PHILIPPINE ADVENT COLLEGE

School of Nursing
Ramon Magsaysay
Sindangan Zamboanga Del Norte

Case Study On
Acute
Gastroenteritis
Submitted By:

Narzabal, Ivy
Jugo, Lea
Jugo, Rodelyn
Rosaldo, Jacque
Vagilidad, Mylene
Quezon, Michaella
Ungad, Nur Sheika
Pelarin, Janovdenels
Sagayan, Sheina Mae
Dumaboc, Maria Lexan
Fernandez, Rhezel Mae

Submitted To:

Archovell Partosa, RN, MAN (IP)

Clinical Instructor
 INTRODUCTION
Gastroenteritis is an inflammation of the stomach, small intestine, or large intestines, leading to a
combination of abdominal pain, cramping, nausea and vomiting, and diarrhea. Acute
gastroenteritis usually last fewer than 14 days. This is in contrast to persistent gastroenteritis
which lasts between 14 to 30 days, and chronic gastroenteritis, which last for more than 30 days.
Most cases are infectious, although gastroenteritis may occur fter ingestion of drugs,
medications, and chemical toxins. Acquisition may be foodborne, waterborne, person-to-person
spread, or occasionally through zoonotic spread.

Most episodes of gastroenteritis are self-limited but cause uncomfortable symptoms. Electrolyte
and fluid loss is usually little more than an inconvenience to an otherwise healthy adult but can
be grave for people who are very young (see Dehydration in Children), who are older, or who are
immunocompromised or have serious concomitant illnesses.

Etiology of Gastroenteritis
Infectious gastroenteritis may be caused by viruses, bacteria, or parasites. Many specific
organisms are discussed further in the Infectious Diseases section.
Viral gastroenteritis
Viruses are the most common cause of gastroenteritis in the United States, and most viral
gastroenteritis is caused by
*Norovirus
*Rotavirus
Most other viral gastroenteritis infections are caused by astrovirus or enteric adenovirus.
Astrovirus can infect people of all ages but usually infects infants and young children. In
temperate climates, infection is most common in winter months, and in tropical regions, infection
is more common in summer months. Transmission is by the fecal-oral route. Incubation is 3 to 4
days.
Adenoviruses are the 4th most common cause of childhood viral gastroenteritis. Infections occur
year-round, with a slight increase in summer. Children < 2 years of age are primarily affected.
Transmission is by the fecal-oral route as well as by respiratory droplets. Incubation is 3 to 10
days.
(Viruses infect enterocytes in the villous epithelium of the small bowel. The result is
transudation of fluid and electrolytes into the intestinal lumen; sometimes, unabsorbed
carbohydrates resulting from malabsorption in the affected bowel subsequently worsen
symptoms by causing osmotic diarrhea. Diarrhea is watery. Inflammatory diarrhea (dysentery),
with fecal white blood cells (WBCs) and red blood cells (RBCs) or gross blood, is uncommon.)
In patients with immunocompromise, additional viruses (eg, cytomegalovirus, enterovirus) can
cause gastroenteritis.

Bacterial gastroenteritis
The bacteria most commonly implicated are
*Campylobacter
*Clostridioides difficile
*Escherichia coli (especially serotype O157:H7)
*Salmonella
*Shigella
*Staphylococci, causing staphylococcal food poisoning
Bacterial gastroenteritis is less common than viral. Bacteria cause gastroenteritis by several
mechanisms.
Enterotoxins are produced by certain species (eg, Vibrio cholerae, enterotoxigenic strains of E.
Coli) that adhere to intestinal mucosa without invading. These toxins impair intestinal absorption
and cause secretion of electrolytes and water by stimulating adenylate cyclase, resulting in
watery diarrhea. C. Difficile produces a similar toxin
Exotoxins that are ingested in contaminated food are produced by some bacteria (eg,
Staphylococcus aureus, Bacillus cereus, Clostridium perfringens). The exotoxin can cause
gastroenteritis without bacterial infection. These toxins generally cause acute nausea, vomiting,
and diarrhea within 12 hours of ingestion of contaminated food. Symptoms abate within 36
hours.
Mucosal invasion occurs with other bacteria (eg, Shigella, Salmonella, Campylobacter, C.
Difficile, some E. Coli subtypes) that invade the mucosa of the small bowel or colon and cause
ulceration, bleeding, exudation of protein-rich fluid, and secretion of electrolytes and water. The
invasive process and its results can occur whether or not the organism produces an enterotoxin.
The resulting diarrhea has evidence of this invasion and inflammation with WBCs and RBCs
present on microscopy and sometimes with gross blood.
Salmonella and Campylobacter are common bacterial causes of diarrheal illness in the United
States. Both infections are most frequently acquired through undercooked poultry; unpasteurized
milk is also a possible source. Campylobacter is occasionally transmitted from dogs or cats with
diarrhea. Salmonella can be transmitted by consuming undercooked eggs and by contact with
reptiles, birds, or amphibians.
Species of Shigella are also common bacterial causes of diarrhea in the United States and are
usually transmitted person to person, although foodborne epidemics occur. Shigella dysenteriae
type 1, which is rare in the United States (1) produces Shiga toxin, which can cause hemolytic-
uremic syndrome.
E. coli gastroenteritis can be caused by several different subtypes of the bacteria. The
epidemiology and clinical manifestations vary greatly depending on the subtype.

