TEACHING

-LEARNING
CONTRIBUTORY ACTIVITY
S.N. OBJECTIVES TIME CONTENTS A.V. METHOD EVALUATION
AIDS OF
TEACHING
1. To give self 1min SELF INTRODUCTION: -
introduction. Good afternoon to all of you. I am
Mr.mahesh kumar bagherwal
msc.nursing(pre.) student. Today I will
be discussing about diarrhea and
dysentery

Definition diarrhea :

Diarrhea can be described as an

2. To give introduction 3min. abnormal increase in the frequency,
about the topic.
volume or liquidity of your stools. The
condition usually lasts a few hours to a Black Lecture What do you
couple of days. Diarrhea is typically board method cum know about
associated with abdominal cramps. and discussion diarrhea and
chalk dysentery?
Definition dysentery:

is characterized by the presence of

blood & pus in the stools, abdominal
cramps & fever Gross blood in the
stools is the most reliable sign
Malena or episodes where blood
streaks are present on the surface of
formed stools are not considered
 cause of diarrhea:

3 To enlist cause/risk 1. Viruses. Viruses that can cause

3. factor of diarrhea and 5min. diarrhea include
dysentery.  Norwalk virus,
 Cytomegalovirus
 and viral hepatitis.
Transp Lecture method Enlist cause/risk
Rotavirus is a common cause of acute
arency cum discussion factor of
childhood diarrhea.
diarrhea and
dysentery?
2. Bacteria and parasites.

Contaminated food or water can transmit

bacteria and parasites to your body.
Parasites such as

 Giardia lamblia and

cryptosporidium can cause
diarrhea.

Common bacterial causes of diarrhea

include:

 Campylobacter
 Salmonella
 Shigella
 and Escherichia coli.

Diarrhea caused by bacteria and

parasites can be common when
traveling in developing countries, and is
often called traveler's diarrhea.

3. Medications

Many medications can cause diarrhea.

The most common are antibiotics.
Antibiotics destroy both good and bad
bacteria, which can disturb the natural
balance of bacteria in our intestines.
This disturbance sometimes leads to an
infection with bacteria called
Clostridium difficile, which also can Lecture method
cum discussion
cause diarrhea.

4. Lactose intolerance. Lactose is a

sugar found in milk and other dairy
products. Many people have
difficulty digesting lactose and
experience diarrhea after eating
dairy products. Your body makes an
enzyme that helps digest lactose,
but for most people the levels of
this enzyme drop off rapidly after
childhood. This causes an increased
risk of lactose intolerance as you
age.
5. Fructose. Fructose, a sugar found
 naturally in fruits and honey and
added as a sweetener to some
beverages, can cause diarrhea in
people who have trouble digesting
it.
6. Artificial sweeteners. Sorbitol and
mannitol, artificial sweeteners
found in chewing gum and other
sugar-free products, can cause
diarrhea in some otherwise healthy
people.
7. Surgery. Some people may
experience diarrhea after
undergoing abdominal surgery or
gallbladder removal surgery.
8. Other digestive disorders. Chronic
diarrhea has a number of other
Lecture method
causes, such as Crohn's disease,
cum discussion
ulcerative colitis, celiac disease,
microscopic colitis and irritable
bowel syndrome.

Causes of Dysentery :

 Digestive bacterial infection

 Digestive viral infection
 Scurvy
 Crohn's disease
  Colon cancer adenocarcinoma

To enlist sign and Signs and symptoms of diarrhea :

4. symptoms of diarrhea 5min.
and dysentery. associated with diarrhea may include:

 Frequent, loose, watery stools

 Abdominal cramps Enlist sign and
 Abdominal pain transp Lecture method symptoms of
 Fever arency cum discussion diarrhea and
 Blood in the stool dysentery?
 Bloating

sign and symptoms of

Dysentery:

