Republic of the Philippines

NUEVA ECIJA UNIVERSITY OF SCIENCE AND

Cabanatuan
TECHNOLOGY City, Nueva Ecija, Philippines
ISO 9001:2015 CERTIFIED

CASE PRESENTATION :

ACUTE
GASTROENTERITIS
IN PEDIATRIC CLIENT
 PREPARED BY :

AZARCON, BENEDICTO, ANDREA BERIN, LYCA

JAMAICA JANE J. LORRAINE G. B.

Ms. Golda Mir Macabitas

HEAD STUDENT NURSE

SEVILLA C. GUINTO MAN,.RN

CLINICAL INSTRUCTOR
CHAPTER 1
GENERAL OBJECTIVES :

• As a level 2 NEUST-CON student nurse, the general

objective of this case study is to be able to gain more
knowledge, improved our skills and acquiring a good
attitude as necessary in dealing with different
patients, perform basic nursing skills with confidence
and competence as well as providing an appropriate
nursing management to a pediatric patient dealing
with Acute Gastroenteritis.
 SPECIFIC OBJECTIVES :
At the end of the clinical duty the student-nurses will be able to:
• 1.Assess the client from head to toe, focusing on the parts affected by the Acute Gastroenteritis;
• 2.Obtain, document, and present a comprehensive medical history;
• 3.Explain the anatomy and physiology of Digestive System;
• 4.Define the Acute Gastroenteritis with Severe Dehydration, become familiar with the important
diagnostic/laboratory examinations that will be used in the confirmatory and management of
Acute Gastroenteritis;
• 5.Understand the pathophysiology of Acute Gastroenteritis
• 6.Recognize the different medications used, its action, side effect and its action in the
management of Acute Gastroenteritis;
• 7.Understand the suggested medical management, employed to resolve problems;
• 8.Formulate appropriate Nursing Care Plan utilizing the Nursing Process; and
• Identify nursing priorities; provide prompt nursing intervention that would help alleviate the
condition of the client thus increasing their capacity to function.
 INTRODUCTION
• Gastroenteritis is characterized by diarrhea or vomiting and is described as
inflammation of the mucus membranes of the gastrointestinal tract. It's a very
common childhood illness. Children in developing countries are at a higher risk of
morbidity and mortality than children in developed countries.
• Although the exact burden and cost of FWBDs are uncertain, they are expected to
be significant. The incidence of diarrheal diseases is estimated to be 3.6 percent of
overall Disability Adjusted Life Years (DALY) worldwide, according to the World
Health Organization (WHO). According to the most recent Department of Health
(DOH) survey, acute watery diarrhea (AWD) is the seventh leading cause of
morbidity, affecting 76.3 people per 100,000. With a prevalence of 0.5 per 1,000 live
births, AWD is also the seventh leading cause of child mortality. Diarrhea is a leading
cause of death in children under the age of five in developing countries, with an
estimated 2 million deaths per year.
• Acute gastroenteritis (AGE) is still a leading cause of death and morbidity in people of all
ages. Human noroviruses and sapoviruses, among other enteric caliciviruses, are now
recognized as essential etiologic agents of this disease. Almost all acute infectious
diarrhea, however, was thought to be caused by bacteria or parasites.
• Acute diarrhea is characterized by a sudden rise in recurrence and changes in stool
consistency. It's usually caused by an infectious agent in the GI tract, but it may also be
caused by upper respiratory or urinary tract infections.
• Antibiotic treatment or the use of laxatives can increase the risk of acute diarrhea in
children. If dehydration does not cause serious problems, it is normally self-limited within
14 days and no new therapy is needed.From 2008 to 2015, the mortality rate for acute
watery diarrhea and acute bloody diarrhea decreased, following the pattern for diarrhea
and gastroenteritis of suspected infectious origin. However, since the mortality rate for
acute watery diarrhea cannot be calculated, separate reporting would be required in the
future.
CLIENT’S PROFILE :
DEMOGRAPHIC PROFILE :
• Name: Patient X
• Age: 6 Years Old
• Date of Birth: March 14, 2015
• Sex: Male
• Civil Status: Child
• Nationality: Filipino
• Religion: Roman Catholic
• Address of parents: Mabini St. Cabanatuan City
• Date of Admission: April 8, 2021
• Attending Physician: Dr. X
 FAMILY HISTORY :