Yersinia enterocolitica can cause gastroenteritis or a syndrome that mimics appendicitis because
patients may have pain in the right lower quadrant. It is transmitted by undercooked pork,
unpasteurized milk, or contaminated water. Several Vibrio species (eg, V. Parahaemolyticus)
cause diarrhea after ingestion of undercooked seafood. V. Cholerae sometimes causes severe
dehydrating diarrhea in regions where people lack access to clean drinking water and sanitary
disposal of human waste and is a particular concern after natural disasters or in refugee camps.
Listeria can rarely cause foodborne gastroenteritis but more often causes bloodstream infection
or meningitis in pregnant women, neonates (see Neonatal Listeriosis), or older adults.
Aeromonas is acquired from swimming in or drinking contaminated fresh or brackish water.
Plesiomonas shigelloides can cause diarrhea in patients who have eaten raw shellfish or traveled
to tropical low-resource regions.

Parasitic gastroenteritis
The parasites most commonly implicated in high-resource countries are
*Giardia
*Cryptosporidium
Certain intestinal parasites, notably Giardia intestinalis (G. Lamblia), adhere to the intestinal
mucosa, causing nausea, vomiting, diarrhea, and general malaise. The infection can become
chronic and may cause a malabsorption syndrome. It is usually acquired via person-to-person
transmission (often in day care centers) or from ingestion of cysts in contaminated water or food.
Cryptosporidium parvum causes watery diarrhea and can sometimes be accompanied by
abdominal cramps, nausea, and vomiting. In healthy people, the illness is self-limited, lasting
about 2 weeks. In patients with immunocompromise, illness may be severe and prolonged,
causing substantial electrolyte and fluid loss. Cryptosporidium is usually acquired through
contaminated water. It is not easily killed by chlorine and is the most common cause of
recreational waterborne illness.
Other parasites that can cause symptoms similar to those of cryptosporidiosis include Cyclospora
cayetanensis and, in patients with immunocompromise, Cystoisospora (Isospora) belli and a
collection of organisms referred to as microsporidia (eg, Enterocytozoon bieneusi,
Encephalitozoon intestinalis). Entamoeba histolytica (Amebiasis) is a common cause of subacute
bloody diarrhea in low-resource regions with poor sanitation but is rare in the United States.
Amebiasis can cause an ulcerating colitis that mimics ulcerative colitis and must be excluded
when that diagnosis is considered.