 Abdominal pain
 Tenesmus
 Bloody stool
 Mucus in stool
 Intestine inflammation

Investigation/diagnosis of
diarrhea and Dysentery:
5. To describe Tests and procedures used to determine
Investigation/diagnosis of what's causing your diarrhea may include: Describe
diarrhea and Dysentery. 5min. transp Lecture method Investigation/diagnos
 Physical exam. Examine abdomen arency cum discussion is of diarrhea and
to determine the location of any Dysentery?
abdominal pain. also listen t
abdomen sound with stethoscope.
 Review of your medications. Ask
about any medications taking,
 including over-the-counter drugs.
Also
 Blood test. A complete blood count
test may help determine what's
causing diarrhea.
 Stool test. recommend a stool test
to determine whether a bacterium or
parasite is causing your diarrhea.
 Colonoscopy
 Sigmoidoscopy

Prevention of diarrhea:-

1. Preventing viral diarrhea

6. To prevent diarrhea and
dysentery Wash your hands frequently to prevent
10min.
the spread of viral diarrhea. To ensure
you or your child is washing your hands
thoroughly, always: Lecture method Describe prevention
2. Wash frequently. Wash your hands cum discussion of diarrhea and
after preparing food, handling uncooked dysentery?
meat, using the toilet, changing diapers,
sneezing, coughing and blowing your
nose.
3. Lather with soap for at least 20
seconds. After putting soap on your
hands, rub your hands together for at
least 20 seconds. This is about as long
as it takes to sing "Happy Birthday"
 twice through.
4. Use hand sanitizer when washing
isn't possible. Use an alcohol-based
hand sanitizer when you can't get to a
sink. Apply the hand sanitizer as you
would hand lotion, making sure to
completely cover the fronts and backs
of both hands. Use a product that
contains at least 60 percent alcohol.

5. Preventing diarrhea from

contaminated food Lecture method
To guard against diarrhea caused by cum discussion
contaminated food:

6. Serve food right away or refrigerate

it after it has been cooked or reheated.
Leaving food out at room temperature
can encourage growth of bacteria.
7. Wash work surfaces frequently to
avoid spreading germs from one food
item to another. Wash your hands and
your work surfaces several times during
food preparation.
8. Use the refrigerator to thaw frozen
items. Or try putting plastic-wrapped
frozen items in a bowl of cold water to
thaw. Don't leave frozen items on the
counter to thaw.
9. Preventing traveler's diarrhea
Diarrhea commonly affects people who
travel to developing countries, where
diarrhea is sometimes due to inadequate
sanitation and contaminated food and Lecture method
water. To reduce your risk: cum discussion

10. Watch what you eat. Eat hot, well-

cooked foods. Avoid raw fruits and
vegetables unless you can peel them
yourself. Also avoid raw or
undercooked meats and dairy foods.
11. Watch what you drink. Drink bottled
water, soda, beer or wine served in its
original container. Avoid tap water and
ice cubes. Use bottled water even for
brushing your teeth. Keep your mouth
closed while you shower. Beverages
from boiled water, such as coffee and
tea, are probably safe. Remember that
alcohol and caffeine can aggravate
diarrhea and dehydration.
12. Ask your doctor about using
antibiotics. If you're traveling to a
developing country for an extended
period of time, ask your doctor about
starting antibiotics before you leave on
your trip. In certain cases, this may
reduce the risk that you'll develop
 traveler's diarrhea.
Prevention of Dysentery:-
Prevention information for Dysentery
has been compiled from various data
Lecture method
sources and may be inaccurate or cum discussion
incomplete. None of these methods
guarantee prevention of Dysentery.

 Avoid contaminated food

 Keep food away from flies
 Avoid contaminated water

Treatments and drugs used in

To describe medical diarrhea:-
7. management of 8min
diarrhea and dysentery  Most cases of diarrhea clear on their
own within a couple of days
without treatment. If you've tried
lifestyle changes and home
remedies for diarrhea without
success, your doctor may
Lecture method describe medical
recommend medications or other
cum discussion management of
treatments.
 Antibiotics diarrhea and
Antibiotics may help treat diarrhea dysentery
caused by bacteria or parasites. If a
virus is causing your diarrhea,
antibiotics won't help.

 Treatment to replace fluids

Your doctor likely will advise you
to take steps to replace the fluids
 and salts lost during diarrhea. For
most people, replacing fluids means
drinking water, juice or broth. If
drinking liquids upsets your
stomach or causes diarrhea, your
doctor may recommend getting
fluids through a vein in your arm
(intravenously).