• No family history of the disease related to

acute gastroenteritis.
 HISTORY OF PAST ILLNESS :

• The client had a diarrhea 3 months ago but

is now treated and resolved.
ADMITTING HISTORY
• On April 8, 2021 at around 10:00 AM, a 6-year-old
boy named X is admitted in the Pediatric ward of
ELJH with his parents. According to his mother
complain, the client experienced diarrhea and
vomited for 3 times. The client experienced
restlessness and also fever and the client’s
temperature is at 38.4 C. The client’s final
diagnosis was Acute Gastroenteritis. The client is
now receiving an IV fluid of D5 0.3 NaCL 500ml
bottle, connected to a microset, to run for 8 hours.
ADMITTING VITAL SIGNS

Temperature: 38.4°C
Pulse Rate: 120 bpm
RespiratoryRate: 26 cpm
Blood Pressure: 90/70 mmHg
 PRELIMENARY TESTS DONE
• The preliminary test that is done is Fecalysis
• Notable observation: yellowish and loose
watery stool
STATUS OF PRESENT ILLNESS
• The client shows weakness of the body due to
poor appetite and diarrhea. The mother also
observes that her child has an intermittent fever.
But due to multiple defecations and vomiting the
mother decided to admit the client in the
hospital to know the proper treatment of the
child’s condition.
PHYSICAL ASSESSMENT

Body Part Normal Findings Result

The client’s eyes are sunken and Abnormal

White sclera, pink conjunctiva. sensitive to light.
Eyes Clear pupils and reactive to
light.

Abnormal
Normal, lips are pinkish and The client’s lips are symmetrical.
Mouth His lips are pale and very dry due
symmetrical. to vomiting.

The client’s skin is flushed and Abnormal

The skin is normally uniform, warm to touch. Skin turgor is
Skin whitish pink or brown in color performedTemp: 38.4 degree
defending on the race of client, Celsius
should be moist and soft.
PHYSICAL ASSESSMENT

• All the physical assessment are normal

except for the eyes because the client has a
sunken eyes and experience sensitivity to
light, the client’s mouth are dry and his lips
are pale because of vomiting, and lastly the
client’s skin shows abnormalities because of
having flushed and warm to touch skin
which indicates fever.
CHAPTER II
DEFINITION OF THE CASE
• Acute gastroenteritis (AGE) is a diarrheal disease with a
rapid onset and a variety of symptoms and signs, including
nausea, vomiting, fever, and abdominal pain. It occurs when
pathogenic microorganisms (such as Clostridium perfringens,
Vibrio cholera, and E. Coli) or their toxins are consumed in
food or water. Nausea, vomiting, diarrhea, and abdominal
pain are some of the symptoms. A viral or bacterial
infection, as well as a parasitic infection, is the most common
causes of gastroenteritis.
 ANATOMY AND PHYSIOLOGY
• The gastrointestinal (GI) tract, also known as
the digestive tract, as well as the liver,
pancreas, and gallbladder, make up the
digestive system. From the mouth to the anus,
the GI tract is made up of a series of hollow
organs connected by a long, twisting tube.
• The mouth, esophagus, liver, small intestine,
and large intestine, which includes the rectum
and anus, are the hollow organs that make up
the GI tract. Food enters the mouth and
travels through the GI tract’s hollow organs to
the anus.
• The stable organs of the digestive system are
the liver, pancreas, and gallbladder. The Figure 1: Gastrointestinal Tract
Source: https://images.app.google
digestive system aids in the digestion of food.
PATHOPHYSIOLOGY
 BOOK - BASED PATHOPHYSIOLOGY
Toxicogenic agents
The pathological conditions depend on the *E.coli Pathogenic agents
*Shigella strains *Rotaviruses
causative agent. Toxicogenic agent such as some *Salmonella species

E.coli, and Shigella strains, release an exotoxin that

Toxicogenic agents penetrate the mucosa Attached to the mucosal
impairs intestinal absorption. Invasive pathogens of the small bowel wall
such as some Shigella and Salmonella species and
E.coli, penetrate the mucosa of the small bowel, Release an exotoxin
Destroy cells in the
intestinal villa
causing cellular destruction, necrosis, ulceration,
Impairs intestinal
bleeding, and exudation of protein-rich fluid. absorption
malabsorption of
Pathogens such as rotaviruses attach to the mucosal electrolytes

wall and destroy cells in the intestinal villa, causing Cause cellular destruction, necrosis,
ulceration, bleeding, and exudation
malabsorption of electrolytes. Parasites and toxins of protein-rich fluid.

