Tutorial 9: Case 2 Flashcards
(4 cards)
Maria is a 32-year-old client who asks for your advice on an upset tummy she has had for the past day. Maria asks “can you give me something for an upset tummy please?”
A) Who is it for?
B) What are the symptoms?
C) How long have you had these symptoms?
D) Action taken
E) Medications being taken?
F) Medical conditions
G) Allergies
H) Pregnant or breastfeeding?
A) Myself
B) I have had diarrhea, very watery and lots of time on the toilet
C) In the last 12-18 hours or so
D) I tried to eat a banana as I heard that helped, it hasn’t
E) None
F) None
G) None known
H) No
Appropriate extended questions
- Are there any other symptoms
- How is your daughter, follow up from question 1
- Is anyone else in the house experiencing this symptoms?
- Any blood in stools, pain on defecating
- Have you had this before?
- Have you been traveling in the last few months, particularly overseas?
- Has anything changed recently? Any activities?
- Will you be traveling or going anywhere specific today or tomorrow
- I have been feeling lethargic this morning I think from going to the toilet so often in the night and the fact that my daughter has had something similar the past few days
- she is fine now
- My daughter, 4 years old, has been sick with diarrhea and nausea earlier this week, she was much better yesterday and almost perfect today
- No
- I have had diarrhea and vomiting and things in the past though not for many years.
- Not for at least a year.
- No
- No, I will just be staying home
What is the diagnosis? Explain reasoning to patient.
Based on the signs and symptoms you have told me, I believe you have viral gastroenteritis which is also known as viral diarrhea. The watery stools, the frequency of which you are going to the toilet, feeling lethargic due to dehydration have confirmed my diagnosis. You most likely have gotten this from your daughter. It should go away within a few days.
What product would you recommend for this patient? Provide IDARL.
Oral rehydration salts - FIRST LINE FOR DIARRHOEA (gastrolyte, hydralyte)
- Indication: Will replace the electrolytes and sugars you have lost over the past day to counteract the dehydration and the lethargic feeling you are experiencing.
- Dosage and directions: Dissolve one sachet in 200mL of water, discard within 24 hours once refrigerated. Use a maximum of 20 sachets a day. (Or dissolve 2 tablets in 200mL of water, max 40 tablets a day)
- Adverse effects: Generally well tolerated
- Duration of treatment, time to recovery, when to refer: Use it for 3 days, if diarrhea is still persistent I will refer you to a doctor. Will also refer you if there is blood in your stool or you have signs of dehydration
- Lifestyle/self-care: limit fatty, spicy foods. Wash hands well before food preparation and after toileting. Eat more starchy foods, increase fluid intake
I will give you a self care-card for diarrhoea and a consumer medication information leaflet. Do you have any questions for me?
