WE CARE COLLEGE OF HEALTH TECHNOLOGH

IPERU REMO, OGUN STATE

A CARE STUDY OF A 5 YEARS OLD GIRL WITH

DIARRHOEA

PRESENTED BY
JAMES RACHEAL EBONG

MATRIC NO: HAS /2022/ 154

SUBMITTED TO THE DEPARTMENT OF PUBLIC HEALTH

NURSING IN PARTIAL FULFILMENT OF THE REQUIREMINT
FOR THE AWARD OF CERTIFICATE IN HEALTH ASSISTANT

APRIL, 2024
 CERTIFICATION
This is to certify that this family care study on diarrhea of a 5 years old girl was
done by JAMES RACHEAL EBONG as a partial fulfilment of the requirement
for the award of certificate in the Health Assistant Department.

MR FAGBUARO FAVOU R ---------------------------------

Internal Supervisor Signature and Date

MISS ILE MERCY _____________________

Lecturer Signature and Date

MR IHEANANCHOR CHIMA _____________________

External Supervisor Signature and Date

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 DEDICATION
I dedicate this care study to Almighty God, the maker of Heaven and Earth, who

in his mercy grant me the grace and privilege to accomplish this programme

successfully glory and honor to his name. I equally dedicate this project to my

loving and caring sponsor guardian MR VICENT NNNADOZIE ANDREW my

beloving husband with all others my loving father and mother Mr. and Mrs.

JAMES EBONG UFOKIKO for their Love, Motivation, Endurance and

Understanding throughout the course of my program. Supporting me financially

and materially God bless every one of you in Jesus name. Amen

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 ACKNOWLEDGEMENT

I wish to express my profound gratitude to almighty God, the creator of the

universe who saw me through my studies in college and who has enhanced me with
the ability of sound mind and good health to carry out this care study. My heart felt
gratitude goes to my ever dynamic supervisor, in person of FAGBUABO
FAVOUR whose expert counsel, I found in dispensable. My appreciation also goes
to my HOD, Mrs. Mercy, Supervisor you all are a sources of inspiration to me.
I also appreciate all my lecturer for their word of encouragement and the support
they gave their concerns and commitment, guidance and moral support have
contributed in no small measure to the success of this care study.
I also want to use this medium to appreciate my parents and siblings for their love,
care and support morally, financially and spiritually. I give God all the Glory for
sparing their lives for me. Furthermore I also want to appreciate my client and his
family for devoting their time and attention to me.
Lastly, my sincere appreciation goes to my colleagues in the Health Assistant
Department for their support during my academic session in the school. I want to
say a big thank you to you all.

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TABLE OF CONTENT
Title Page i
Certification ii
Dedication iii
Acknowledgement iv
Table of Content v

CHAPTER ONE
1.0. Introducing
1.1. Background of the Core Study
1.2. Family Pedigree
1.3. Objective of the study

CHAPTER TWO
2.0. Literature Review
2.1. Definition of Diarrhea infection
2.2. Types of Diarrhea
2.3. Signs and Symptoms of diarrhea
2.4. Causes of Diarrhea
2.5. Treatment of Diarrhea / Management of Diarrhea
2.6. Complication of Diarrhea
2.7. Prevention of Diarrhea

CHAPTER THREE
3.0. SCHEDULE OF HOME VISIT

CHAPTER FOUR
4.0. SUMMARY
4.1. CONCLUSION
4.2. RECOMMENDATION
4.3. REFERENCES

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 CHAPTER ONE

1.0. INTRODUCTION
First Contact with my Client
This is a case study of miss. BT a 5 years old girl with diarrhea infection caused by
bacteria, whom I had my first contact with during my siwes (student industrial
work experience) practical at Imobido health center Iperu Remo on 3rd July, 2023
her mother brought her to the facility due to fever and severe cough, her vital signs
was taken by me, and physical examination was also done for her temperature was
39oC which was indicating fever, she was attended to by the chief matron in charge
who confirmed that she had abdominal pain (diarrhea diseases or infection) She
was placed on some medication that consist of antibiotics? to help manage the
infection of the abdomen and also to eliminate malaria, fever and cough. So I seek
for their consent about using her as my case study which I implored my client and
her family to continue environmental cleanliness as well as the adherence to the
usage of mosquito nets.
We both exchanged contacts for follow up, care, and home visitation.

