration?
- cap refill > 4 seconds
- orthostatic BP –> shock
- extreme thirst
- very dry mucous membranes and tented skin with no tears
- sunken eyeballs and anterior fontanels
how much oral re-hydration can be given for patients with diarrhea?
replacement of diarrhea losses can be treated by giving 10 mL/kg for each stool
what is contraindicated with hypertonic solution?
rapid fluid replacement is contraindicated due to risk of cerebral edema so give fluids slowly if they have this type of dehydration
