I.

INTRODUCTION

Acute Gastroenteritis (AGE)

Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the
stomach and intestine. It is frequently referred to as the stomach or intestinal flu, although the
influenza virus is not associated with this illness. Major symptoms include nausea and
vomiting, diarrhea, and abdominal cramps. These symptoms are sometimes also accompanied
by fever and overall weakness. Gastroenteritis typically lasts about three days. Adults usually
recover without problem, but children, the elderly, and anyone with an underlying disease are
more vulnerable to complications such as dehydration.

Gastroenteritis arises from ingestion of viruses, certain bacteria, or parasites. Food that has
spoiled may also cause illness. Certain medications and excessive alcohol can irritate the
digestive tract to the point of inducing gastroenteritis. Regardless of the cause, the symptoms
of gastroenteritis include diarrhea, nausea and vomiting, and abdominal pain and cramps.
Sufferers may also experience bloating, low fever, and overall tiredness. Typically, the
symptoms last only two to three days, but some viruses may last up to a week.
A usual bout of gastroenteritis shouldn't require a visit to the doctor. However, medical
treatment is essential if symptoms worsen or if there are complications. Infants, young
children, the elderly, and persons with underlying disease require special attention in this
regard.
The greatest danger presented by gastroenteritis is dehydration. The loss of fluids through
diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life-
threatening problems such as heart beat abnormalities (arrhythmia). The risk of dehydration
increases as symptoms are prolonged. Dehydration should be suspected if a dry mouth,
increased or excessive thirst, or scanty urination is experienced.
If symptoms do not resolve within a week, an infection or disorder more serious than
gastroenteritis may be involved. Symptoms of great concern include a high fever (102 ° F
[38.9 °C] or above), blood or mucus in the diarrhea, blood in the vomit, and severe abdominal
pain or swelling. These symptoms require prompt medical attention.

Gastroenteritis is a self-limiting illness which will resolve by itself. However, for comfort and
convenience, a person may use over-the-counter medications such as Pepto Bismol to relieve
the symptoms. These medications work by altering the ability of the intestine to move or
secrete spontaneously, absorbing toxins and water, or altering intestinal microflora. Some
over-the-counter medicines use more than one element to treat symptoms.
 II. Patient’s Profile

S.Q. is a female, 11/12 months old, residing at P2 Blk1 L38 Pabahay Nanadero,
Calamba City, Laguna. Her mother is J.Q., works part time in a shop and her father
is R.Q., factory worker. She has one sibling older than her, K.Q., 3 years old. S.Q.
was born on March 6, 2009, and born at Calamba, Laguna, Filipino in nationality.
Their whole family is Born Again in religion. She weighs 8.7 kg. She’s admitted on
January 30, 2010 at room 103-C, pedia ward with chief complaint of high fever for
2 days with emesis and has a diagnosis of Acute Gastroenteritis. And she was
discharged on January 6, 2010, Saturday at 1:30 pm. Their attending physicians
were Campos, Angelie, M.D. and Bonagua, Aireen, M.D.

III. Health History & Chief Complain

Chief Complaint

She was admitted for having high fever for 2 days with vomiting.

Present Illness

S.Q. was only admitted to the hospital due to gastrointestinal problem now and was also
suspected of urinary tract infection by Dra. Campos. Aside from the diagnosis, no other
disease or complication was seen or diagnosed.

Past Health History

Mrs. Q says “ eto first time nya ma-admit after nya ipanganak.” S.Q. gets seasonal
cough and colds at times but never serious because it usually last only for a few days. They
always consult their doctor once sick. She is complete in her vaccinations except those which
would be taken on her 1 year of age.

Family Health History

No one in the family had any respiratory illness or allergies. On her father’s side,
almost all have hypertension. One member of their family died on a heart attack.