Signs And Symptoms

The character and severity of symptoms of gastroenteritis vary.Generally, onset is sudden, with
anorexia, nausea, vomiting, abdominal cramps, and diarrhea (with or without blood and mucus).
Malaise and myalgias may occur. The abdomen may be distended and mildly tender; in severe
cases, muscle guarding may be present. Gas-distended intestinal loops may be palpable.
Hyperactive bowel sounds are present on auscultation even without diarrhea (an important
differential feature from paralytic ileus, in which bowel sounds are absent or decreased).
Persistent vomiting and diarrhea can result in intravascular fluid depletion with hypotension and
tachycardia. Hypovolemic shock with vascular collapse and oliguric renal failure may occur in
severe cases.
If vomiting is the main cause of fluid loss, metabolic alkalosis with hypochloremia can occur. If
diarrhea is more prominent, metabolic acidosis is more likely. Both vomiting and diarrhea can
cause hypokalemia. Hyponatremia may develop, particularly if hypotonic fluids are used in
replacement therapy.
Symptoms involving the intestines (diarrhea, cramps), together with symptoms involving your
stomach (nausea, vomiting) are the hallmarks of gastroenteritis.
Gastroenteritis symptoms may include:
• Diarrhea.
• Nausea and vomiting.
• Loss of appetite.
• Abdominal pain and cramping.
• Fever.
• Chills.
• Fatigue.
• Body aches.
Gastroenteritis symptoms often come on suddenly. Gastrointestinal symptoms appear first.
Patient might have diarrhea, stomach pain or cramps, nausea and/or vomiting many times in a
short period. As the day goes on, Patient may or may not begin to experience what are called
“systemic symptoms” — symptoms that affect the rest of your body. These may include fever,
chills and body aches.
The most common types of gastroenteritis only last a day or two. The body can overcome most
bacterial and viral infections on its own. Some types may last longer or need treatment to go
away.

Diagnostic Test
General tests
Serum electrolytes, blood urea nitrogen (BUN), and creatinine should be obtained to evaluate
hydration and acid-base status in patients who appear seriously ill.
Complete blood count (CBC) is nonspecific, although eosinophilia may indicate parasitic
infection.
Renal function tests and CBC should be done about a week after the start of symptoms in
patients with E. Coli O157:H7 to detect early-onset hemolytic-uremic syndrome.

Stool testing
Stool testing is guided by clinical findings and the organisms that are suspected based on patient
history and epidemiologic factors (eg, immunosuppression, exposure to a known outbreak, recent
travel, recent antibiotic use).
Treatment
In most cases, gastroenteritis goes away by itself. The best way to help our body recover is to
give it lots of rest and fluids. You might want to stick with bland, easy-to-digest foods for a few
days. But certain, less common causes of gastroenteritis do need treatment. If the symptoms
don’t seem to be going away, or believed that it have a type of toxic poisoning, tell a healthcare
provider.
Medical Treatment
Most of the time, medical treatment for gastroenteritis is supportive. That means the treatment
supports the body’s natural healing process rather than curing gastroenteritis. It might include:
• IV fluids to prevent or correct dehydration and electrolyte imbalances.
• Parenteral nutrition to give your body energy without using the stressed digestive system.
• Medications to treat symptoms like nausea and diarrhea, in certain cases.
But some causes of acute gastroenteritis may need medication to go away. For example, Patient
may need a specific antibiotic or antiparasitic medication to treat a specific type of bacterial or
parasite infection.
If Patient have chemical gastroenteritis due to toxic poisoning, they may need additional
treatment to help clear the toxin out of the body. The treatment will depend on the toxin and on
the condition.

Prevention
Not every case of gastroenteritis is preventable. But there’s a lot we can do to reduce our
personal risk and prevent common gastrointestinal infections from spreading in our communities.
For example:
• Good hand washing. Good hand washing is one of the most important and easiest ways to
protect yourself and others from infections. Lathering with soap for at least 20 seconds removes
germs and toxins from your hands that might transfer to your mouth or to other people.
• Good cleaning. Diligent cleaning is especially important in community places like schools,
daycares, nursing homes and hospitals, where many people use the same facilities every day.
Cleaning with disinfectants can help remove germs that may linger on common surfaces.
• Safe food handling. Food can become contaminated at any stage of production, from harvesting
and storage to cooking and preparation. Remember to wash your hands before and after handling
food. Wash, refrigerate, freeze, cook and serve food according to food safety guidelines.
• Safe travels. It’s especially easy to get food poisoning while traveling abroad. (This is
called traveler’s diarrhea.) You may be exposed to microorganisms there that you wouldn’t meet
at home. When traveling, it’s best to stick to cooked, peeled or packaged foods and bottled water.
• Safe substance use. Only use drugs as directed. If you feel like your medications aren’t doing
enough as directed, or you’re self-medicating with substances, see a healthcare provider for a
better long-term treatment plan. If you have a substance use disorder, treatment can help.

