Question

John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. No known allergies (NKA). Non-significant past medical Hx. Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. Neuro WNL's, alert and cooperative. IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. Stools are decreasing but patient remains very weak. Wife at bedside. Diet as tolerated.

Diagnosis: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Pathophysiology: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Etiology and Risk Factors: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Manifestations: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Diagnostic Tests and Rationale (labs, radiology, etc) _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Treatment: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Expected Outcomes: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Possible Complications: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Possible Nursing Diagnoses: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Answer 1

Diagnosis-    Gastroenteritis

Pathophysiology - The pathological process of developing gastroenteritis are discussed below-

•Etiological factors ( such as- genetic factor, environmental factor,Diet etc )

•Increase susceptibility of the bacteria & flora of the GI system

•Decrease immune response

•Causes inflammation of the mucous lining of the stomach & small intestine

•Causes the pathological condition named as Gastroenteritis..

Etiology & Risk factors -

• Family History or genetic factors
• Environmental factors such as smoking,exposure of air pollution, etc
• Alterations of diet like- allergic food ( Bringel,egg etc )
• Emotional factors like-stress
• Use of NSAIDS ( Non steroidal anti-inflammatory drugs )
• Use of Oral contraceptive pills etc

Clinical Menifestations -

• Mild to severe abdominal pain
• Weight loss
• Diarrhea
• Vomiting
• Abdominal cramping
• Fever occours sometime due to infection
• Fatigue
• Rectal bleeding occour in rare cases..

Diagnosis Tests With Rationale -

• History taking
• Physical Examination
• Complete blood count (CBC) to determine the presenting infection
• Barium contrast Radiological test to visualise the abnormal condition
• Endoscopy can be also done for visualization

Treatment -

• Drug therapy ( Antimicrobial,anagesic, immunosuppressants , corticosteroid therapy )
• Antipyretic can be given for management of fever
• Nutrition Therapy ( High calorie, vitamin,protien rich food should be given )
• Proper rest should be provided
• Comfortable possition should be given
• Intake-Output chart should be maintain properly..

Expected Outcomes -

After taking all the management patient will improve to some extent

Possible Complications -

1. IN Joints-

• ​​​​​​​Sacroilitis
• Arthritis

2.Skin -

• Rash
• pyoderma

3. Eye -

• Conjunctivitis

4. Apart from Kidney stone,liver disease, ulcer in mouth may occour as a complication of Gastroenteritis

Possible Nursing Diagnosis -

• Diarrhea related to bowel inflammation as evidenced by patient refuse to eat and monitoring intake-Output chart..