IV. Gordon’s Pattern

Health Perception

As Mrs Q. stated, “lagi naman kami nagpapacheck up ni stephani. Napunta

talaga kami kay Dra. Campos. Malikot lang talaga yan pero inaalagaan yan sa bahay.”
S.Q. has a mannerism of sticking anything on her mouth. Whatever she touches she
directs it toward her mouth. Although, she doesn’t practice hand washing every now
and then. There are some medications she takes easily but there are also those
medications which is hard for her because of the taste.

Nutritional-Metabolic

S.Q. weighs 8.7 kg. She eats soft foods. She drinks 6-7 bottles of milk in a day.
Mrs. Q provides her daughter milk and food in accordance to age and doctor’s advise.
She drinks formula milk. She stop being breastfed when she was 10 ½ moths. She has
no allergy.

Elimination

She defecates once or twice a day in her usual days. She changes diaper 3-5
times in a day when full or had defecated. She was advise to use Lactacid for her
perennial wash and calmoseptin ointment on her diaper rash.

Activity-Exercise

S.Q. is a very playful and active girl. She has lots of energy but cries when she
doesn’t like something. She smiles and laughs a lot. Her coordination, gait, balance is
not yet stable due to age. Her daily living activities were provided by her parents. There
is no musculoskeletal impairment. She usually plays after she wakes up in the morning.

Sleep-Rest

She sleeps at 8 P.M. in the evening and usually gets up 7 A.M. – 8 A.M. in the
morning. After playing or eating she takes a nap. She has straight undisturbed sleep at
night.

Cognitive Perceptual

S.Q. has no sensory deficits. She response well to verbal stimulus by looking at
you or having facial expressions. “Bibo nga yan bata nay an, makulit pero mabilis mo
naman makuha attention,” as her mother stated.

Self-Perception

S.Q. is not afraid of new people around her. She is friendly and is easy to
accommodate.

Sexual-Reproduction

Prior to age, S.Q. is not yet oriented with any sexual matters.
 Coping Stress

In her age, she usually cries when something is wrong about her. Simple smile or
cry is a sign of her comfort, distress or feelings. She is familiarized to her family
members and long for them when she doesn’t want the situation like giving of
medications or other procedures.

Role-Relationship

She doesn’t know the concept of death yet due to age. Forms words like “dede”
and “dada”. She knows her family members and can easily familiarize the people
around her.

Value-Belief

The family is Born Again. They regularly attend church together with all the
members of the family. They don’t usually believe in “hilot”. Once one is sick in the
family, they go immediately to the hospital or for check-up.

V. Head-to-Toe Assessment

General Assessment: Playful and active, neat

Initial Vital Sign: T=36.4°C RR=27 PR=118

Area Assessed Technique Normal Findings Actual Findings Evaluation

Skin
Color Inspection Light brown, brown skin Normal
tanned skin (vary
according to race)
Lips, nail beds, Lighter colored Lighter colored
soles and palms Inspection palms, soles, lips palms, soles, lips and Normal
and nail beds nail beds
Moisture Inspection/ Skin normally dry Skin normally dry Normal
Palpation
Temperature Palpation Warm to touch 36.4 o C, warm to Normal
touch
Smooth, soft and Smooth, soft and
Texture Palpation flexible palms and flexible palms and Normal
soles (thicker) soles (thicker)

Turgor Palpation Skin snaps back Skin snaps back Normal

 immediately immediately 1-2
seconds
Skin appendages
a. Nails
Inspection Transparent, Transparent, smooth Poor
smooth and and convex grooming
convex cut and Uncut and dirty
clean
Nail beds Inspection Pinkish Pinkish Normal
Nail base Inspection Firm Firm Normal
White color of White color of nail
nail bed under bed under pressure
Capillary refill Inspection/ pressure should returned to pink Normal
Palpation return to pink within 2-3 seconds
within 2-3
seconds
b. Hair
Distribution Inspection Evenly distributed Evenly distributed Normal
Color Inspection Black Black Normal
Texture Inspection/ Smooth Smooth and curly Normal
Palpation
Eyes
Eyes Inspection Parallel to each Parallel to each other May be a
other but slightly sunken sign of
dehydration
Visual Acuity Inspection PERRLA- Pupils PERRLA- Pupils Normal
(penlight) equally round equally round react to
react to light and light and
accommodation accommodation
Eyebrows Inspection Symmetrical in Symmetrical in size, Normal
size, extension, extension, hair texture
hair texture and and movement
movement
Eyelashes Inspection Distributed evenly Distributed evenly Normal
and curved and long curved
outward outward
Eyelids Inspection Same color as the Same color as the Normal
skin skin