also interfere with intestinal functioning. The general

Increased Gastrointestinal Increased secretion of fluid
result of all pathogenic agents increased motility electrolytes

gastrointestinal motility and increased secretion of

Fig 2: Pathophysiology of AGE
fluids and electrolytes. Source: Mosby’s Handbook of Diseases pg. 263
 • CLIENT - BASED PATHOPHYSIOLOGY
Modifiable Factors
*Poor Hygiene
The diagram above shows the client- *Poor Sanitation Non- Modifiable Factors

based pathophysiology of a pediatric (Contaminated foods and  *Age

water) 
patient experiencing Acute *Presence of Bacterial
*Sex

Gastroenteritis. The modifiable Infection (E.coli, Shigella and

Salmonella)
factors are poor hygiene; poor  
sanitation like in their environment
there waas a contaminated food and Ingestion of contaminated food and
water
water and presence of bacteria such
as E.coli, Shigella and Salmonella Sign and Symptoms
that will be ingested. The client Diarrhea
Fever
developed signs and symptoms of Poor appetite
having diarrhea, fever, poor appetite, Vomiting
vomiting and feeling of restlessness Restlessness
 
which results to have a fluid and
electrolyte imbalance that leads to Fluid and Electrolyte
Imbalance
dehydration and furthermore
diagnosed with Acute
Dehydration Acute Gastroenteritis
Gastroenteritis.
 •RISK FACTORS
People who may be more susceptible to gastroenteritis
include:
• Young children. Children in child care centers or elementary
schools may be especially vulnerable because it takes time for a
child’s immune system to mature.
• Older adults. Adult immune systems tend to become less
efficient later in life. Older adults in nursing homes, in particular,
are vulnerable because their immune systems weaken and they
live in close contact with others who may pass along germs.
• Anyone with a weakened immune system. If your resistance
to infection is low — for instance, if your immune system is
compromised by HIV/AIDS, chemotherapy or another medical
condition — you may be especially at risk.
•CLINICAL MANIFESTATION
• Book-based • Client-based

• Dehydration (mild, moderate, • Diarrhea

severe) • Fever
• Electrolyte disturbances • Poor appetite
• Abdominal cramps • Vomiting
Malnutrition • Restlessness
• Nausea and Vomiting
• Diarrhea with or without blood and
mucus
• Anorexia
• General Malaise
• Muscle ache

Source : Mosby’s Handbook of Diseases page.263

 •MEDICAL MANAGEMENT
Medical treatment for gastroenteritis include:
• Oral rehydration solution (ORS) is the treatment of
choice for children with mild-to-moderate gastroenteritis
in both developed and developing countries, according to
the American Academy of Pediatrics (AAP), the European
Society of Pediatric Gastroenterology and Nutrition
(ESPGAN), and the World Health Organization (WHO).
 •MEDICAL MANAGEMENT

• IV rehydration. In extreme dehydration, IV access

should be provided, and patients should receive a
60-minute bolus of 20-30 mL/kg lactated Ringer (LR)
or regular saline (NS) solution.
• Diet. In general, children with gastroenteritis should
be put back on a regular diet as soon as possible;
early eating shortens the length of the illness and
improves nutritional outcomes.
 •NURSING MANAGEMENT
• Reduce infection transmission. All caregivers must wear gowns;
when handling feces-contaminated articles, gloves must be worn;
contaminated linens and garments must be placed in specially
designated containers to be handled according to facility policy;
guests are restricted to family members only; teach and follow the
principles of aseptic technique; and good hand washing must be
practiced.
• Promote skin integrity. Cleanse the buttocks and genital region
regularly and apply a calming protective preparation such as lanolin A
or D ointment to minimize itching and excoriation; change diapers as
soon as practicable,and putting disposable pads under the baby may
promote simple and regular changing.
 •NURSING MANAGEMENT
• Prevent dehydration. Count and weigh diapers to accurately
calculate the infant’s output; assess each voiding in the older child;
and keep track of the number and type of stools, as well as the
volume and type of vomitus.
• Maintain adequate nutrition. Weigh the child on the same scale
every day; take measurements in the early morning before the
morning feeding; and keep a close eye on his or her intake and
production. When a child is NPO, good oral hygiene is essential;
when oral fluids are added, the child is given oral replacement
solutions; if the child tolerates these solutions, half-strength formula
may be introduced.
• Maintain body temperature. If there is a fever, monitor vital signs at
least every 2 hours, follow effective fever-reduction protocols, and
administer antipyretics and antibiotics as prescribed.
CHAPTER III
 LABORATORY RESULTS
Fecalysis

