‫بسم اهلل الرحمن الرحيم‬

‫تمريض صحة مجتمع‬

‫(مركز الزبيري)‬

‫بحث بعنوان‪:‬‬

‫‪Diarrhea‬‬
‫تحت إشراف ‪/‬‬ ‫عمل الطالب ‪/‬‬

‫د‪ /‬أسامة عبدالحليم‬ ‫عبداهلل خالد محمد ق ايد الحياسي‬

‫د‪ /‬نصر رعدان‬

‫‪1‬‬
 Introduction:
Diarrhea is most common causes of morbidity in children under five years old and
responsible for killing (1.5) billion children especially in developed counters as
Yemen.

Definition:
Diarrhea: its increase in number and liquidity of defection more than normal habit.
OR: its watery stool repeated more 3 times per day.

Risk factor of diarrhea:

1- Age.
2- Artificial feeding.
3- Early introduction of weaning food.
4- Malnutrition children.
5- Low immunity.
6- Child with chronic disease (leukemia).
7- Unsanctioned of environment.
8- Climate change.
9- Life stress.

Type of diarrhea:
1- Acute watery diarrhea: its sudden onset less than 14 days without possible
blood.
2- Bloody diarrhea: it's called dysentery can present pus & blood.
3- Persistent diarrhea: its occur more than 14 days as result from of post
infection.
4- Chronic diarrhea: its continuance diarrhea more than 14 days & it can be
lead to (Dehydration / Malnutrition).

Type of diarrhea depend on severity:

- Mild: 4-6 time per day.
- Moderate: 6-10 time per day.
- Severe: more than 10 time per day.

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 Common causes of diarrhea:
- Microbial:-
1- Bacteria: (E.coli / Shigella / Salmonella).
2- Virus: (Rota virus / Arbor virus / Adenovirus).
3- Protozoa: (Amboise's / Giardia labella).
4- Parasite: (Ascaris / Hookworm thread worm).
5- Fungi.
- Non microbial:-
1- GIT diseases (e.g. Celica disease / IBD).
2- Food poisoning.
3- Food allergy (e.g. Lactose intolerance).
4- Medication (e.g. Antibiotic).
5- Some of food as mlokhia.

Clinical manifestation of diarrhea:

1- Diarrhea.
2- Thirst.
3- Anorexia.
4- Nausea.
5- Vomiting.
6- Fever.
7- Oliguria & anuria.
8- Fatigue, weakness.
9- Pale.
10- loss of body weight.
 Can be associated with:
- Signs & symptoms of dehydration.
- Signs & symptoms of shock.

Diagnosis:
1- History.
2- Physical examination (signs & symptoms).
3- Stool examination.
4- CBC.
5- Some of serology test e.g. (CRP / ASO).
6- Rectal examination.
7- Asigmoidoscopy (Colonoscopy).

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 Seasonality:
 Cholera Winter.
 Rotavirus Winter.
 Shigellosis Dry summer.

Complication of diarrhea:
1- Dehydration related to (N,V & D).
2- Electrolyte imbalance (K, Ca & Na).
3- Shock (Hypovolemic shock – Septic shock).
4- Renal failure (Oliguria – Anuria – Edema – Acidotic breath).
5- Hypoglycemia.
6- Convolution.
7- Rectal prolapse.
8- Malnutrition.
9- Can lead to (Anemia – septicemia or DIC).

Prevention of diarrhea:
1- Breast feeding promotion as early as possible.
2- Natural many food.
3- Hand washing.
4- Uncontaminated water.
5- Health education.
6- Vaccination agonist (cholera).
7- Keep breathing clean.
8- Avoid introduction of weaning food before 6 month age of child.

Treatment of diarrhea:
 Treat of diarrhea depend on degree & severity of diarrhea:-
- Mild diarrhea: treatment at home by:
1- Increase number of breast feeding.
2- Increase number of fluid.
3- Good balance diet.
- Moderate diarrhea: treatment in outpatient or at house:-
1- Oral rehydration solution (ORS).
2- High fluid & good diet.
3- Supplementary diet.
- Severe diarrhea:

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 1- Nothing per oral (NPO).
2- ORT.
3- ORS (e.g. Sodium chloride 3.5gm / Potassium chloride 1.5gm / Sodium
nitrate 2.9gm / Glucose 20gm).
4- Treatment of causes & any complication.
 Treatment of causes of diarrhea as antibiotic – antifungal (Metronidazole) –
anti helminthes (Vermox).
 Treatment of any complication.
 Supplementary therapy.

Nursing care of diarrhea:

1- Assess and monitoring characteristic & pattern of diarrhea.
2- Encourage mother about breast feeding.
3- Instruct mother to give small & frequent feeding.
4- Instruct mother & his child to avoid hot or cold water.
5- Encourage mother to give balance diet as some of bananas.
6- Teach mother & his baby about hand washing & important of it in prevent
diseases.
7- N/C depend on signs/symptoms.
8- Give medication as prescribed.
9- Monitor patient body weight & serum of electrolyte & intake & output.
10- Teach mother about perianal skin care.
11- HE about diseases (Causes – S/S – Severity / Complication /
Treatment).
12- N/C for any complication.

Reference:
- Pediatric nursing.
- Internet.