Blinks Blinks involuntarily

involuntarily and and bilaterally up to Normal
bilaterally up to 16 times per minute
20 times per
minute Do not cover the
 pupil and the sclera, Normal
Do not cover the lids normally close
pupil and the symmetrically
sclera, lids
normally close
symmetrically
Conjunctiva Inspection Transparent with Transparent with light Normal
light pink color pink color
Sclera Inspection Color is white Color is white Normal
Cornea Inspection Transparent, Transparent, shiny Normal
shiny
Pupils Inspection Black, constrict Black, constrict Normal
briskly briskly
Iris Inspection Clearly visible Clearly visible Normal
Ears
Ear canal Inspection Free of lesions, Free of lesions, Normal
opening discharge of discharge of
inflammation inflammation

Canal walls pink Canal walls pink Normal

Hearing Acuity Inspection Client normally Client normally hears
hears words when words when Normal
whispered whispered
Nose
Shape, size and Inspection Smooth, Smooth, symmetric
skin color symmetric with with same color as Normal
same color as the the face
face
Nasal septum Inspection Close to midline, Close to midline,
thicker anteriorly thicker anteriorly than Normal
than posteriorly posteriorly

Nares Inspection Oval, symmetric Oval, symmetric and

and without without discharge Normal
discharge

Mouth and
Pharynx
Lips Inspection Pink, moist Pink, moist Normal
symmetric symmetric

Buccal mucosa Inspection Glistening pink Glistening pink soft Normal

soft moist moist
 Gums Inspection Slightly pink Slightly pink color,
color, moist and moist and tightly fit Normal
tightly fit against against each tooth
each tooth
Tongue Inspection Moist, slightly Moist, slightly rough
rough on dorsal on dorsal surface Normal
surface medium medium or dull red
or dull red
Teeth Inspection Firmly set, shiny Firmly set, shiny Normal
No tooth decay, milk
tooth present
Hard and soft Inspection Hard palate- Hard palate- dome-
palate dome-shaped shaped Normal
Soft Palate- light Soft Palate- light pink
pink
Neck
Symmetry of Neck is slightly Neck is slightly hyper
neck muscles, Inspection hyper extended, extended, without Normal
alignment of without masses or masses or asymmetry
trachea asymmetry
Neck Rom Inspection Neck moves Neck moves freely, Normal
freely, without without discomfort
discomfort
Thyroid gland Palpation Rises freely with Rises freely with Normal
swallowing swallowing
Trachea Inspection Midline Midline Normal
Thorax and Auscultatio Clear breath Clear breath sounds Normal
Lungs n sounds
Abdomen Inspection Skin same color Skin same color with Normal
with the rest of the rest of the body
the body
Clicks or gurling
Bowel sounds Auscultatio Clicks or gurling sounds occur
n sounds occur irregularly and range Normal
irregularly and from 5-35 per minute
range from 5-35
per minute
Neurology
system
Level of Inspection Fully conscious, Fully conscious,
consciousness respond to respond quickly to Normal
questions quickly, stimulus
perceptive of
events Unstable gait, balance
 and coordination Normal for
age (11
months)
Behavior and Inspection Makes eye Makes eye contact
appearance contact with with examiner,
examiner, hyperactive expresses Normal
hyperactive feelings with
expresses feelings response to the
with response to situation
the situation

VI. Anatomy & Physiology

Digestion is the process by which food is broken down into smaller pieces so that the body
can use them to build and nourish cells and to provide energy. Digestion involves the
mixing of food, its movement through the digestive tract (also known as the alimentary
canal), and the chemical breakdown of larger molecules into smaller molecules. Every
piece of food we eat has to be broken down into smaller nutrients that the body can absorb,
which is why it takes hours to fully digest food.

