Question

what is the non-pharmacological option you could offer a patient with acute gastroenteritis as the Registered Nurse?

Patient infomation: Gastroenteritis secondary to likely campylobacter bacterial infection.

Priscilla Preshus is 28 years old veterinary nurse graduate who has just completed a 5 day placement in Indonesia. During her stay, she mostly worked in the city area, however Priscilla spent the last two days at a pet shelter (for abandoned kittens) in a remote part of the town. She tells you that she was “really careful” with eating and avoided seafood vigilantly choosing to eat chicken mostly, “to be safe”. Since returning 2 days ago, Priscilla has had significant amounts of watery diarrhoea. She has been managing to eat very small meals and tolerate small sips of water, however, has not been able to control the diarrhoea. Priscilla advises she was initially able to keep some fluids down, but since last night has been unable to due to nausea and now vomiting. When Priscilla presents in the afternoon, she is pale and guarding her abdomen. She states that she is feeling nauseous, dizzy when she stands up, has a cramping ache in her stomach and has been having “chills” at night. She is very anxious (and teary) today after noticing blood in the toilet after her last couple of bowel movements.

HR 121 beats per minute BP 92/78 O2 Sats. 98% RA RR 24 Temp 38.1o C BGL 5.9mmol/L Pain 7/10 Dry mucosa Mild abdominal distention Abdominal area tender to touch on palpation Hyperactive bowel sounds (Borborygmus+ on auscultation) States has been feeling fatigued, weak, describes myalgia, for last 2 days Dark cloudy urine. Specific Gravity 1.030, pH 5.0, protein++ A stool sample sent away for testing (noted haematochezia) Medical History: Type 2 Diabetes Mellitus (diet controlled), mild hypertension Medications: Oral Contraceptive Pill, Olmesartan

Answer 1

Non pharmacological options for acute gastroenteritis

Based on the signs and symptoms of is clear that patient having

• fluid volume deficit
• Imbalanced nutrition
• fatigue and tiredness
• anxiety

some of the nursing management to improve the fluid status

• encourage the patient to drink clear liquids and oral rehydration therapies
• ORS solutions which helps to maintain hydration
• Encourage the patient to increase fluid intake to 2-2.5 litres. If she have nausea or vomiting she can continue antiemetics as prescribed.
• For maintaining nutrition advise the patient to take bland diet. which will be easy to digest and also reduce irritations
• It is important to advise her to avoid caffeine , milk and dairy products until she completely recovered.
• Encourage to take pottassium rich foods which helps to balance the electrolytes in the body.
• provide proper educatio regarding perineal care and asses the skin integrity.. advise to apply moisturizer if necessary.
• Advise the patient to take adequate rest. avoid stress and tension.
• provide a comfortable position and a calm environment for adequate sleep.
• It is necessary to continous assesment of the patient's vital signs because complications can be occur
• Provide a counselling to deviate her anxiety and further tensions.
• From the clinical symptoms patient having fever so tepid sponging would be beneficial.