Question

A 36-year-old client was admitted with gastroenteritis. She has been vomiting and having severe diarrhea for 2 days. She is very weak. The current laboratory results are Na+ 128 mEq/L, K+ 3.0 mEq/L, Cl− 90 mEq/L. The physician orders IV of 0.9% normal saline solution at 100 mL/hr, NPO, and I & O.

Are the lab results normal or abnormal? If so, which ones?

What other treatment and/or medication(s), if any, would be ordered?

What complication(s) if any is likely to develop if the symptoms persist? (Discuss one)

What education would you provide to the client to prevent this issue in the future?

Answer 1

GASTROENTERITIS

It is an inflammation of the mucosa of the stomach and small intestine. Acute gastroenteritis is defined as sudden diarrhea accompanied by nausea, vomiting and abdominal cramping.

Virus are the most common cause of gastroenteritis.

INVESTIGATION REPORTS

The given lab results are abnormal.

It is showing electrolyte imbalance.

​​​​​​Normal value of sodium : 135-145 mEq/L

Normal value of potassium : 3.5-5.2 mEq/L

Normal value of chloride : 97-107 mEq/L

There is a great difference in the values of sodium and chloride. A slight decrease in potassium also.

TREATMENT

Most cases of gastroenteritis are self limiting. Acute monitoring of fluid intake and output and electrolyte status is necessary to determine replacement therapy. Monitor the vital signs frequently. Antiemetics may be administered to decrease nausea and vomiting and prevent further electrolyte losses.

COMPLICATIONS

​​​​​​It can lead to dehydration, nerve problems, kidney failure and even death.

If dehydration occurs, IV fluid replacement may be necessary. As soon as tolerated, oral fluid containing glucose and electrolytes should be given. Provide high calorie food too.

EDUCATION

- Consider all cases as infectious until the cause is known.

- Strict infection control precautions are necessary to prevent the illness from spreading to others.

- Wash hands before and after contact with patient and when handle body fluids of any kind.

- Flush vomitus and stool in the toilet.

- Wash contaminated clothes immediately with soap and water.

- Teach them the principles of hygiene, control precautions and the potential dangers of the illness that is infectious to themselves and others.

- Provide private rooms and ensure the visitors and health care members wear gloves and gown.

- Consider all the objects in the room contaminated and ensure they are disinfected with a 10% solution of household bleach.

- Clean the fingers and nails after defeacation.

- Take easily digestible and well balanced diet.