The digestive system is made up of the digestive tract. This consists of a long tube of
organs that runs from the mouth to the anus and includes the esophagus, stomach, small
intestine, and large intestine, together with the liver, gall bladder, and pancreas, which
produce important secretions for digestion that drain into the small intestine. The digestive
tract in an adult is about 30 feet long.

Mouth and Salivary GlandsDigestion - begins in the mouth, where chemical and
mechanical digestion occurs. Saliva or spit, produced by the salivary glands (located under
the tongue and near the lower jaw), is released into the mouth. Saliva begins to break down
the food, moistening it and making it easier to swallow. A digestive enzyme (called
amylase) in the saliva begins to break down the carbohydrates (starches and sugars). One
of the most important functions of the mouth is chewing. Chewing allows food to be
mashed into a soft mass that is easier to swallow and digest later.

Esophagus - Once food is swallowed, it enters the esophagus, a muscular tube that is about
10 inches long. The esophagus is located between the throat and the stomach. Muscular
wavelike contractions known as peristalsis push the food down through the esophagus to
the stomach. A muscular ring (called the cardiac sphincter) at the end of the esophagus
allows food to enter the stomach, and, then, it squeezes shut to prevent food and fluid from
going back up the esophagus.

Stomach - a J-shaped organ that lies between the esophagus and the small intestine in the
upper abdomen. The stomach has 3 main functions: to store the swallowed food and liquid;
to mix up the food, liquid, and digestive juices produced by the stomach; and to slowly
empty its contents into the small intestine.

Small Intestine - Most digestion and absorption of food occurs in the small intestine. The
small intestine is a narrow, twisting tube that occupies most of the lower abdomen between
the stomach and the beginning of the large intestine. It extends about 20 feet in length. The
small intestine consists of 3 parts: the duodenum (the C-shaped part), the jejunum (the
coiled midsection), and the ileum (the last section). The small intestine has 2 important
functions. First, the digestive process is completed here by enzymes and other substances
made by intestinal cells, the pancreas, and the liver. Glands in the intestine walls secrete
enzymes that breakdown starches and sugars. The pancreas secretes enzymes into the small
intestine that help breakdown carbohydrates, fats, and proteins. The liver produces bile,
which is stored in the gallbladder. Bile helps to make fat molecules (which otherwise are
not soluble in water) soluble, so they can be absorbed by the body. Second, the small
intestine absorbs the nutrients from the digestive process. The inner wall of the small
intestine is covered by millions of tiny fingerlike projections called villi. The villi are
covered with even tinier projections called microvilli. The combination of villi and
microvilli increase the surface area of the small intestine greatly, allowing absorption of
nutrients to occur. Undigested material travels next to the large intestine.

Large intestine - forms an upside down U over the coiled small intestine. It begins at the
lower right-hand side of the body and ends on the lower left-hand side. The large intestine
is about 5-6 feet long. It has 3 parts: the cecum, the colon, and the rectum. The cecum is a
pouch at the beginning of the large intestine. This area allows food to pass from the small
intestine to the large intestine. The colon is where fluids and salts are absorbed and extends
from the cecum to the rectum. The last part of the large intestine is the rectum, which is
where feces (waste material) is stored before leaving the body through the anus. The main
job of the large intestine is to remove water and salts (electrolytes) from the undigested
material and to form solid waste that can be excreted. Bacteria in the large intestine help to
break down the undigested materials. The remaining contents of the large intestine are
moved toward the rectum, where feces are stored until they leave the body through the
anus as a bowel movement.
VII. Pathophysiology
VIII. Course in the Ward

On day 1, January 30, 2010, at 8:40 am S.Q. is for check up with her attending
physician due to high fever for 2 days associated with vomiting. She was seen and
examined by Dra. Campos and was advised to be admitted for further test and treatment
due to suspected UTI. She was diagnosed with Acute Gastroenteritis. An IVF D5 INM
500 ml x 10cc/hr is hooked and CBC was done. She was brought to pedia ward at
around 11:00 am and received by nurse on charge. Monitoring of input and output was
ordered by the doctor with increase fluid intake. Medications were Paracetamol drops 1
ml every 4 hours for fever. 1 dose was given on admission and following doses for
every 4 hours was given.

