Outcome Criteria

V Resolution of diarrhea with establishment of pattern of soft formed stool elimination (specify).

V Absence of precipitating factors causing diarrheal episodes (specify). NOC: Bowel Elimination

INTERVENTIONS

Assess normal pattern of bowel elimination and characteristics of stool (frequency, amount, consistency, presence of blood, pus, mucus, color change), presence of diseases or contact with contaminants, infective organisms, medications being taken.

Assess abdomen for distention palpation and bowel sounds for increases in auscultation (specify when).

Assess for temperature elevation, irritability, flaccidity, lack of expression, whiny cry, lethargy, anorexia, vomiting, eyes lackluster.

RATIONALES

Provides information about baseline parameters for comparison, reason for changes; diarrhea may be acute caused by an inflammation, toxin or a systemic disease and last about 72 hours, or chronic caused by inflammation, allergy, malabsorption, bowel motility changes or disease and last longer than 72 hours; antibiotic therapy may cause diarrhea as it destroys the normal flora in the bowel.

Indicates a distended bowel with fluid and hypermotility of bowel which reduces the amount of material that is absorbed by the bowel mucosa.

Provides information about signs and symptoms associated with diarrhea.

Assess for fluid loss with a light weight loss, dry skin and mucous membranes, poor skin turgor, serum potassium, sodium for decreases (specify when).

Obtain stool specimen for laboratory examination for toxins, ova and parasites, number of calories of infective organisms present; fecal analysis for occult blood, fat content; repeat specimen examination as needed to confirm presence of organism.

Place on enteric isolation and explain reasons why this is necessary until diagnosis is confirmed; maintain precautions if cause is identified as an infective organism.

Place on NPO, administer and monitor IV fluids and electrolytes (specify).

Administer oral rehydration fluids q 4 to 6 hours and increase or decrease depending on hydration status; volume should equal stool losses and as prescribed, and maintenance therapy includes the addition of breast milk or plain water for every 2 bottles of rehydration fluid (specify).

Encourage continuation or reintroduction of the child's regular diet as soon as possible.

Administer anti-infective therapy and antidiarrheals as ordered (specify drug, dose, route, and times; include therapeutic and side effects to monitor for.

Change diaper frequently as needed (in infant), expose buttocks to air and apply skin protective ointment to buttocks and perianal area in infants and anal area in children if irritated and sore; wash area with warm water after each diarrhea episode (commercial wipes may be used if skin not irritated).

Teach parents and child about enteric precautions including handwashing technique after bowel movement and before meals, disposal of and

Indicates possible dehydration associated with fluid/electrolyte loss from frequent watery stools and vomiting and insensible fluid loss from fever that leads to metabolic acidosis.

Indicates possible cause of diarrhea.

Prevents undue anxiety and transmission of disease to others since bacterial and viral infections are the most common causes of diarrhea in children.

Allows bowel to rest and IV replaces lost fluids and electrolytes.

Provides therapy of choice for milk or moderate dehydration in infants.

A regular diet provides the nutrients the child needs and has been shown to have no adverse effects according to the American Academy of Pediatrics.

Specify drug action.

Protects skin from excretions and secretions that are irritating and cause excoriation and skin breakdown.

Prevents transmission or spread of microorganisms causing diarrhea to others.

laundering of linens and articles contaminated by excrement, demonstrate and allow for return demonstration of handwashing.

Teach parents signs and symptoms of dehydration or changes in characteristics of diarrhea and to report them to physician; diarrhea that becomes chronic or returns or diet that is not tolerated should be reported.

Discuss proper refrigeration and handling of foods.

Instruct parents on procedure to collect stool specimen and take to laboratory labeled properly.

Instruct parents to stop milk and solid foods if diarrhea starts again and begin with sips of fluid and advance diet as before.

Instruct parents in medication administration if prescribed and avoidance of medications in children under 12 years of age (absorbents, antidiarrheals).

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