Childhood Disorders

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Diarrhea / ORT DEFINITION | SIGNS/SYMPTOMS | Most commonly due to acute infectious diarrhea (gastroenteritis) from a variety of causative organismsAntibiotics are a common cause of acute diarrhea! | Acute inflammation of the lining of the stomach and intestines caused by viruses, bacteria or their toxins or parasitesPresents commonly with diarrhea, abdominal cramps, and vomiting.CommunicabilityOften fecal-oral route (especially viruses)Food poisoning (especially bacteria)Day care centers, crowded living conditions, poor sanitation and cleanliness | DIAGNOSTIC TESTS | MAIN TREATMENT | Stool gram stain and culture (if bloody stools)Stool for Ova & Parasites (if hx suggestive)CBC – assess for anemia/infectionUrinalysis and urine culture (r/o UTI)Electrolytes | Oral rehydration therapy (ORT) is one of the major worldwide health advances of the last decade:Safer, less painful, and less costly than IV rehydrationOral rehydration solution enhances and promotes reabsorption of H2O and NaReduces vomiting, diarrhea, and duration of illnessORT GuidelinesDiarrhea w/o dehydrationMild dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet in the older childAdvise them never to try to formulate an OR solution themselves.Teach personal hygiene/ hand washingProper preparation and storage of breast milk or formulaCareful food preparationImmunization for RotavirusAvoid unnecessary antibiotic usage | Acute diarrhea is leading cause of illness in children <5 years (10’s of millions cases in US)65% of hospitalizations and 85% of…...

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