On the second day, January 31, 2010, IVF was changed to #2 D5 INM 500 ml x 10cc/hr
at 9:50 am. She was seen by Dra. Campos at 10:15 am and given an order of urinalysis
and fecalysis. She was prescribed with Omeprazole (Omepron) 5mg IV once a day, 1st
dose is given at 8:00 am the next morning. Also, Zinc Sulfate (E-Zinc) drops (0.6 ml)
once daily was ordered. Her fever decreases gradually unitl there administration of
paracetamol every 4 hours for fever was discontinued. She is being given Ceftriaxone
(Xtenda) 750 mg IV once a day side drip every 12 noon. She was playful all through
out the day. The laboratoty results was followed up.

On the third day, February 1, 2010, Monday, she was crying when received. She has
fever of 37.9 °C and administration of Paracetamol drops 1 ml every 4 hours was
resumed. She has been irritable all day. 10:40 am Dra. Campos, examined S.Q. and was
refered to Dr. Zablan due to decreased results of urinalysis. All laboratory results were
seen by Dra. Campos. During the afternoon, her fever subsides to 37.2 °C . IVF #3 D5
INM 500 ml x 10 cc/hr was hooked at 1:00 pm. All medications were given.

On the fourth day, February 2, 2010, Tueasday, she has no fever, negative vomiting and
playful. Dra. Campos had her round at 4:50 pm and checked S.Q. she ondered continue
all medications and treatment and wait for Dr. Zablan’s assessment. IVF #4 D5 INM
500 ml x 10 cc/hr was hooked at 11:30 am.

On the fifth day, February 3, 2010, Wednesday, Dr. Zablan had his round at 11:30 am.
Findings were with positive diaper rash, decrease laboratory results and afebrile, no
vomiting. He ordered repeat UA from AM (clear catch), urine culture and sensitivity,
use of Lactacid pink for perennial wash, and apply Calmoseptin ointment to diaper rash
3x a day. IVF #5 INM 500 ml x 10cc/hr was hooked at 12:15 nn.

On the sixth day, February 4, 2010, Thursday, Dra. Campos ordered continue all
medications and follow order of Dr. Zablan. IVF #6 INM 500 ml x 10cc/hr was hooked
at 11:00 am. S.Q. is received active, playful but cries at times. All medications were
given on time. Dr. Zablan saw laboratory results and advise client to increase fluid
intake and replace loses with PLRS. Follow up urine culture and sensitivity. Repeat
 urinalysis and notify him when WBC is 1-3. IVF #7 INM 500 ml x 10cc/hr was hooked
at 1:00am.

On the seventh day, February 5, 2010, Friday, Dra Campos ordered continue all
medeications and treatments. Proceed to Dr. Zablan’s orders. All 8:00 am medications
were given. S.Q. is taking a bath, playful and laughing when received. IVF was
regulated. IVF was ordered to shift to D5 IMB ½ L x 20 cc/hr. IVF #8 IMB ½ L x 20
cc/hr was hooked at 11:30 am. Dr. Zablan had his round at 11:45, he checked S.Q. and
the laboratory test. He said all test were now stabilized and normal. He ordered follow
up of urine culture and sensitivity and advised periodic complete emptying of urinary
bladder.

