Nursing patients with diarrhea

DEFINITIONDiarrhea is a bowel movement (defecation) by the number of stools more than normal (normal 100-200 cc / hour stool). With liquid stools / half solid, can be accompanied by increased frequency. According to WHO (1980), diarrhea is loose, watery stools more than 3 times a day.Etiology1. Factors of infection: bacteria (Shigella, Shalmonella, Vibrio cholera), viruses (enterovirus), parasites (worms), Candida (Candida albicans).2. Parenteral factors: Infections other parts of the body (OMA often occurs in children).3. Malabsorption factor: karbihidrat, fats, proteins.4. Dietary factors: Food stale, toxic, too much fat, cooked vegetables mature bra.5. Psychological factors: fear, anxiety.PathophysiologyBasic mechanisms that cause diarrhea are:1. osmotic disruptionThe presence of food or substances that are not absorbed will cause the osmotic pressure in the intestinal lumen, causing increased water and elektroloit shift into the intestinal lumen. Excessive intestinal cavity contents will stimulate the intestine to release it causing diarrhea.2. impaired secretionDue to certain stimuli (such as toxins) in the intestinal wall will be increased secretion, water and electrolytes into the intestinal lumen and subsequent diarrhea arise because they increase the contents of the intestinal lumen.3. motilitasusus disordersHiperperistaltik will cause a reduction in intestinal opportunity to absorb food causing diarrhea. Conversely, if the decreased intestinal peristalsis will result in excessive growth of bacteria, subsequent diarrhea also can occur.

SIGNS AND SYMPTOMSAcute diarrhea due to infection may be accompanied by vomiting, fever, tenesmus, hematoschezia, and abdominal pain or stomach cramps. Most fatal consequence of diarrhea that lasts long without adequate rehydration is the cause of death due to dehydration or hypovolemic shock in the form of biochemical disorder continued metabolic acidosis. Who is dehydrated gar will feel thirst, weight loss, sunken eyes, dry tongue, cheek bones appear more prominent, decreased skin turgor, and the voice becomes hoarse. Complaints and symptoms caused by the depletion of water isotonic. The loss of bicarbonate (HCO 3) the comparison with carbonic acid is reduced resulting in decreased blood pH stimulates the respiratory center so that the increased respiratory frequency and deeper (Kussmaul breathing).Cardiovascular disease at the stage of severe hypovolemic shock can be the sign of a rapid pulse (> 120 x / min), decreased blood pressure to be measured. The patient became restless, pale face, cold akral and sometimes cyanosis. Due to lack of potassium in acute diarrhea also can occur cardiac arrhythmias. Decrease in blood pressure will cause decreased renal perfusion to arise oliguria / anuria. If this situation does not arise immediately diatsi complications of acute renal tubular necrosis, which means a state of acute renal failureDIAGNOSTIC EXAMINATION1. History of allergy to drugs or food2. stool cultures3. Examination of the electrolyte; BUN, creatinine, and glucose4. Stool examination; pH, leukocytes, glucose, and bloodMEDICAL THERAPY1. Handling focus on causes2. Giving fluids and electrolytes; oral (such as Pedialyte or ORS) or parenteral therapy3. In infants, breastfeeding is not forwarded if the cause of breast milktreatment of diarrhea1. Give plenty of water to replace the fluids and chemicals hilng body. Drink fluids every 2 hours by approximately 2 ounces.2. If diarrhea lasts longer, say 1-2 days and when the urine reduced the number and frequency rumash bring the patient to the hospital because he was exposed to the possibility of dehydration3. Avoid solid foods