1.1. BACKGROUND OF THE CARE STUDY

This family care study is focused on the care of Miss. BT who had diarrhea
infection which was caused by bacteria. She resides in Imobido Health Center area
Iperu Remo of Ogun State, her mother gave history of using different local herbs as
remedies which only relieved her for some time but it later became complicated
leading to persistence storing and fatigue. She has been having sleepless nights for
about 3 to 5days now coupled with severe fever malaria and cough.
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CLIENT FAMILY SOCIAL HISTORY
Miss. BT is a 5 years old girl, she is the first born in the family 2 her family is a
large family. She was born into the family of Mr. and Mrs. T. I. they live in Iperu
Remo area. Ogun State, my client’s parent her mother is a very good business
owner at Iperu morning market. She is a secondary school certificate holder who is
acquiring knowledge in training as a health assistant presently, she used to stay in
her mother chemist to make some money whenever she’s is back from School.

FAMILY PEDIGREE Father

The family pedigree of Miss. BTI with diarrhea Name
Age
SOC
Occupation
Religion

Mother
Father Mother Name
Age
Occupation
SOC
Religion

Client
Client Son Name
Age
KEYS Occupation
FATHER SOC
Religion
MOTHE

SON (CLIENT) Daughter

DAUGHTER Name
Age
DAUGHTER Occupation
SOC
Religion

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FAMILY HEALTH HISTORY PAST AND PRESENT
My Client did not have any serious illness before, she have and past medical
history now her family often managed with anti – malaria drugs.

PRESENT AND PAST MEDICAL HISTORY OF MY CLIENT PRESENT

Medical history when she was diagnose with diarrhea diseases and she is on
medication before e.g. Zinc tablet.
Rehydration solution drinking water metronidazole 200mg.
She has a history of malaria, she is presently diagnose with diarrhea

Treatment
Zinc Tablet
Tablet metronidazole 200mg
Intake of plenty fluid

VITAL SIGNS
Pulse rate 80 b/mm
Temperature 39oc
Weight 20kg

1.3. OBJECTIVE OF THE CARE STUDY

- To know the cause of diarrhea in Miss. BT.
- To intervene in the management and recovery process of Miss. BT.
- To educate the family in proper hygiene and diarrhea infection
- To prevent re-occurrence of diarrhea in my client
- To educate compliance to previous intervention and also to informed my
client about the end of my visit.

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 CHAPTER TWO

2.0. LITERATURE REVIEW

Diarrhea Diseases
Diarrhea is the passage of three or more watery stool in a 24hours period.
Frequent passing of formed stools is not diarrhea. Babies feed only breast milk
often pass loose, pasty stools this also is not diarrhea mothers usually know when
their children have diarrhea and may provide useful working definitions in local
situations. During diarrhea there is decreased food intake, decreased nutrient
absorption, and increases nutrient expenditure and requirement. These factors
combine to cause weight loss and failure to grow the Childs nutrient status
declines and any preexisting malnutrition is made worse. The main danger is
diarrhea. Diarrhea diseases is dehydration, a person experience about three
episodes of Watery stools a day, diarrhea disease are the leading cause of
childhood morbidity and mortality in development countries, and important cause
of malnutrition. In 2002 an estimated 1.87 million children below 5 year old of
age died from the effects of diarrhea. Eight out of 10 of these deaths occurred in
the first two years of life. On average, children below 3 years old of age in
developing diarrhea.

