GASTROENTERITIS

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GASTROENTERITIS
An acute inflammation of the gastric and intestinal mucosa which is most commonly due to bacterial, viral, protozoal, or parasitic infection. It may also be caused by irritation due to chemical or toxin exposure or allergic response. Viral exposure is more likely in winter; bacterial exposure is more common in summer when food-borne illness exposure is likely.

PROGNOSIS
Symptoms may be self-limiting or may need prescription medication to resolve the illness. Older or debilitated patients may have more severe symptoms or require hospitalization due to dehydration.

SIGNS AND SYMPTOMS
• Nausea and vomiting due to gastric irritation
• Diarrhea: watery, soft, may be mixed with mucous or blood
• Abdominal pain due to intestinal irritation
• Abdominal distention
• Fever due to infection
• Anorexia due to gastric irritation
• Malaise due to infection
• Headache due to viral illness
• Signs of dehydration—dry, flushed skin and mucous membranes, decreased urine output, tachycardia, poor skin turgor, orthostatic blood pressure changes.

DIAGNOSIS
• CBC may show leukocytosis or eosinophilia (parasites).
• Electrolytes show imbalance due to GI loss.
• BUN and creatinine elevated due to dehydration.
• Stool for ova and parasites show positive with parasitic infection.

TREATMENT
• Monitor intake and output.
• Replace fluids lost.
• Administer antiemetic medication for symptom relief:
• Prochlorperazine
• Trimethobenzamide
• Administer antidiarrheal medications for symptom relief:
• Loperamide
• Diphenoxylate
• Kaolin-pectin
• Bismuth subsalicylate
• Need to allow organism one way out of gastrointestinal system (either antiemetic or antidiarrheal, not both).
 • Administer antimicrobials for infectious cause:
• Ciprofloxacin
• Metronidazole
• Intravenous fluids to correct dehydration.
NURSING DIAGNOSES
• Risk for imbalanced nutrition: less than what body requires
• Deficient fluid volume
• Altered bowel elimination
• Diarrhea
• Fatigue

NURSING INTERVENTION
• Monitor vital signs for changes.
• Monitor intake and output.
• Replace fluids lost.
• Assess skin and mucous membranes for signs of dehydration.
• Assess abdomen for bowel sounds, tenderness

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