Mortality and Morbidity Rate

Mortality rate
According to the Canters for Disease Control, viral gastroenteritis infections account for over
200,000 childhood deaths per year worldwide. Acute gastroenteritis (AGE), characterized by
diarrhea, vomiting, fever, and abdominal pain, causes 1.3 million deaths globally every year.
Historically, AGE prevention and control efforts have focused on children, but adults experience
a substantial proportion of illness; most US deaths are in older adults. Both viral and bacterial
pathogens play important roles in AGE across all age groups, and norovirus and Clostridioides
difficile are important emerging infectious causes of AGE among US adults, including AGE-
associated death.
In the Philippines, the World Health Organization (WHO) noted that acute gastroenteritis is the
most common cause of morbidity and it ranks among the top 20 causes of mortality. The
standard treatment as provided by WHO is the use of oral rehydration solution, intravenous fluid
if indicated, and zinc supplement. Recently, the use of probiotics has been introduced as an
adjunct to the treatment of acute gastroenteritis; however, its role in the management of the
disease has not yet been fully established.

Morbidity Rate
Gastroenteritis affects children of all ages but is most prevalent in toddlers and young children.
Infectious diarrhea and accompanying dehydration are estimated to be responsible for the deaths
of 2 million children per year worldwide, primarily in developing countries where sanitation and
access to medical care are limited. The most frequent cause of diarrheal disease worldwide is
acute viral gastroenteritis. Men and women are affected equally. Norovirus is the most common
viral cause. It is responsible for 90% of epidemic diarrheal cases worldwide and approximately
50% of all viral gastroenteritis cases. It accounts for 19 to 21 million cases of diarrheal illness
annually in the United States alone. Norovirus causes 50% of all foodborne diarrheal outbreaks.
The number of Acute Gastroenteritis cases in the Philippines amounted to approximately 60.6
thousand in 2020, reflecting a decline from the previous year’s total. The number of diarrhea
cases in the country had fluctuated in the past years.
The number of Acute Gastroenteritis cases in the Philippines amounted to approximately 60.6
thousand in 2020, reflecting a decline from the previous year’s total. The number of Acute
Gastroenteritis cases in the country had fluctuated in the past years.
 ANATOMY AND PHYSIOLOGY

Gastroenteritis is an inflammation of the lining of the stomach, and small and large intestines.
Most cases are infections, although gastroenteritis may occur after ingestion of drugs,
medications, and chemical toxins. You can acquire this by food borne, water borne, and person
to person spread.
Symptoms: anorexia, nausea, vomiting, diarrhea and abdominal discomfort.
Diagnosis is clinical or by stool culture, polymerase chain reaction testing is increasingly used.
Treatment is supportive and directed at symptoms, but some parasitic and some bacterial
infections require specific anti-infective therapy. Infectious gastroenteritis may be caused by
viruses, bacteria or parasites.

STOMACH
Most dilated portion of the digestive system. The esophagus precedes it, and the small intestine
follows. Large muscular and hollow organ allowing for a capacity to hold food. Comprised of 4
main regions, the cardia, fundus, body and pylorus. J-shaped organ that digests food. Digestive
system into which food passes from the esophagus for mincing and digestion before passing to
the duodenum of the small intestine.
DIGESTIVE SYSTEM
Functions of the Digestive System:
Ingestion – food is plaud into the mouth before it can be acted on, this is an active and voluntary
process
Propulsion – foods are to be processed by more than one digestive organ; they must be propelled
from one organ to the next
Breakdown – mechanical digestion, the food molecules are broken down into their building
blocks by enzymes
Absorption – transport of digested and products from inner of the GI tract to the blood or lymph
absorption and go through passive transport processes
Defecation – elimination of the indigestible residues from the GI tract via the anus in the form of
feces.
ANATOMY OF THE DIGESTIVE SYSTEM
The organs of the digestive system can be separated into two main groups. Alimentary Canal
also called the gastrointestinal tract, is a hollow molecular tube that winds through the ventral
body cavity and is open at both ends. Its organs are:
Mouth – food enters the digestive tract through the mouth
Pharynx – from mouth, food passes posteriorly into oropharynx and laryngopharynx
Esophagus – or gullet, runs from the pharynx through the diaphragm to the stomach
Stomach – J-shaped organ that digests food
Small Intestine – the body’s major digestive organ
Large Intestine – dry out indigestible food residue from body as feces