DIAGNOSTIC TEST FOR DIARRHEA

Blood Test: A complete electrolytes and Kidney stool test is commonly used to
diagnose diarrhea for gastrointestinal pathogen clostridoides. The management of
diarrhea in children is focused on the prevention and treatment of dehydrating
diarrhea kills children by draining liquid from the body, thus dehydrating the
child. As soon as diarrhea starts, it is essential that the child is often taking in
extra fluid as well as food. A Childs life is in danger if there several watery stools
within an hour of if there is blood in the faeces immediately help from a trained
health worker is needed.
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ORS / SALT SUGAR SOLUTION
Low osmolality ORS is a special combination of dry salt that, when properly
mixed with safe water, can help replenish fluids and electrolytes in the body.
To make the Loses drink.
- Put the contact of LOORS packet in a clean container. Check the packet
for directions and the correct quantity of clean water.
- Add water only, do not add loses to juice milk, soup, and do not add sugar.
- Stir well and feed it to the child from clean up.
How much LOORS drink to give strength.
- Encourage the child to drink as much as possible.
- A child under the age of five needs at least a quarter to half a large cup of
the LOORS drink after each watery stool.

2.1. DEFINITION OF DIARRHEA

Diarrhea is defined as the passage of three or more loose or liquid stools per day
of more frequent passage than in normal for the individual. It is intestinal tract
which can be caused by a variety of bacterial viral and parasitic organisms.

Types of Diarrhea
There are 3 chemical type of diarrhea
Acute watery diarrhea last several hours or days and includes cholera.
Acute bloody diarrhea also called dysentery.
Persistent diarrhea last 14 days or longer.

Diarrhea diseases coil cholera

Campylobacter Salmonella non Typhoidal
Drinking water
Sanitation
Immunization
Coverage
Diarrhea happens when not enough water is removed from your stool, making it
loose. There are many different causes of diarrhea it can because by a short term
illness that clears up in a few days.

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 Missing bowl

Signs and Symptoms

Is a manifestation of diseases apparent to the patient herself, while a sign is a
manifestation of disease as that the physician perceives? The sign is objective
evidence of diseases.

A rash could be a sign a symptom, or both. If the patient notices the rash to the
doctor or nurse.

2.2. CAUSES OF DIARRHEA

Diarrhea is usually a Symptom of an infection in the intestinal tract, which can be
caused by a variety of bacteria viral and parasitic organisms. Infection is spread
through contaminated food or drinking water or from person to person as a result
of poor hygiene.
Treatment of Diarrhea / Management
- Diarrhea should be treated with oral Rehydration solution (ORS) a solution
of clean water, sugar and salt in addition, a 10 -14 day supplemental

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 - Treatment course of dispersible Zinc tablets shortens diarrhea duration and
improves.
- Drink plenty of liquid, including water broths and juices. Avoid caffeine
and alcohol. Add semi solid and low fiber foods gradually as your bowel
movements return to normal. Try soda crackers, toast eggs, rice and
chicken.

Treatment cont’d
In most cases, acute diarrhea is treated with over the counter medicines such as
loperamide link (Imodium) and bismuth subsalicylate link pepto. Bismol
Kaopectate).

Complication of diarrhea
Lack of fluid causes (dehydration) and salt (electrolyte) imbalance in the body.
Diarrhea can cause dehydration which can be life threatening if untreated
dehydration is particularly dangerous in children, older adults and those with
weakened immune systems if you have signs of serious dehydration seek medical
help.

PREVENTION OF DIARRHEA
Key measure to prevent diarrhea include:
- Access to safe drinking water.
- improved sanitation.
- Hand washing with soap.
- Exclusive breast feeding for the first 6 months of life.
- Good personal and food Hygiene.
- Rotavirus vaccination.

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 Adequate fluids intake
Balance Diet.
Anti-diarrheal medications
Anti-biotic
Preventing Spread hand washing.
Preventing diarrhea includes properly preparing food, protecting yourself against
infections and following some good hygiene practices.