02/17/21 Interpretation

Color Yellowish Normal

Consistency Loose watery Sign of Diarrhea

Parasites No OVA or Parasite seen Normal

 LABORATORY RESULTS
Hematology
02/17/21 Results Normal Value Interpretation

Hemoglobin 12.5 11.3 – 14.1 Normal

Hematocrit 0.45 0.31 – 0.41 Increased, dehydration

RBC 4.98 4.6 – 5.2 Normal

WBC 19.1 5 – 10 x 10/L Increased, Infection

Increased, acute bacterial
Neutrophils 9000 1500-8500
infection
Lymphocytes 9700 3000-9500 Increased, Infection

Platelets 297 140 – 340 x 10/L Normal

MCV 77.3 86 – 100 Normal

MCH 26.7 26 – 31 Normal

MCHC 31.9 31 – 37 Normal

 LABORATORY RESULTS
Blood Chemistry

02/17/21 Results Normal Value Interpretation

BUN 11 7 – 17 Normal

Creatinine 0.5 0.2-0.5 Normal

CHAPTER IV
NURSING CARE PLAN
 Outcome
Assessment Diagnosis Identification
Planning Intervention Evaluation

Subjective data: Risk of fluid After 8 hours Short term: Independent: After 8 hours
of nursing
volume of nursing After 4 hours of
“Naka apat na beses nursing Establish rapport intervention
deficit related intervention
na siyang sumuka sa to vomiting the client will intervention, -to gain trust and
participation from the client
the client is
continuosly
bahay” as verbalized as evidenced maintain fluid
the client will and gradually
exhibit moist
by the mother. by dry lips volume at mucous
Assess vital signs.
-Fever that occurs with
regaining
his/her energy.
and poor skin functional membrane and gastroenteritis increases fluid Goal was
Objective data: turgor. level as good skin loss through perspiration and partially met
evidenced by turgor. increased respiration.The
Dry lips stable vital Long term: change in HR is a
Restlessness signs, moist After 8 hours of compensatory mechanism to
maintain cardiac output.
Sunken eyes mucous nursing Usually, the pulse is weak and
intervention no
Poor skin turgor membranes
signs of
may be irregular if electrolyte
imbalance also
Vital signs: and good skin dehydration occurs. Hypotension is
turgor.
Temp: 38.4° will be noted. evident in hypovolemia

PR:120 bpm
RR:26 cpm
BP:90/70mmHg
Assess skin turgor
-Fluid loss occurs first in
extracellular spaces, resulting in
poor skin turgor and dry mucous
membrane

Place the client in a position of

comfort upright or lateral
recumbent as tolerated and
monitor the airway status
-to prevent caspiration

Do not give the client any food

or drinks for several hours of
vomiting

Instruct the client to sip small

amounts of water or suck ice
chips every 15 mins for 3-4
hours.Next, sip clear liquids
every 15 mins for 3-4 hours.
Examples include water, clear
broth, gelatin and apple juice.

Avoid foods spicy foods,

fats/oils, milk and citrus juice.
-it can irritate your stomach or
may be difficult to digest.
Assess intake and output every
shift and assess the color and
amount of urine.
-A decrease in urine volume and
concentrated urine, as evidenced
by a darker urine color, denotes
fluid deficit.

Provide the client with a well-

ventilated room
-a well-ventilated room promote
easier breathing and relaxation .

Dependent:
Administer parenteral fluids as
prescribed.
- if vomiting persists, IV infusion
is used to achieve rehydration.

Admister anti emetic as ordered

-these drugs will reduce vomiting
and the risk for fluid volume
deficit.
 Outcome
Assessment Diagnosis Planning Intervention Evaluation
Identification
Subjective: Diarrhea related to After nursing Short term: Independent: After 8 hours of
After 8 hours of nursing intervention
“Tatlong beses ng presence of toxin intervention, client the clients’ mother
as evidenced by is able to re- nursing intervention Establish rapport
dumudumi ang anak ko the clients’ mother -to gain trust and promote cooperation
reported decrease in
frequency of
frequent establish and
ng lusaw” as verbalized will report decrease with the client elimination of
elimination of maintain normal in frequency of
by the mother bowel functioning.
stools.
watery stools. elimination of stools.Ask the client about the recent history of
drinking contaminated water or After 3 days of
Long term: ingestion of uncooked food. nursing intervention,
the client defecate
Objective: After 3 days of -Ingestion of contaminated food or drink formed soft stool
nursing intervention, may predispose the client to intestinal
-Dry lips the client will infection.
daily.

