Flashcards in 1229 Exam 7 Gastroenteritis Deck (41):
What is the patho of Gastroenteritis?
An increas in frequency and water content of stools or vomiting, as a result of inflammation of the mucous membranes of the stomach and intestinal tract. Can be viral or bacterial in orgin. All organisms that are implicated in gastroenteritis cause diarrhea!
What does gastroenteritis effect?
stomach and intestines
What does enteritis effect?
What does colitis effect?
what does enterocolitis effect?
intestines and colon
leading cause of illness <14 days.
last more than 14 days
Intractable Diarrhea of Infancy
intractable=incurable or resistant to treatment
first few months of life. >2weeks
Chronic Nonspecific Diarrhea (CNSD)
irritable colon 6-54 months of age.
loose stool with undigested food.
>2 weeks duration
Causes of viral acute diarrhea
Causes of bacterial acute diarrhea
Cases of Parasitic acute diarrhea
What does it look like?
frequent loose stools
How is it diagnosed?
History and physical
urine and blood testing
Complication of gastroenteritis?
when total output of fluids exceeds the total intake
Types of dehydration:
(salt and water lost in equal amounts.)
(loose more electrolytes)
(loose more water)
salt and water lost in equal amounts
primary form in children
loss from ECF (extracellular fluid)
reduce plasma volume
effects skin muscles and kidneys
can lead to shock
sodium levels will remain within norm limits
loose more electrolytes than water
ICF more concentrated than ECF
water moved to higher concentration (ICF)
this further dehydrates ECF
shock is a frequent finding
physical symptoms more severe with smaller fluid loses
serum sodium is less than 130*****
loose more water than electrolytes
requires more specific fluid replacement
happens in high protein NG feedings
happens with high solute fluids
fluid shift from less concentration ICF to ECF
serum sodium is greater than 150***
shock is less apparent
cerebral changes are serious and may result in permanent damage
S&S of dehydration
absence of tears, sunken look to eyes
decrease in skin turgor
irritable to lethargy
urine specific gravity >1.020--anuria
Treatment goals for dehydration:
assessment (fluid/electrolyte imbalance)
maintenance fluid therapy
reintroduction of an adequate diet
ORT: oral rehydration therapy
ORS: Oral rehydration solutions
Maintenace fluid therapy
Early reintroduction of nutrients
intravenous fluid replacement--- only when oral is not possible.
What is Giardiasis?
most common intestinal parasitic pathogen in US
cysts can survive for months in environment
mode of transmission: person to person, water, food, and animals
What are common symptoms of Giardiasis?
What is giardiasis caused by?
the protozoan Giardia lamblia
How do you diagnose Giardiasis?
direct aspiration of duodenal fluid
EIA enzyme immunoassay of specimens
Medications for Giardiasis:
Flagyl (metronidazole) -tast bitter, n/v
Tindamax (tinidazole) -taste bitter, n/v 80-100% cure rate with single dose
Albendazole--fewer side effects
Alinia (nitazoxanide) --no bitter taste, give with food to prevent N&V
What am I gonna teach my pt?
education to prevent
1. Ascaris Lumbricoides (Most common roundworm)
2. Necaator Americanus
3. Trichuris truchiura
4. Strongyloides Stercoralis
5. Enterobius vermicularis
(Most common roundworm)
Ascar if she is gonna be round.
Americans are hooked
I can pop a mean trich whip
This one has strong threads
Enterobius vermicularis (pinworm)
don't go "en the pin"
What is it???
- Enterobius vermicularis (nematode, human pinworm)
-Most common helminth infection (40k Infected)
-Eggs are ingested/inhaled then hatch in upper intestine.
-Adult females migrate to anus and lay
-Eggs can live in the environment for 2-3 weeks.
What does it look like???
- Most common symptom
`intense itching at the anal area
`Irritable, restlessnes, poor sleep
`perianal dermatitis, vaginal/urethral infection
How is it diagnosed???
Tape test (see diagram)
How is it treated???
-Mebendazole (vermox) choice (not under 2 years)
-Pyrantel pamoate (antiminth)
-Piperazine phospate (pripsen)
-Pyrvinium pamoate (Povan) (Stool and emesis brigt red)
-- Entire family s treated
-1 dose initially
`2nd dose in 2 weeks (to prevent re-infection)
-- If re-infected
` Start over with same tx
What am I gunna teach???
-Proper testing for pinworms
(I dose now and 2nd dose in 2 weeks)
-Prevention of re-infection
`Wash all clothes and bed linens in hot water
`One piece PJ's
`Show not tub
Additional Helminthic Infestations
Passed to humans via snail-contaminated water