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3.0. CHAPTER THREE

Home visit
First visit
Date: July 14, 2024
Time: 4:00pm

OBJECTIVES
To know the cause of diarrhea in Miss. BTI

Activities / Interaction
My first visit to my client’s house was on July 14, 2023 which was on Thursday
evening, I got to my clients house at exactly 4.00pm with the address she gave
me. On getting to my client house she lay down in her room, so I get to her and
notice that after the treatment given to her she’s still stooling and having
weakness of body, I advise the parent to continue giving her ORS to help her
regain back her strength with some drugs follow.

OBSERVATION
I observed that my client were playing with her brother at home in the sand and I
observed that my client pick some things on the ground and ate it, that was where
my client contracted diarrhea infection.

HOUSE DESCRIPTION
TYPE OF CONSTRUCTION
The house was a bungalow with bricks display and painted in colour green and
white with a state roofing.

ELECTRICITY SUPPLY
The house has its electricity supply from IBEDC (Ibadan Electricity Distribution
Company) authority, with one petrol generator for backup.

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VENTILATION
The room was well ventilated, because, it was a modern building, the living room
is shared by members of the family fairly arranged with four cushion chairs, a
center table and a big shelf for radio and television. There are old aids and new
photographs hang on the wall.

KITCHEN FACILITIES
The kitchen was well equipped, all the floors are tiled. One deep freezer and gas
cooker. All the food stuffs are well kept.

TOILET FACILITY AND BATHROOM FACILITY

Each room in the house has a toilet and bathroom, each with a good water supply
from the tap

NUMBER OF ROOMS
The family occupies a four bedroom flat. Each room has its own toilet and
bathroom.
One master bedroom for the parents and one for their youngest son. Another room
for their two children and one visitors room.

REFUSE DISPOSAL
A drum with cover was provided but nearly filled up on refused which is place
outside the compound of the house.

DRAINAGE SYSTEM
The drainage system was well connected to the main gutter on the street. It is well
kept and flow freely.

INTERVENTION
- I educate my client on importance compliance to the use of medication given.

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EVALUATION
I evaluated that my client mother brought out the medication, saying that she
couldn’t use it for my client. She also promised to comply with the prescription.
My client’s mother promised to prevent Miss. BT from playing and picking
things on the ground.

SECOND VISIT
DATE: July 21, 2023
Time: 5pm

Objective
To 16ntervene in management and recovery process of Miss BTI
Activities
I made my second visit to Miss BTI house on 21th of July 2023 at exactly 500pm
in the evening on Thursday. I met my client and her family in the house watching
football and they were happy to see me. I saw the medication on the table which
gave me joy that my client mother just finished using the medication for the girl.

OBSERVATION
I observe compliance to use of medication and she’s no longer having abdominal
pain, and fever. She responded to the treatment which shows because her
condition has really improved.
INTERVENTION
I further encouraged and enlightened my client to be practicing a good proper
hygiene in order not to have the recurrence of diarrhea. She should continue to
take her drugs and not miss any dose, so she can speed up her recovery process.

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EVALUATION
My client mother promise to comply with the use of medication she instructed
other members of the family to always remind her when it is time to use the drug
in case she forgot.

THIRD VISIT
DATE: July 29, 2024
Time: 4:30pm
OBJECTIVE
To educate the family on proper hygiene and diarrhea infection

ACTIVITIES
On getting to my client house non 29th July 2023, which was on Friday evening I
met my client and her family sitting outside their apartment we exchanged
pleasantries I asked about her family welfare and her visit to the Imobido Health
Center which she told me that it turned out well, she is responding to treatment.
The abdominal pain and fever as stopped. After this, I requested for a convenient
place where we could sit and discuss. I discuss about the benefit of Personal
Hygiene with the family and as well as its benefit to health. So I asked if they
have any pre-knowledge on the relationship between proper Hygiene and
prevention of diseases such as diarrhea.