ACCESSORY DIGESTIVE ORGANS

Teeth – masticate or chew by opening and closing jaws, tear and grind the food
Salivary glands – process of starch digestion in the mouth
Pancreas – produces enzymes that break down all categories of digestive foods
Liver – produce bile-concentrated by the removal of water
Gallbladder – when food digestion is not occurring, bile duct, up the cystic duct and enters the
gallbladder to be store.
 BIOGRAPHICAL DATA
Name: Christopher Dave Banugon
Age: 4 years old
Address: Gampis, Sindangan,Zamboanga del Norte
Phone: N/A
Gender: Male
Provider of history (patient or other): Mother
Birth date: July 18, 2019
Place of birth: Malaysia
Advance directive explained: yes no
Race or ethnic background: Filipino
Primary and secondary languages (spoken and read):
Marital status:Single
Religious or spiritual practices: Roman Catholic
Educational level: elementary graduate
Occupation: N/A
Significant pothers or support persons(availability):Mother
Living will on chart? Yes no
REASON FOR SEEKING HEALTH CARE
Reason for seeking health care(major health problem or concern):
Fever, diarrhea and vomiting, abdominal pain.
Feelings about seeking health (fears and past experience):
N/A
HISTORY OF PRESENT HEALTH CONCERN USING COLDSPA:
Character(How does it feel,look,smell,sound,,etc.?):
Random pain and guarding behavior
Onset(When did it begin; is it better, worse, or the same since it began?):
It started on early in the morning last Friday, pain jubsided when he was able to defecate and
repeat.
Location(Where is it?Does it radiate?):
Pain radiate at the upper part of the abdomen.
Duration(How long does it last?Does it recur?):
Severity(How bad is it on a scale of 1 [barely noticeable]to 10[worst pain ever experienced?]):
Pain scale is 5\10, pain is bearablePattern(What makes it better?What makes it worse?):
He will feel better when defecation is done, it did not come to worst, but when pain is felt the
child starts to guard his abdomen.
Associated factors (What other symptoms do you have with it? Will you be able to continue
doing your or other activities [leisure or exercise]?):
Associated factor is body weakness, he is not able to play with his playmate, and siblings due
to the current situation.
Past Health History
Problems at birth: N/A
Childhood illnesses: Common flus like cough, colds, headaches, fever.
Immunization to date: Complete
Adult illnesses (physical, emotional, mental): N/A
Surgeries: N/A
Accidents: N/A
Prolonged pain or pain patterns: N/A
Allergies: N/A
Physical, emotional, social, or spiritual weaknesses : N/A
Physical, emotional, social, or spiritual strenghts: N/A
Family Health History
Age of parents (Living? Date of death?):
27-Mother , 37 Father
Parents”illnesses and longevity
Grandparents’illnesses and longevity: Pneumonia, thyroidism, Hypotension
Aunts’ and uncles’ ages illnesses and longevity: N/A
Children’s ages and illnesses or handicaps and longevity : convulsions, asthma, UTI,
premature birth (7 months)
 REVIEW OF SYSTEM FOR CURRENT HEALTH PROBLEMS

SKIN, HAIR, AND NAILS: Burned scar is noted, cold to touch, silky, shine and thin
color, temperature, condition, hair strands, few small lessions in lower extremeties, dry
rashes, lesions, excessive skin, capillary refill normal, no cyanosis.
sweating, hair loss, dandruff.
HEAD AND NECK: Headache, Nontender, supple neck.
stiffness, difficulty swallowing,
enlarged lymph nodes, sore
throat.
EARS: pain, ringing, impaired No ringing sound has been felt, tympanic membranes
vision, redness, tearing, halos, normal bilaterally, no discharge
blurring, blocks spots, flashes,
double vision.
EYES: pain , infections , Sunken eyeballs
impaired vision, redness, tearing
, halos, blurring, block spots ,
flashes, double vision.
Mouth, Throat, Nose, and Dry mocous membrane, Nasal passess clear, no drooling
Sinuses: mouth pain, sore throat,
lesions, hoarseness. Nasal
obstruction, sneezing, coughing,
snoring, nosebleed.
THORAX AND LUNGS: pain, Increase respiratory rate, normal chst expansion, no
difficulty breathing, shortness of wheezing and SOB and cough
breath with activities , orthopnea
, cough, sputum, hemoptysis,
respiratory infections.
BREASTS AND REGIONAL
LYMPHATICS: pain, lumps,
discharge from nipples , N/A
dimpling or changes in breast
size , swollen and tender lymph
nodes axilla.
HEART AND NECK No murmurs rubs or gallops
VESSELS: chest pain or
pressure, palpitations, edema,
last blood pressure, last ECG.

