PATHOPHYSIOLOGY OF ACUTE GASTROENTERITIS WITH NECATORIASIS

MODIFIABLE FACTORS: infectious agent ( Acylostoma duodenale, Necator americanus); Hygiene; Food preparation; Safety Gears Oral (A. Duodenale) Entry into the small intestine Hematophagy Iron depletion Secondary irondeficiency anemia O2 binding capacity of RBC Hypoxemia tissue oxygenation Respiration shifts to anaerobic Lactic acid formation Entry of filariform into the body Dec. Absorption of proteins

NON-MODIFIABLE FACTORS: - Inherent susceptibility; Weak immunity; Endemicity of infectious agent Percutaneous (N.Americanus) Maculopapular rashes Pruritus Dew itch Papulovesicular eruption Post- eruption skin lesions Bleeding Hemoptysis Bronchitis Infiltration of parenchyma Pneumonitis CO2 Eosinophils / leukophils infiltration Respi. acidosis oxygenation Airway obstruction Ascending URT Larva enters the bloodstream Accumulation in the lungs Infiltration of parenchyma

Hypoalbuminemia Abdominal pain Villi damage Bleeding Melena Entry of intestinal bacteria Establishment of infection Bacteremia

Luminal trauma

Dec. osmotic pressure Steatorrhea

Edema

Exposure to other intestinal microorganisms

Inflammation of lumen

Development of hemorrhage

mucus production HCO3- wasting Metabolic acidosis Septic shock Compensatory fluid shift intraluminally

Lung consolidation

Lactic acidosis Expulsion of ova Cerebral hypoxia Hypoxic encephalopathy Depression of vasomotor and respiratory center Respiratory arrest Death Aldosterone release Na reabsorption Fluid retention LOC cerebral perfusion

Diarrhea Fluid and electrolyte imbalance

GI motility

Compression Lung compliance DOB

Compensatory hyperventilation RR

(+) ova in stool Dry mouth

Dehydration

Sunken eyeballs

Poor skin turgor

circulating volume C.O. Hypotension Accumulation of metabolic products Tachycardia

Hypovolemia Adrenal perfusion Cortical activation

renal perfusion Release of rennin from juxtaglomerular apparatus Renin combines with angiotensin Angiotensin I Combination with ACE

GFR urine output

catecholamines , agonist BP PR

azotemia Urine concentration Uremia

edema

Angiotensin II Vasoconstriction and Na retention BP Inhibitory feedback to BP

Prepared by: Ralph R. delos Santos BSN III-2 Pamantasan ng Lungsod ng Maynila College of Nursing Case Study on Acute Gastroenteritis with Moderate Dehydration and Intestinal Parasitism