OBSERVATION
I observed that my client improved personal Hygiene by doing things such as
washing her hand with running water and soap and using hand towel to dry water
in her hand.

INTERVENTION
- I educate my clients on personal Hygiene
- I encourage continuous adherence to usage of medications
- I encouraged them on food security and safety.
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EVALUATION
I noticed my client mother positive attitude to personal Hygiene by the instruction
she gave others in the family immediately as regards to washing hand, clothes,
spoon and cup.

FOUR VISIT
DATE: April 6th, 2024
TIME: 5:00pm
OBJECTIVE
To prevent re-occurrence of diarrhea in my client.

ACTIVITIES
On Sunday being the 6th April, 2024 at about 5:00pm. I visited the family, which
was my fourth visit to my client’s house. I met my client and other family
members at home. I was welcomed into the house and I asked about my client
health condition from the mother and she confirmed to me that she was fine. She
just finished taking her drugs her mother was cooking in the kitchen.

OBSERVATION
- I observed that my client keep maintain personal Hygiene.
By brushing her teeth, bathing and washing her cloths, and all her drinking
cups and plates.

INTERVENTION
- I educate and enlightened my client and her family on disposal of any dirty
things.
- I educate and advised my client and her family on the importance of proper
washing of cups and plate after eating to prevent contamination
- I educate my client and her family to always go for regular checkup.

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EVALUATION
My client mother sent someone to buy personal spoon cup plate for family
member.

FIFTH VISIT
DATE: August 17th, 2024
TIME: 5:30pm

OBJECTIVE
To educate compliance to previous intervention also to informed my client about
the end of my visit.

ACTIVITIES
My fifth visit, which was last visit to the family was on 17th of August, 2024. I
went to my client’s house around 5:30pm on Friday. I met my client playing
football outside, while the rest of the family were inside. He welcomed me and
told me to come inside, which I obliged. They were all happy to see me. I told my
client and his family that this will be my last visit to their house, they were all sad
but they really appreciated my interest and concern about their family. The mother
also share her new experience regarding the previous discussion I encourage my
client and her family to continue adequate personal Hygiene.

OBSERVATION
I observed that my previous intervention was followed by my client because she
now take care of herself properly.

INTERVENTIOIN
- I encourage and advise them that it is important to continue with adherence
to personal Hygiene.
- I educate them that they need to always monitor my client playing mate so
as to detect anyone who has been sick diarrhea in order to prevent my client
from being infected.
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 - I also advised my client family to prevent my client from pet so as to
prevent allergic reactions.
EVALUTATION
I encouraged my client’s family on the procedures to be taken during the
management on the prevention of diarrhea, my client’s mother obliged to all I
said, and they started putting them to adim so as to make sure that my client is
totally healed from his diarrhea and so he won’t contact the infection again in the
nearest future.

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 CHAPTER FOUR

4.0. SUMMARY
I met Miss. BTI at Imobido Health Center where she come to complain about
diarrhea infection abdominal pain & fever. She was attended to and was referred
to the Imobido Health Center for properly care and management the mother
agreed with me to take her as my care study, I went to BT house for house
visitation, counselling and educated him, five visitation were conducted during the
study, the family Health status was looked into.
They were counseled on the importance of good proper Hygiene practices and the
care of her life successful.

4.1. CONCLUSION

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4.2. RECOMMENDATION
The following recommendation were made base on the family care study.

INDIVIDUAL
- Take your drugs three times a day. This keep your healthy body system
normal.
- Making use of your hand washing before you’re eating anything’s
- Practices of regular cleanliness in your houses.
- Washing cloths and plates cleaning kitchen after used.
- Bathing every times in a day can be three time in a day.