PERIPHERAL VASCULAR: N/A

leg or feet pain, swelling of feet
or legs, sores on feet and legs.
ABDOMEN: pain, indigestion, Tender, bowel sounds abnormal, nausea, vomiting
difficulty swallowing, nausea
and vomiting , gas, jaundice
hernias.
MALE GENITALIA: painful
urination, frequency or difficulty N/A
starting or maintaining urinary
system , blood in urine, sexual N\A
problems, penile lesions, penile
pain, scrotal swelling, difficulty
when erection or ejaculation ,
exposure to STIs.
FEMALE GENITALIA: pelvic
pain, voiding pain, sexual pain,
voiding problems (date of last N/A
menstrual), pregnancies and
types of problems, abortions,
STIs, HRT, birth control
methods.
ANUS, RECTUM , AND Pain with defecation, defecate 3x a day or when pain
PROSTATE: pain, with recur, diarrhea
defecation, hemorrhoids, bowel
habits , constipation, diarrhea,
blood in stool.
MUSCULOSKELETAL: pain, Normal appearance, and movement of extremeties.
swelling, redness, stiff joints,
strength of extremities, abilities
to care for self and work.
NEURLOGIC: mood, behavior, Attention problems, irritability, decreased energy level,
depression, anger, headache, alert and oriented
concussions, loss of strength or
sensation, coordination,
difficulty with speech, memory
problems, strange, thoughts or
actions, difficulty reading or
learning.
 Gordon's 11 Functional Health Pattern

Gordon’s 11 Functional Before Hospitalization During Hospitalization

Health Pattern
Health Perception and Patients mother verbalized Patients mother sees to it
Health Management
Pattern: and describes his health that gives vegetables and
What is your opinion about status as fair, sometimes fruits to strengthen
health?
Are you immunized about seven gets common colds, cough immunity, never
target diseases?
Last immunization?
and fever. experienced any surgeries
Do you have any allergy? If yes nor accidents with great
then type of allergy.
Any surgery in past? What type
injuries. No allergies as
of surgery? stated by the mother.
Last physical examination & for
what purpose.
Are you using any medicine
recently?
Do you know about these
medicines?

Nutrition and Metabolism Patient eats 3 meals a day Patients appetite was
Pattern:
Ask about their skin, scalp and with snack in kitchen. Good altered due to the illness
nails?
What is your diet menu?
hair condition, skin is experienced. Preferred
Any food restriction regarding warm, nails are trimmed liquid and soft foods.
disease point of view?
Any food restriction regarding
weekly as verbalized by the However, patient recovered
religious point of view? mother. his appetite after receiving
Any food like or dislike?
Any food allergy?
treatments. Gradually
having progress.

Elimination Pattern: Defecates daily, stool is Defecates when pain

Color of urine, amount,
frequency, odor and any brown and formed. Does occurs, or every after 2
discharge.
Any urinary problem, dysuria,
not use any laxatives nor hours. Experienced
Anuria, Oliguria, polyuria. experience problems diarrhea, watery stool.
Are you using any laxative? If
yes which?
defecating. Urines color is Yellowish in color to soft
Any problem during passing yellow without any brown stool.
defecation?
 discharge.

Activity and Exercise Enjoys playing around, Always playing gadgets

Pattern:
Do you any breathing problem? running and walking with due to the circumstances.
(In which apnea, hypoxia,
hypoxemia, hypercapnia.)
playmates. Loves to draw Laying on bed, sometimes
Do you have cough? (Productive and color when tired of the with minimal movements.
or non-productive)
Any changes in heart beat
physical activities as stated Displaying gloomy
during exercise? by the mother. features.
Do you feel pale during
exercise?
What type of exercise you do or
any problem during exercise?

Cognition and Perception Patient is lively, energetic, Patient was aloof and don’t
Pattern:
Orientation about time place and alert having a lot of want to interact because of
person.
Any difficulty in sentence
playmates and friends the
making?
Loss of memory.