 Water is a good way to replace

fluids, but it doesn't contain the
salts and electrolytes — minerals
such as sodium and potassium —
you need in order to maintain the
electric currents that keep your
heart beating. Disruption of your
body's fluid and mineral levels
creates an electrolyte imbalance that
can be serious. You can help
maintain your electrolyte levels by
drinking fruit juices for potassium
or eating soups for sodium.

 Adjusting medications you're

taking
If your doctor determines that an
antibiotic medication caused your Lecture method
diarrhea, your doctor may modify cum discussion
your treatment plan by lowering
your dose or switching to another
medication.

 Treating underlying conditions

If your diarrhea is caused by a more
serious disease or condition, such as
 inflammatory bowel disease, your
doctor will work to control that
condition. You may be referred to a
specialist, such as a
gastroenterologist, who can help
devise a treatment plan for you.

Lifestyle and home remedies:

Lecture method
Most diarrheas clear up on its own within a cum discussion
few days. To help you cope with your signs
and symptoms until they go away, try to:

 Drink plenty of clear liquids,

including water, broths and juices
every day. But, avoid apple and
pear juices until you feel better
because they can make your
diarrhea worse. Avoid caffeine and
alcohol. Eating gelatin also may
help.

 Add semisolid and low-fiber foods

gradually as your bowel
movements return to normal. Try
soda crackers, toast, eggs, rice or
chicken.

 Avoid certain foods such as dairy

products, fatty foods, high-fiber
foods or highly seasoned foods for a
 few days.

 Ask about anti-diarrheal

medications. Over-the-counter Lecture method
(OTC) anti-diarrheal medications, cum discussion
such loperamide (Imodium A-D)
and bismuth subsalicylate (Pepto-
Bismol), may help reduce the
number of watery bowel
movements you experience. Certain
infections — bacterial and parasitic
— may be made worse by these
OTC medications because they
prevent your body from getting rid
of what's causing the diarrhea. Also,
these drugs aren't always safe for
children. Check with your doctor
before taking these medications or
giving these medications to a child

Some research suggests that

probiotics — foods and supplements
containing beneficial bacteria — may
help treat diarrhea, particularly viral
diarrhea in children. Helpful bacteria
live in your digestive tract, where
they help digest your food and protect
you from harmful bacteria. Probiotics
contain strains of living bacteria that
are similar to the ones normally found
 in your digestive system.

 Probiotic foods, such as yogurt,

cheese, miso and tempeh, are
generally safe to eat and may help.
Side effects of probiotics might
include gas and bloating.

Treatments and drugs used in

Dysentery:-

 Bed rest

 Mercurius corrosives homeopathic

remedy
 Colocynth homeopathic remedy
 Arsenicum homeopathic remedy

 IV fluid
 Oral fluids
 Bismuth subsalicylate
 Kaolin pectin
 Diphenoxylate

To describe nursing Nursing Management:

8. management of 8min. The nurse’s role includes Lecture method Describe nursing
diarrhea and dysentery 1. Assessing and monitoring the cum discussion management of
characteristics and pattern of diarrhea and
diarrhea. dysentery?
2. Complete health history addresses
the patient’s medication therapy,
 medical and surgical history, and
dietary patterns and intake.
3. Reports of recent exposure to an
acute illness or recent travel to
another geographic area are
important.
4. Assessment includes abdominal
auscultation and palpation for
abdominal tenderness.
5. Inspection of the abdomen and
mucous membranes and skin is
important to determine hydration
status.
6. Stool samples are obtained for
testing.
7. During an episode of acute
diarrhea, the nurse encourages
bed
8. Rest and intake of liquids and
foods low in bulk until the acute
attack subsides.
9. When food intake is tolerated, the
nurse recommends a bland diet of
semisolid and solid foods.
10. The patient should avoid caffeine,
carbonated beverages, and very
hot and very cold foods, because
they stimulate intestinal motility.
11. It may be necessary to restrict
milk products, fat, whole-grain
products,fresh fruits, and
vegetables for several days.
12. The nurse administers
antidiarrheal medications such as
diphenoxylate (Lomotil)and
 loperamide (Imodium) as
prescribed.
13. Intravenous fluid therapy may be
necessary for rapid rehydration,
especially for the elderly and
those with preexisting GI
conditions (eg, IBD).
14. It is important to closely monitor
serum electrolyte levels.
15. Immediately reports evidence of
dysrhythmias or a change in the
level of consciousness.
16. The perianal area may become
excoriated because diarrheal stool
contains digestive enzymes that
can irritate the skin.
17. Follow a perianal skin care
routine to decrease irritation and
excoriation.
18. Use of skin sealants and moisture
barriers as needed. Because older
person’s skin is very sensitive
because of decreased turgor and
To summarize topic reduced subcutaneous fat layer
9. discussed
Summary:-