COMMUNITY
- The community head should organize health seminar / outreaches to
educate the members of their community on how to practices good proper
hygiene and avoiding the use of acidic product.
- Counselling the community on the importance of using medication and
prevent infection.
- Ensure that maintainer is always being properly normally carefully used it
is protected in the life of human.
- They should also be encourage to visit Imobido Health Center at least once
a week.
- Have a good food protein, fish, and chicken and do akara and pap for their
child immune system to grow Health body system.

HEALTH WORKERS
- Health worker should do outreach in order to create awareness to the public
about diarrhea infection and proper Hygiene.
- Also, more awareness about the benefit of good proper Hygiene practices
should be in corporates.

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 GOVERNMENT
- Government should make campaign
- Propagation on person Hygiene
- Government should equip relevant agencies under the health sector with
necessary facilities that assist them in discharging their duties as quick as
possible.
- Government should open safety pharmacy in the communities for to take
drugs.
- Government should do a favour bring us generators of solar system to use
in the Hospital.
- Government should take a proper care in Nigeria has well as they can do it
for good of individual benefited.

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REFERENCES
1. JENNIFER WHITLOCK, RN, MSN, FN UPDATED UN OCTOBER
2018. MEDICAL REVIEWED BY SHADI HAMDEH, MD.
2. CYNTHIA TAYLOR CHAVOWSITE MEDICAL REWIEW JANUARY
2013 MPAS, PAC. BY MARKUS
3. THE MOST PROJECT 2013 DIARRHEA TREATMENT GUIDELINES,
INCLUDING NEW RECOMMENDATION FOR THE USE ORS AND
ZINC SUPPLEMENTATION FOR BASED HEALTH CARE WORKER
USAID, WHO, UNICEF AND ZINC.
4. WHO / UNICEF 2013 APRIL JOINT STATEMENT ON CLINICAL
MANAGEMENT OF ACUTE DIARRHEA
5. WHO / FCH / CAH 047 WHO (2013). DIARRHEA MANAGEMENT
TRAINING COURSE.
6. DAVID E. (2013) MY COLOGY THE UNIVERSITY OF ADELAIDE
DORLAND’S MEDICAL DICTIONARY
7. (2013) INFECTION DISEASES, EPIDEMIOLOGY AND
SURVEILLANCE” (2013). CORPORATE COMMUNICATION UNIT.
8. MERIAN WEBSTER UNABRIDGED DICTIONARY (2013). MERIAN
WEBSTER INCORPORATED.
9. WED MD 2013 UNDERSTAND DIARRHEA” WEB LLC SCHOOL IN
CRISIS, LONDON.
CDC, DECEMBER 6, 2013 SYMPTOMS OF DIARRHEA INFECTIONS.
10.ARCHIVE FROM THE ORIGINAL ON 20 JANUARY (2015).
2016 RETRIEVED 5 SEPTEMBER 2016 CDC DECEMBER, 2015.

11.CDC SEPTEMBER 6, 2016 DIARRHEA RISK & PREVENTION

“ARCHIVED FROM THE ORIGINAL ON 5TH DECEMBER, 2016, ON
7TH DECEMBER, 2016 RETRIEVED 5 JANUARY, 2016.

12.DOMINO, FRANK BALDOR, ROBERT A.R GOLDING, JEREMY

(2017) “THE 5 MINUTE CLINICAL CONSULT 2018 LIPPINCOTT
WILLIAMS WILKINS. P. 1226.

13.ISBN 278141188614. ARCHIVED FROM THE ORIGINAL ON 2017

14.DECEMBER 6, 2018 RETRIEVED 5 DIAGNOSIS DIARRHEA

ARCHIVED FROM THE ORIGINAL ON 8TH AUGUST, 2019.

15.SEPTEMBER, 2019 TREATMENT FOR DIARRHEA ARCHIVED

FROM THE ORIGINAL ON 8TH SEPTEMBER, 2020.
THE DRUG AND OTHER TREATMENT FOR DIARRHEAL
INFECTION IS INFECTION THAT HAS DEATHLY SYMPTOMS.
APA EDITION 5.