ASSESS

AND
CLASSIFY DIARRHEA
DIARRHEA:
 Occurs when stools contain more water than
normal. Diarrhea is also called loose watery
stools. It is common in children 6 months to 2
years of age.
 Defined as 3 or more loose watery stools in a 24
hour period
TYPES OF DIARRHEA
 Acute diarrhea=last less than 14 days, acute watery
diarrhea causes dehydration and contributes to
malnutrition.
 Persistent Diarrhea= last for 14 days or more, often
causes nutritional problems
 Dysentry- diarrhea with blood in the stool, with or
without mucus ,most common cause of dysentry is
shigella bacteria. Amoebic dysentry is not common
in young children.
ASSESS DIARRHEA

 A child with diarrhea is assessed for:

1. How long the child has had
diarrhea?
2. Blood in stool to determine if the
child has dysentery and
3. For signs of dehydration
 For how long?
Diarrhea which last for 14 days or more
 Is there blood in the stool?

CHECK FOR SIGNS OF DEHYDATION

When the child becomes dehydrated he/ she is
restless and irritable. If dehydration continues,
the child becomes abnormally sleepy or difficult
to awaken.
LOOK AND FEEL FOR THE FOLLOWING SIGNS

 Look for sunken eyes

 A child not able to drink

 Pinch the skin of the abdomen. Does it goes back

very slowly or longer than 2 seconds
A. Very slowly (longer than 2 seconds)
B. Slowly

C. Immediately
CASE 1

Joel has had diarrhea for 5 days. He has no

blood in the stool. He is irritable. His eyes are
sunken. His father and mother also thinks that
Joel’s eyes are sunken. The health worker
offer some water, and the child drinks eagerly.
When the health worker pinches the skin of
the child’s abdomen, it goes back slowly.
ANSWER IS = SOME DEHYRATION
CLASSIFY DIARRHEA

 All children with diarrhea are classified for

DEHYDRATION,
 If the child had diarrhea for 14 days or
more, classify the child for PERSISTENT
DIARRHREA.
 IF THE CHILD HAS BLOOD in the
stool, classify as DYSENTERY.
 CLASSIFY DEHYDRATION

I. SEVERE
DEHYDRATION
II. SOME DEHYDRATION
III.NO DEHYDRATION
CLASSIFY PERSISTENT DIARRHREA AND SEVERE
DIARRHREA
 CLASSIFY DYSENTERY
 Classify a child with diarrhea and blood in the stool
as having DYSENTERY
Treatment:
Treat the child dehydration. Also give antibiotic as
recommended for shigella in your area. You can
assume that shigella can cause of dysentery because
 Shigella cause 60% of dysentery cases seen in health
centers, and cause of life threatening dysentery
 TREATMENT

Give multivitamins and minerals

including ZINC for 14 days.
Give one dose of VIT.A. Special
feeding is the most important for
persistent diarrhea.
CASE 2
 Fatima is 18 months old. She weighs 11.5 kg. Her temperature is 37.5 °C. The health worker
asked, “What are the child’s problems?” The mother said “Fatima has been coughing for 6 days,
and she is having trouble breathing.” This is the initial visit for this illness.
 The health worker checked Fatima for general danger signs. The mother said that Fatima is able

to drink. She has not been vomiting. She has not had convulsions during this illness. The health
worker asked, “Does Fatima seem unusually sleepy?” The mother said, “Yes.” The health worker
clapped his hands. He asked the mother to shake the child. Fatima opened her eyes, but did not
look around. The health worker talked to Fatima, but she did not watch his face. She stared
blankly and appeared not to notice what was going on around her.
 The health worker asked the mother to lift Fatima’s shirt. He then counted the number of breaths

the child took in a minute. He counted 41 breaths per minute. The health worker did not see any
chest indrawing. He did not hear stridor.
 The health worker asked, “Does the child have diarrhoea?” The mother said, “Yes, for 3 days.”

There was no blood in the stool. Fatima’s eyes looked sunken. The health worker asked, “Do you
notice anything different about Fatima’s eyes?” The mother said, “Yes.” He gave the mother some
clean water in a cup and asked her to offer it to Fatima. When offered the cup, Fatima would not
drink. When pinched, the skin of Fatima’s abdomen went back slowl

WHAT IS OUR CLASSIFICATION BASED on our Case?

ANSWER
SHUKRAN KATIR!!!!
THANK YOU SO
MUCH