Sleep and Rest Pattern: Usually sleeps for 10 hours Sleep most of the time in
Sleeping hour?
Are you using nap (evening type a day with afternoon naps the afternoon or morning.
sleeping)?
What are your rituals before
or more Pain does not occur. Sleep
going to sleep? during night is altered due
Do you use blanket, pillow, stuff
toys or any? How many?
to pain and vital signs
What do you feel after waking? taking, monitoring, and
(Fresh, headache, drowsy).
Are you using any medication
for sleeping?
administering of
Do you have any exercise or medication.
walking at night?

Self-Perception and Self-
Concept Pattern:
What is your self-perception
about yourself?
Are you satisfied with your self-
body image?
Do you like grooming?
Patient is able to express
feelings and pain felt
clearly. Patient act as
independent in doing ADL
such as eating and drinking
water.
Patient’s mother stated that
her child trusted the
treatments and procedure
done, and know that the
healthcare team renders
utmost care for her child.

Roles and Relationships According to the mother, Patient is still dependent on

Pattern:
What is your role in family? the patient brings a lot of her mother for his needs
If you are in hospital then who
will perform your
happiness and joy in the
responsibilities? family
All the family members are
cooperative with you?
Who is decision maker in your
family?

Sexuality and
Reproduction Pattern:
When you first notice changes
in your menarche (first menses
is called menarche)
Do you have any sexual
problem? (Loss of libido)
Active sex (direct sex with male N/A N/A
and female)
Passive sex (sex without male
and female partner)
Digital sex
Reproductive: Infertility

Coping and Stress Patient copes up stress Patient plays non-stop to

Tolerance Pattern:
If you have stress then what is through playing, sometimes his mother’s phone to be
your coping mechanism towards
stress?
crying and asks for some distracted from pain felt
Crying, angry, violence, (what is hugs and “lambing” from and sometimes sleeps when
your opinion regarding that)
his mother as verbalized by tired.
the mother.

Values and Belief Pattern: As verbalized by the The family continues to

What is your religion?
Do you offer prayer? mother, they goes to church pray for the quick recovery
What are your beliefs as a
Christian and as a citizen?
when she is not busy, also of the patient so they can
pray and asks God for go home as soon as
guidance everyday. possible.
 PHYSICAL ASSESSMENT

Physical Assesment Area Normal Findings Abnormal Findings

Vital Sign: BP- 90/50 mmhg RR-
38 cpm, PR- 110 bpm,SPO2- 99
% T-36.5
Height: 121 cm
Weight: 19 kg BMI:13 kg/m2

Observe LOC, posture and body -Awake and alert -Abnormal problems,
 movement, facial expressions, -Normal motor and sensory irritability decreased energy
though process and perceptions. exam level
Assess cognitive abilities -Respond appropriately for
his age N/A
-Alert and orienred
Give client a specimen cup if
sample is needed, ask client to N/A N/A
empty bladder and change into
gown.
Ask cognitive to sit on the N/A N/A
examination table
General Appearance Well-developed male child,
awake and alert, No N/A
cyanosis. His able to speak
With normal-sounding
voice

Skin No cyanosis. Burned scar is noted, cold to

touch, few small lessions, dry
skin.

Hair and Nails Silky, shine, and thin hair N/A

strands, capillary refill
normal

Head Nontender, can turn side to N/A

side, can control the head
and the ROM
Eyes Pupils are equal round, Sunken eyeballs
react to light and
accommodation.
Ears Bilateral, no ringing heard, N/A
no discharges, has the
ability to hear during
normal conversation
Nose Nasal pallages clear, middle N/A.
of the face
Throat and Mouth No drooling N/A
Neck Supple neck N/A
Musculoskeletal- upper Normal appearance and N/A
Extremities movement of extremities
Thorax Nose wheezing and cough,
no SOB N/A
Normal chest expansion
Lungs No restractions or use of Increased RR
accessory muscles
Breast N/A N/A
Lymph nodes No palpable lymph nodes N/A
Breast Malignacy N/A N/A
Heart No murmury rubs or N/A
gallops

Abdomen Round Tender to touch, bowel

sounds abnormal
Musculoskeletal – lower Normal appearance and N/A
extremeties movement of extremeties

