Medical 4-MS61-Gastroenteritis
Terms
undefined, object
copy deck
- Define gastroenteritis?
- an increase in frequency and water content of stools or vomiting as a result of inflammation of mucous membranes of stomach and intestinal tract
- What organ does gastroenteritis primarily affect?
- small bowel...can be either viral or bacterial...both forms have similar manifestations...all cause watery diarrhea
- Dysenteries affect large or small bowel?
- large
- Gastroenteritis affects large or small bowel?
- small
- GI illnesses can be caused by what 3 mechanisms?
-
noninflammatory
inflammatory
penetrating - Define enterotoxin?
- a noninflammatory toxic substance specific to intestinal mucosa...what is released by infecting organism which causes watery diarrhea (ex: E. coli)
- Shigella or Campylobacter release enterotoxins similar to E. coli, but these 2 organisms also?
- can attach themselves to mucosal epithelium without penetrating it...cells of intestinal villi are then destroyed...malabsorption results...then diarrhea
- What might be found in the stool due to invasion of intestine by mcos?
- WBCs and RBCS...due to possible ulceration of intestine by mcos
- Is GI motility increased or decreased due to mcos invading?
- increased...with fluids and electrolytes being secreted into intestine at rapid rates
- Who do rotaviruses affect?
- children
- Norwalk virus affects who?
- adults and children year round
- Hhow is Norwalk virus spread?
- oral-fecal route
- What are the 3 common bacterial gastroenteritis types?
-
E. coli diarrhea
(traveler's disease)
Campylobacter enteritis
(another traveler's
diarrhea")
Shigellosis (bacillary
dysentery) - The reservoir for E. coli is?
-
human...often asymptomatic...transmitted through fecally contaminated
food, water, or fomites - The reservoir for Campylobacter jejuni is?
- domestic or wild animals and birds...transmitted through fecal-oral route by ingestion of water or food contaminated with feces or be direct contact with infected animals or infants...incubation from 1-10 days...communicable for 2 to 7 weeks
- The reservoir for Shigellosis is?
- human or other carrier...transmission is fecal-oral..incubation 1-7 days..communicable for up to 4 weeks...carrier can carry for months...occurs most frequently in children under age 10
- What is the symptom that occurs in the first 1 or 2 days of gastroenteritis?
- diarrhea
- Symptoms of epidemic viral gastroenteritis include?
-
myalgia (muscle aches)
headache
malaise
abdominal distention
hyperactive bowel sounds
diffuse tenderness palpated
dehydration
there should be NO REBOUND TENDERNESS, which might indicate peritonitis - Dehydration may be manifested by?
-
poor skin turgor
dry mucosa membranes
orthostatic b.p. changes
hypotension
oliguria - Prolonged dehydration may cause patient to go into?
- shock
- Norwalk virus is not too severe and has the following symptoms?
- rapid onset of nausea, abdominal cramps, vomiting, diarrhea...lasts 24 to 48 hours
- Campylobacter is more severe than Norwalk virus and has the following symptoms?
-
foul-smelling stools
10 day diarrhea - Shigella symptoms?
- stools containing blood and mucus, continuing up to 5 days
-
Gram stain of stool is usually done before?
If there are many WBCs on Gram stain, then it's which organism?
If there are WBCs and RBCs in the stool, then which type of gastroenteritis is it? -
culture
shigellosis
Campylobacter - The following 5 interventions are indicated with gastroenteritis?
-
fluid replacement
diet therapy
drug therapy
skin care
health teaching - Upon admission, nurse should get what information?
-
weight
orthostatic b.p.
VS - What type of IV might be prescribed?
-
hypotonic
ex: half-strength NS
(0.45% sodium chloride) - A rapid gain or loss of 1 kg or 2.2. pounds of body weight is equal to the gain or loss of?
- 1 Liter of fluid...so continue to monitor I&O, weight, VS
-
It is mandatory that every case of ______ be reported to the local health department.
In some endemic areas, Campylobacter is reported on a case by case basis
(endemic means its found in a specific population or particular region of the w - shigellosis
- What is the difference between endemic and epidemic?
-
endemic means its found in a specific population or particular region of the world
epidemic means it affects a large group of persons in a geographic region or defined population group - If not actively vomiting, patient may receive small volumes of clear liquids with electrolytes for ____ hrs
-
24
increase if n&v not present..withhhold foods if n&v present...instuct client NOT TO DRINK WATER as it doesn't contain replacement electrolytes - After 24 hours of clear liquids, the patient may start a diet of?
-
crackers, toast, jelly...if this stays down, then start bland diet of nonfat soup, custard, yogurt, cottage cheese, mashed or baked potatoes, cooked vegetables..
AVOID CAFFEINE as it increases intestinal motility - What type of drugs are not routinely given for bacterial or viral gastroenteritis?
- anticholinergics and antiemetics...both suppress intestinal motility...use of these drugs can suppress infecting organisms from being eliminated from the body
- What might physician prescribe if antiperistalic measures are needed?
- an initial dose of loperamide (Imodium) 4 mg orally, followed by 2 mg after each loose stool, up to 16 mg daily
- What might a doctor prescribe to reduce watery volume of stool?
- bismuth subsalicylate (Pepto-Bismol) 30 mL or 2 tabs every 30 minutes for 8 doses...Pepto-Bismol has aspirin (salicylate) in it, so make sure okay for patient to use
- Bacterial infection with fever and diarrhea may require rx for?
-
antibiotics
ex: norfloxacin (Chibroxin,
(Noroxin) 400 mg twice
daily PO
ciprofloxacin (Cipro)
500 mg twice daily PO
for 3 days - If gastroenteritis is due to shigellosis, an anti-infective agent such as _________/________ may be administered.
- trimethoprim/sulfamethoxazole
-
When diarrhea persists, check for ________ or _______
to determine what kind of medicine to give. -
Salmonella
parasite -
It's probably NOT gastroenteritis if diarrhea persists for longer than ____
days. - 10
-
Because of the diarrhea, the anal area is irritated so teach patient to avoid ______ _______ and harsh _____. It's ideal to clean with warm water or absorbent
_______ and dry with _____.
Use cream, oil, or gel to remove _____.
___________ -
toilet paper
soaps
cotton
cotton
excrement
hydrocortisone
witch hazel
sitz - What should nurse do if leakage of stool is a problem?
-
put absorbent cotton next to anal orifice, keep in place with snug underwear...
if incontinent, keep perineal and buttock aras clean and dry...use of incontinent pads instead of briefs allows air to circulate skin and prevent iritation - Measures to prevent transmission of gastroenteritis include?
-
wash hands with antibacterial soap...
don't share dishes, glasses,
toothpaste...
keep commode clean to prevent exposure to stool...
don't prepare or handle food that will be consumed by others...if it's Shigella, then adhere to precautions for 7 weeks or several months