On the eighth day, February 6, 2010, Saturday, all findings were on normal range. S.Q.
is afebrile, no vomiting, diminished diaper rash, and was active and playful. All
morning medications were given. IVF #9 imb ½ l X 20 cc/hr was hooked at 10:45 am.
Dra. Campos, advised that they may go home. S.Q. was discharge at 1:30 pm.

IX. Laboratory Results

Urinalysis

01/30 Int. 01/31/ Int. 02/03/ Int. 02/05 Int.

/10 10 10 /10
Color Yellow Normal Yellow Normal yellow Normal Light Normal
Yello
w
Transparenc SI increased SI increased Clear Normal Clear Normal
y turbid urine turbid urine
concentrati concentrat
on ion
Reaction 5.5 Decreased 6.0 Normal 6.0 Normal 8.0 Normal
Specific 1.025 Normal 1.010 Normal 1.025 Normal 1.010 Normal
Gravity
Albumin Traces Normal Traces Normal +1 UTI (-) Normal
Sugar (#) Increase (-) Normal (-) Normal (-) Normal
sugar
WBC 7-10 Infection 15-20 Infection 28-30 Infection 1-3 Normal
Fecalysis

01/31/10 Interpretation
Color Green Sign of diarrhea
Consistency Soft Sign of diarrhea
Parasites No OVA or parasites seen Normal

Hematology

01/30/10 Results Normal Value Interpretation

Hemoglobin 123 120-150 Normal
Hematocrit 0.38 0.37-0.45 Normal
RBC 4.98 4.6-5.2 Normal
WBC 19.1 5-10 x 10/L Increase, infection
Neutrophils 0.77 0.55-0.65 Increase, acute
bacterial infection
Lymphocytes 0.23 0.25-0.35 Decrease, may cause
severe malnutrition
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

Blood Chemistry

01/30/10 Results Normal Value Interpretation

BUN 11 7-17 Normal
Creatinine 0.3 0.52-1.04 Decrease,indirectly
proportional to
glomerular filtrate
rate
 X. Drug Study

Generic Brand Classification Indication Action Nsg.

Responsibilities
Zinc-Sulfate E-Zinc Vitamins & To prevent Participate in > Explain need
Minerals individual trace synthesis & for zinc
Drops (0.6 element stabilization administration
ml) OD deficiencies in of protein & to patient &
patient nucleic acids family
receiving long- in
term total subcellular > Report signs
parenteral & membrane of
nutrition transport hypersensitivity
system promptly
Omeprazole Omepron Proton Pump Gastrointestinal Inhibits > Sodium
Inhibitor disturbaces and activity of restricted diet
5mg IV OD irritations acid (proton) should be
pumps & cautious
binds to
hydrogen- > take 30
potassium minutes before
adenosine meals
triphosphate
at secretory
surface of
gastric
parietal cells
to block
formation of
gastric acid
 XI. Nursing Care Plan

Assessment Nsg. Planning Intervention Rationale Evaluation

Diagnosis
S > “Oo, Risk for The client >Demonstrate > first-line of Goal Met
mahilig nga Infection will be able & teach defense AEB afebrile
yan magsubo to proper against until
ng kahit demonstrate handwashing infection/ discharged
anong no signs of technique and cross-
mahawakan infection stress its contamination
nya,” as (fever) until importance (NANDA 10th
stated by discharge Ed. Pg. 323)
mother
> ”sa halos > first-line
1 week > Instruct in defense and
naming na daily bath/ eliminate
stay ditto sa shower, rough edges or
ospital, 3-4 regular long nails,
times ko sya cutting of which can
pinaliguan nails harbor
ditto,” as microorganism
stated by (Kozier 8th Ed.
mother Vol I pg. 682)

O > very > to prevent

playful exposure of
> does not > Limit client
wash often visitors (NANDA 10TH
> age = Ed. Pg. 323)
11/12 moths
old > same
> dirty nails
> Advise to
avoid
opening of
door or going
out the room > One source
too much of fecal-oral
route mode of
> Instruct transmission
mother to of pathogens
neglect her (Kozier 8th Ed)
child from
putting hands
or objects on >To avoid
 mouth microbial
growth
> Suggest (NANDA 10TH
techniques Ed.)
for safe food
preparation
and
presentation