Spine Can sit straight N/A

Genetalia ( female) N/A N/A

Anus and rectum Defecate 2-3 times a day Pain with defecation, diarrhea
Genetalia ( female) No enlargement or swelling N/A
of the lymph nodes, no
drainage is noted
Anus and rectum Area are smooth and free of N/A
lesions, swelling,
inflammation, and
tenderness
HEALTH EDUCATION PLAN
Learning Content Outline Methods of Time Instructional Expected
Objectives Instruction Resources Outcomes
After 30 mins of
health teaching
patient/SO will
be able to:

1. Acquire
knowledge about  Acute gastroenteritis is Lecture 5 mins Powerpoint
Acute defined by loose or presentation
Gastroenteritis watery diarrhea that
consists of 3 or more
bowel movements in a
day. Other symptoms
may include nausea,
vomiting, fever, or
abdominal pain [3].
Symptoms usually last
for less than a week,
most often improving
after 1 to 3 days.
2. Determine the
causes of Acute  CAUSES: Lecture 5 mins Powerpoint
Gastroenteritis -viruses, bacteria, presentation
bacterial toxins,
parasites, particular
3. Know the risk chemicals and some
factors of Acute drugs
Gastroenteritis

 RISK FACTORS: Discussion 5 mins Powerpoint

presentation
 Close contact to
person with bacterial
gastroenteritis
(household, daycare)
 Animal exposure:
farm animals, petting
zoo, pet reptiles
 Undercooked meat
or poultry,
unpasteurized dairy
products, raw
shellfish
 Community
outbreaks of specific
bacterial
gastroenteritis
 Exposure to
freshwater

4. Identify the
symptoms of
Acute
Gastroenteritis Interaction 5 mins Powerpoint
presentation
  SYMPTOMS:

 loss of appetite
 bloating
 nausea
 vomiting
 abdominal cramps
 Abdominal pain
 diarrhea
 bloody stools (poo) –
5. Have in some cases
knowlegde  pus in the stools – in
regarding self some cases
care of Acute  generally feeling Exchanging 5 mins Powerpoint
Gastroenteritis unwell – including of ideas presentation
lethargy and body between the
aches. patient/SO
and the
 SELF CARE: student nurse

Rehydration: Drinking plenty

of fluids helps reduce
dehydration from vomiting
and diarrhea. While water is
most helpful, soup and diluted
fruit juice may also help. Pain
relief: OTC medications such
6. Identify when
as acetaminophen can ease
to seek help
fever, aches, and pains. Rest:
when having Exchanging
Getting plenty of rest allows
Acute of ideas 5 mins Powerpoint
the body to recover.
Gastroenteritis between the presentation
patient/SO
and the
student nurse
 Adults and older
children should seek
medical advice if their
symptoms include a
fever, severe abdominal
pain, blood in their
diarrhoea or signs of
dehydration, such as
thirst and decreased
urination, lethargy, dry
mouth, sunken eyes or
feeling faint when
standing.
 Prognosis And Recommendation
Acute gastroenteritis is a common disease that can cause significant discomfort and, in some
cases, can lead to serious complications. However, the prognosis is generally good, especially in
developed countries. It often resolves on its own within a week, though some cases may last
longer.
Here are some recommendations for managing acute gastroenteritis:
1. Hydration: This is the most important aspect of managing acute gastroenteritis.
Because diarrhea and vomiting can lead to dehydration, it’s important to drink plenty of fluids.
Oral rehydration solutions, which are available at pharmacies, can be especially helpful.
2. Rest: Your body needs energy to fight off the infection, so it’s important to get
plenty of rest.
3. Diet: Try to eat when you can, but follow a bland diet. Start with easy-to-digest
foods like rice, crackers, and bananas.
4. Avoid certain foods: Dairy products, fatty foods, highly seasoned foods, and
alcoholic beverages can worsen symptoms.
5. Over-the-counter medication: Certain medications can help manage symptoms.
For instance, bismuth subsalicylate can help with symptoms such as nausea, heartburn, and
diarrhea.
6. Seek medical attention: If symptoms are severe or persist for more than a few
days, it’s important to seek medical attention. Infants, older adults, and people with weakened
immune systems should also see a doctor, as they’re at higher risk of complications.