To give introduction about the topic, To

enlist cause/risk factor of diarrhea and
dysentery, To enlist sign and symptoms of
diarrhea and dysentery, To describe
Investigation/diagnosis of diarrhea and
Dysentery, To prevent diarrhea and
dysentery, To describe medical
management of diarrhea and dysentery ,
To describe nursing management of
diarrhea and dysentery

Assignment:-

Define diarrhea and dysentery, enlist risk

factor of diarrhea and dysentery
and describe nursing management of patient
with diarrhea and dysentery?

BIBLIOGRAPHY:-
1. Kozier&Erb’s “fundamentals of nursing”.
8th edition Pp236-243

2. Brunner&Suddarth’s “Textbook of
medical-surgical nursing”.11th edition.
Vol.1st Pp1253-1256

3. Shaffer’s “medical-surgical nursing”.1st

edition. Pp225-229

4. Rustgi AK. Neoplasms of the stomach.

In: Goldman L, Ausiello D, eds. Cecil
Medicine. 23rd ed. Philadelphia, Pa:
Saunders Elsevier; 2007:chap 202.

5. www.google.in
 LESSON PLAN
BASELINE INFORMATION

Name of Student Teacher: MR. MAHESH BAGHERWAL

Group : Bsc. Nursing post basic (prev.)
Subject : medical surgical nursing
Unit
Topic : diarrhea and dysentery.
Place : College of Nursing
Date& Time : /02/2011
Duration : 45 min.
Method of Teaching : Lecture cum Discussion
Teaching Aids : Choke Board, OHP, and Transparency
Previous Knowledge : Students have quite Knowledge about the topic.

General Objective:-

After the teaching the topic, student will be able to enhance their knowledge about diarrhea and dysentery, and apply this
knowledge in their practices.
Specific objectives:-

Students should be able:-

To give introduction about the topic.
To enlist cause/risk factor of diarrhea and dysentery.
To enlist sign and symptoms of diarrhea and dysentery
To describe Investigation/diagnosis of diarrhea and Dysentery.
To prevent diarrhea and dysentery
To describe medical management of diarrhea and dysentery
To describe nursing management of diarrhea and dysentery

GOVT. COLLEGE OF NURSING, RAJASTHAN

JAIPUR

PRACTICE TEACHING

SUBJECT: - MEDICAL SURGICAL NURSING

TOPIC: DIARRHEA AND DYSENTERY

SUBMITTED TO SUBMITTED BY
MR. BABULAL SHARMA MAHESH KUMAR BAGHERWAL
LECTURER MSc. NURSING (PREV.) GOVT COLLEGE OF NURSING
GOVT COLLEGE OF NURSING RAJASTHAN.JAIPUR RAJASTHAN .JAIPUR

GOVT. COLLEGE OF NURSING, RAJASTHAN

JAIPUR

PRACTICE TEACHING

SUBJECT: - MEDICAL SURGICAL NURSING

PRESENTATION ON: - CARCINOMA OF STOMACH

SUBMITTED TO SUBMITTED BY
MR. BABULAL SHARMA MAHESH KUMAR BAGHERWAL
LECTURER MSc. NURSING (PREV.) GOVT COLLEGE OF NURSING
GOVT COLLEGE OF NURSING RAJASTHAN.JAIPUR RAJASTHAN .JAIPUR