-Restlessness defecate formed soft Goal was met.

-Sunken eyes stool daily. Evaluate the pattern of defecation.
-Poor skin turgor - Defecation pattern can promote
immediate treatment.
Vital Signs taken as:
T: 38.6 C Assess for abdominal pain, abdominal
PR: 120 bpm cramping, hyperactive bowel sounds.
- These assessment findings are commonly
RR: 28 cpm connected with diarrhea.
BP: 90/70 mmHg
Teach the client about the importance of
hand washing after each bowel
movement and before preparing food for
others.
- Handwashing is the most efficient way to
prevent the transmission of infection to
others.
Teach the client’s mother to boil
drinking water.
- To ensure that drinking water is
safe and clean.

Instruct the mother of the client

to avoid giving BRAT(bananas,
rice, apples, and toast)diet.
-They provide excessive
Carbohydrates and, overall, are
also low in electrolytes
.
Dependent:
Administer antidiarrheal
medications as prescribed:
Erceflora
-Antidiarrheals are commonly used
for treating the diarrhea of
gastroenteritis.
 ASSESSMENT DIAGNOSIS OUTCOME PLANNING INTERVENTION EVALUATION
IDENTIFICATION
Subjective: Hyperthermia related The client will maintain Short term: After 1 hour of
to dehydration as normal body temperature. *After 1 hour of Independent: nursing intervention,
the client’s
“Pagkagising ng anak ko evidenced by performing temperature
ay mainit na siya” as elevated body *Establish rapport decreased to 37.5C.
verbalized by the mother temperature. nursing To gain trust and promote cooperation with
of the patient. intervention, the the client. After 4 hours of
client’s nursing intervention,
Objective: temperature will *Monitor Vital signs. the client’s vital
To provide more accurate indication of core signs returned to it’s
decrease from normal range.
hot, flushed skin 38.6C to 37.5C. temperature.
warm to touch The goal was met.
increased respiratory *Provide tepid sponge bath.
rate. Long term: TSB helps in lowering the body temperature.
After 4 hours of
Vital signs: performing *Encourage ample fluid intake by mouth.
Temp: 38.9 C nursing the patient is dehydrated , therefore fluid loss
PR: 120bpm intervention, the contributes to fever.
RR; 26cpm client’s vital signs
BP: 90/70mmHg *Promote a well ventilated room
will return to Opening the window can supply fresh air for
normal range: a the patients that can help them to improve
temperature of their health.
36.5C to 37.5C, a
pulse rate of 60- Dependent:
100bpm and a
respiratory rate of *Administer anti-pyretic medication as
prescribed by the physician.
12-20cpm. Antipyretic medication are used to treat fever
by reducing body temperature.
CHAPTER V
DRUG STUDY
NAME OF THE MECHANISM OF DOSAGE INDICATIONS CONTRAINDICATIONS NURSING
ACTION
ADVERSE
DRUG CONSIDERATION
EFFECT
Generic name: Acts as antiemetic 1-3 years Prevention of Metoclopramide is Drowsiness Before:
Metoclopramide by blocking 1 mg (1ml) PO nausea/ vomiting contraindicated in Restlessness -Observe the 12 rights of
dopamine receptors 3-5 years children aged less than Rash drug administration
Brand name: and promotes GI 2 mg (2ml) PO 1 year). due to an Seizures -Assess for allergy to
Reglan motility by 5-9 years increased risk of Swelling (especially metoclopramide.
enhancing the 2.5 mg (2.5ml) extrapyramidal hands and feet) -Assess for other
Classification: response to PO disorders Constipation or contraindications
Antiemetic GI stimulant acetylcholine of diarrhea
tissue in upper GI During:
tract causing -Monitor BP carefully
enhanced motility during IV administration.
and accelerated - Monitor for
gastric emptying extrapyramidal reactions,
without stimulating and consult physician if
gastric, biliary, or they occur.
pancreatic -For IV infusion, give
secretions and over at least 15 minutes.
increases lowe
esophageal After:
sphincter tone -Educate the parents about
the possible side effects
-Disposed of used
materials properly
 Mechanism of
Name of Drug Action Dosage Indication Contraindication Adverse Effects Nursing Consideration
Generic Name: Contributes to Acute diarrhea Ascertained No known Before:
Bacillus Clausii the recovery of Dosage: with duration of hypersensitivity adverse effects. -Observe the 12 rights of drug
the intestinal Children 2-11 years: 1- <14 days due to towards the
Brand Name: microbial flora 2 vials per day infection, drugs or components of administration
Erceflora altered during poisons. Chronic the product.
the course of Route: Oral or persistent -Check and verify with doctor’s
Classification: microbial diarrhea with order and Kardex.
Anti-diarrheal disorders of Frequency: OD duration of >14  
diverse origin. It days.
produces various Stock on hand: During:
vitamins, 2 billion/ 5 mL -Administer drug orally.
particularly suspension  
group B vitamins After:
thus contributing
to correction of  
vitamin -Monitor patient for any unusual
disorders caused effects from drug.
by antibiotics & -Disposed of used materials
chemotherapeuti
properly
c agents.
Promotes
normalization of
intestinal flora.
NAME OF THE DRUG MECHANISMS OF DOSAGE INDICATION CONTRAINDICATION ADVERSE NURSING CONSIDERATION
ACTION REACTION

