Diarrhoea

A LECTURE
ON
DIARRHOEA
Prepared by: Jay Honey Boy Ramirez, RN
Diarrhoea
Definition:
is the passage of loose or liquid stools usually at least three times in 24 hour period primarily a symptom of gastrointestinal infection may be watery (cholera for example) or passed with stool (dysentery for example)
Causes of Diarrhoea:
unclean drinking water poor personal and food hygiene maybe associated with other infections, chemical irritation or non-infectious bowel disease
Clinical Types of Diarrhoea:

acute watery diarrhoea acute bloody diarrhoea persistent diarrhoea diarrhoea with severe malnutrition
Dehydration
During diarrhoea there is an increased loss of:
water electrolytes ( sodium, chloride, potassium and bicarbonate )
If water and salts are not replaced fast, the body starts to dry-up or get dehydrated. If more than 10 % of bodys fluid is lost death occurs.
Assessment of the Child with Diarrhoea for Dehydration A B C

Look at: Condition Eyes Thirst well, alert normal drinks normally restless, irritable lethargic or unconscious sunken sunken drinks poorly or thirsty, drinks not able to drink eagerly goes back slowly goes back very slowly Severe Dehydration
Feel: goes back Skin Pinch quickly Decide
No signs of Some Dehydration Dehydration
Treatment Plan A:
Treat Diarrhoea at Home
1. Give extra fluid ( ORS, water, breast milk, food-based fluids )
Suitable Fluids Unsuitable Fluids ORS Soft drinks Salted rice water Sweetened fruit drinks Vegetable or chicken soup Sweetened tea Plain water Coffee Green coconut water Some medicinal teas or Unsweetened Weak tea and fruitinfusions juice
After each loose stool, give: - half cup of fluid for children below 2 y/o - one cup of fluid for 2 y/o and above
Treatment Plan A:
Treat Diarrhoea at Home 2. Continue feeding What foods to give?
cereals, vegetable, meat, fish, egg foods rich in potassium such as banana small frequent feeding is advised
in general, foods suitable for a child diarrhoea are the same as those required by healthy children
Treatment Plan A:
Treat Diarrhoea at Home 2. Return to health facility when patient
Starts to pass many watery stools and does not get better Repeated vomiting Becomes very thirsty Eating or drinking poorly Has blood in the stool Develops a fever
2. Give supplemental Zinc ( 10- 20 mg ) to child everyday for 10 to 14 days
How to prepare Home Made ORS?

Ingredients: 1 teaspoon of salt 8 teaspoon of sugar 1 Litre of clean or boiled water then cooled Preparation Method: Stir the mixture till the sugar and salt
Treat Some Dehydration with ORS 1. Give in the health centre the recommended amount of ORS for a 4 hour period
age weight <4 mos <5 kg 4-11 mos 12-23 mos 2-4 y/o 5-14 y/o
Treatment Plan B:
15 y/o and older
5-7.9 kg
8-10.9 11-15.9 16-29.9 30 kg kg kg kg or more 600800 8001200 12002200 22004000
Amount 200-400400(in mL) 600
the approximate amount of ORS required in mL can also be calculated by multiplying patients weight by 75
Treat Some Dehydration with ORS
Treatment Plan B:
2. After 4 hours, reassess then select appropriate treatment plan 3. Give food 4. Begin Zinc supplement as soon as the child can eat
Treat Some Dehydration with ORS
Treatment Plan B:
5. If mother must leave before completing treatment plan B:

1. Show mother how much ORS solution to give to finish the 4 hour treatment at home. 2. Give enough ORS to complete 4 hour treatment and to continue oral rehydration for 2 or more days. 3. Show her how to prepare ORS solution
Treat Dehydration quickly
Treatment Plan C:
1. Start IV fluids immediately 2. Monitor progress of IV rehydration (reassess every 15-30 mins.) 3. What to do if IV therapy is not available
1. If available within 30 mins. send patient and give ORS during the journey 2. If IV therapy is not available nearby, give ORS by mouth at a rate of 20
Dysentery, Cholera and Persistent Diarrhoea

Cholera
starts from acute watery diarrhoea leading to severe dehydration more water loss treat dehydration bloody diarrhoea treat dehydration needs hospitalization if with severe malnutrition Diarrhoea which lasts more than 14 days bring to hospital if with other infection such as pneumonia, with signs of dehydration and less then 4 mos. old. prevent and treat dehydration
Dysentery
Persistent Diarrhoea
Prevention of Diarrhoea
1. 2. 3. 4. 5. 6. Breastfeeding Improved feeding practices Use of safe water Handwashing Food safety Use of latrines and safe disposal of stools 7. Measles immunization
1. Breastfeeding
complete food for the child in the first 6 months of life and provide about a half of the needed water and nutrients up to two years of age has immunologic properties no bottles, nipples and water needed promotes bonding birth spacing
2. Use of Safe Water
collect water from a clean source not allow washing, bathing or defecation near source keep animals away from protected source collect and store water in clean containers boiling (only to a rolling boil)
3. Handwahing
all diarrhoeal diseases can be spread by hands that have been contaminated by faeces
Wash your hands:

after defecating after cleaning child who has defecated disposing childs stool before preparing food before eating
4. Food Safety
1. Wash hands before preparing and eating food. 2. Dont eat raw food. 3. Cook food until hot throughout. 4. Eat food while its hot or reheat it before eating. 5. Wash utensils before using. 6. Protect food from flies.
THE END
- Jay Honey Boy Ramirez, RN

Diarrhoea

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A LECTURE

Clinical Types of Diarrhoea:

Assessment of the Child with Diarrhoea for Dehydration A B C

Feel: goes back Skin Pinch quickly Decide

No signs of Some Dehydration Dehydration

2. Give supplemental Zinc ( 10- 20 mg ) to child everyday for 10 to 14 days

How to prepare Home Made ORS?

15 y/o and older

8-10.9 11-15.9 16-29.9 30 kg kg kg kg or more 600800 8001200 12002200 22004000

Amount 200-400400(in mL) 600

Treat Some Dehydration with ORS

Treat Some Dehydration with ORS

5. If mother must leave before completing treatment plan B:

Treat Dehydration quickly

Dysentery, Cholera and Persistent Diarrhoea

Wash your hands:

- Jay Honey Boy Ramirez, RN

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