Assessment Nsg. Planning Intervention Rationale Evaluation

Diagnosis
S> “Sadyang Risk for Fall The client will > Provide > Prevent Goal Met
malikot nga be able to assistive from falling AEB free
yan, maliksi maintain device or onto one side from injury
kumilos,” as safety safety device or the other, upon
stated by measure with like side rails also helps discharge
mother free from stabilize
injury within balance
O > Tantrums hospitalization (Kozier 8th
at times > Encourage Ed)
> Age= family for
11/12 months proper > Supervision
old supervision helps one
> Unstable child to be
gait, balance safe as well
and as gain
coordination courage to be
>Unfamiliar independent
environment on activity
> Active > Practice (Kozier 8th
and playful walking with Ed.)
support /
exercise of > helps mucle
legs and and bones to
extremities stabilize and
gain balance
on
coordination
> Discuss (Kozier 8th
safety Ed.)
measures that
should be in > To avoid
precautions injury and
 lessen the
risk (Kozier
8th Ed)

Assessment Nsg. Diagnosis Planning Intervention Rationale Evaluatio

n
S>“ Deficient The client > Describe > to prevent Goal Met
Hinuhugasan Knowledge will be able ways to possible cross- AEB
ko naman (Infection to practice manipulate the contamination mother
kamay nya Control) R/T understandin bed, room & (Kozier 8th Ed. performed
pag information g of teaching other facilities Vol I pg. 682) hygiene
nadudumiha misinterpretatio after 1-2 care for
n sya. Ganun n AEB hours of > Instruct to > to induce self and
sabi nung verbalized data teaching rinse soiled death of child and
nurse, pero cloth in cold microorganis cleaning
hindi ko na water, wash in m of place
minamaya’t hot water if (Kozier 8th Ed.
maya ang possible & add Vol I pg. 682)
hugas, pag a cup of bleach
madumi or phenol-
lang,” as based
stated by disinfectant
mother
> Perform &
O > client teach hand > first-line
has a habit hygiene defense
of putting (before & after against
everything to handling/eatin infection/
mouth g of foods, or cross-
> hands are toileting) contamination
always wet (NANDA 10th
with saliva Ed. Pg 323)
> nails > Promote nail
uncut and care > eliminate
dirty rough edges or
> long nails,
Unorganized which can
bed & bed harbor
side table microorganis
> No bed m (Kozier 8th
linens Ed. Vol I pg.
> Instruct not 682)
share personal
 items > Infections
can be
transmitted
from shared
personal items
through
fomites
(Kozier 8th Ed.
Vol I pg. 682)

XII. Prognosis

Medications – Upon discharge client was advised to continue intake of Zinc-Sulfate (E-
zinc) drops 0.6 ml once a day.
Economics – Advised client to buy foods within the budget. The client, prior to admission
present a health insurance card, ( + ) HMO. They had discount on S.Q.’s hospitalization
and also to the doctor’s fee.

Treatment – S.Q. was still advised for increase fluid intake, periodic complete emptying of
urinary bladder, use of lactacid for perinial wash, and keep hands clean. She still have a
follow up check up after 1 week after discharge.

Health Teaching – Proper hygiene of both child and parent are very important as defense
from infection. Proper and strict supervision of child until balance, gait, and coordination is
gained. Advise to restrict child from handling items or objects especially if unfamiliar and
not edible. Emphasize importance of hand washing and nail care.

Out Patient – Client was discharge on January 6, 2010. Last advises and follow up check
ups were reminded. Other treatments were elaborated.

Diet – Client was ordered with diet for age, with increase fluid intake.
 Calamba Doctors’ College
S.Y. 2009-2010

CASE STUDY
(ACUTE GASTROENTERITIS)

KIRSTEN E. PAPERA
BSN LEVEL 3
GROUP 6