Generic Name: Paracetamol is an Dosage: Used in the relief Contraindicated in Before:

Paracetamol analgesic and 60mg/kg of mild to moderate patients with known Thrombocytopaenia, -Observe the 12 rights of drug
antipyretic. It’s fever. hypersensitivity to anaphylaxis, skin administration
Brand Name: mechanism of Route:Oral paracetamol or any rashes, and -Explain to the client’s relatives
Calpol action is believed other components of angioedema. what are the possible side effects of
to include Frequency: the formulation. the medication.
Classification: inhibition of q4h -Check that the patient is not taking
Antipyretic and prostaglandin any other medication containing
Analgesic synthesis, primarily Stock on paracetamol.
within the central hand:
nervous system. 120mg/5ml During:
suspension -Shake well before use.
-Make sure that the patient must not
exceed the recommended dose.

After:.
-Monitor any adverse reaction
towards medication
-Stores at temperature not
exceeding 30c. keep out of direct
light exposure.
-Keep out of reach of children.
CHAPTER VI
 Evaluation and Findings
• After conducting the study, the student-nurses
were able to appreciate more the essence of
utilizing the nursing process by providing clinical
care and management for the pediatric client.
Acute diarrhea is an abrupt increase in
recurrence and changes in consistency of stools.
Infants and children are in danger or at risk for
the development of dehydration and malnutrition
which is two significant outcomes of the diarrhea.
 Evaluation and Findings
• Acute Gastroenteritis is an inflammation of the
gastrointestinal tract in both the stomach and small and
large intestine. The digestive system is concerned with
digestion and absorption of food. Therefore, the inner
lining of the digestive tract serves as a protective barrier
to those indigestible and harmful materials while
allowing for the specific absorption of nutrients across
the wall of the digestive tract. Once across the wall of
the digestive tract, the nutrients enter the blood and are
distributed to the tissues of the body.
 Evaluation and Findings
• Early accurate detection is important to improve
patient outcomes. This study provides the student-
nurses a huge knowledge and understanding with
regards on taking good care of a pediatric client in
the real clinical setting and taught the student-
nurses to provide client’s care more efficiently and
competently to achieve an effective and quality
nursing care.
 RECOMMENDATION
• Children who are old enough should be
taught to wash their hands and avoid
improperly stored food and contaminated
water.
• All of the food that is placed out for
consumption should be consumed within an
hour.
• Parents should encourage their child to
drink fluids even if just in small frequent
amounts.
 RECOMMENDATION
• Parents should not allow their children to swim in public
water if they have diarrhea.
• Children who are vomiting should be given small amounts
of fluid to prevent dehydration.
• Infants and children with weakened immune system
should not touch reptiles, birds or amphibians because
these types of animals typically carry salmonella bacteria
that can cause severe infection and diarrhea.
• Parents should teach their children to avoid swallowing of
water when they swim.
 THANK
YOUUUUUU!!! :)