NURSING MANAGEMENT OF A PATIENT (3YEARS) WITH DIARRHOEA AT THE BUEA ROAD INTEGRATED HEALTH CENTRE FROM THE 13TH MARCH TO THE 13TH APRIL 2019

Abstract

Diarrhea disease is the second leading cause of death in children under 5 years old, Diarrhea is defining as the passage of 3 or more loose or liquid stool per day. It should be noted that the frequent of formed stools is not diarrhea nor the passage of loose stool “pasty” stools b t breastfeeding babies. Diarrhea is mostly a symptom of an infection in the intestinal tract. Diarrhea can be cause by a variety of bacterial, viral and parasitic organism. Diarrhea can be spread through contaminated food and drinking water or from person to person as a result of poor hygiene, the signs and symptoms of Diarrhea include loose watery stool, fever, abdominal cramps, nausea and bloating, light headache and dizziness. The predisposing factors include age, medication, and environment, weaken immune system, not being immunized and close contact with infected persons. If diarrhea is not treated it may complicate to dehydration and lose of electrolytes in the body. The prevention of diarrhea may jut include; proper sanitation that is taking care of the water we drink and what we eat and also avoiding open defecation and proper care of our toilets. Hand washing is another very important aspect of preventing this disease as well as proper nutrition not leaving out vaccination which helps boost our immune systems and hence prevent diarrhea. Studies have shown too that proper breast feeding helps prevent diarrhea as it also helps boot our immune system. It is rather unfortunate that the developing countries suffer most of this disease and the practice of all of the above preventive methods or ways will be of great help to reduce the incidence of diarrhea disease especially among children.

CHAPTER ONE

INTRODUCTION

1.1 Background

Diarrhea disease is the leading cause of death in children under5 years old and is responsible for killing about 525,000 children every year. Diarrhea can last for several days and can live in the body without water and electrolyte that are necessary for survival. In the past for most people severe dehydration and fluid loss were the main cause of diarrhea death. (WHO 2017).

Diarrhea is the passage of 3 or more liquid stool per day (or more passage of fluid than it`s normal for an individual). Frequent passage of formed stool is not diarrhea. An estimated total of 10.6million death among children younger than 5 years of age worldwide, about 42% occurs in Africa regions (Bryce.et.al 2005).

According to the W.H.O 2005 the under 5 mortality rate in Africa is 7 times higher than that in Europe. A factor that may contribute to this is HIV/AIDS (walker et al 2007).

However, diarrhea disease continue to be an important cause of morbidity and mortality worldwide and despite all endurances in health technology, improved management and increase use of oral rehydration therapy (O.R.T) in the past decades, they remain among the 5th major killers of children under 5years of age.(Kosek.et.al 2006).

Acute diarrhea is usually caused by a bacterium (e.g. Salmonella), viral (e.g. norovirus or rotavirus) or parasite (Giardia) infections of bowels. Diarrhea caused by any of this infections s is known as Gastrointeritis. The most common cause of acute diarrhea is associated with gluteninolerance (e.g. coeliac disease) and lactose intolerance (inability to proper digest lactose in dairy products) (Mayo clinic 2018)

Diarrhea is easily diagnosed by its symptoms. If the diarrhea last longer than 2or 3 days it is accompanied by symptoms such as fever or blood stool, the doctor may perform diagnostic test for infection, blood test to rule out the disease .Sigmoidoscopy or Colonoscopy to look for signs of inflammatory bowel disease(this test involves using a device with a thin flexible tube with light and a camera at one end to look inside the bowel).Chronic or severe diarrhea can lead to rapid dehydration which is the excessive loss of vifluid from the body. Dehydration is particularly dangerous in children and infants, the elderly people with weaken systems or immune suppressed persons (people with HIV/AIDS) or undergoing chemotherapy. In developing countries, an average of 3 episodes per child per year in children younger than 5 years is reported, however some areas report 6-8 episodes per year per child.in this setting, and malnutrition is an additional risk factor for diarrhea and recurrent episodes of diarrhea leads to growth flattering and substantially increase mortality (Talbert et al, 2012).childhood mortality associated with diarrhea has constantly but slowly decline during the past two decades, mostly because of the widespread use of oral rehydration solutions. However, it appears to have plateaued over the past several years because the single most common infections diarrhea worldwide is rotavirus and because a vaccine has been used for the past 3 years now, a reduction in the overall frequency of diarrhea episode is hope for the near future (WHO 2010).

Most cases of infectious diarrhea are not sex specific. Females have higher incidence of carmpylodrome(HUS). Viral diarrhea is most common in young children; Rotavirus and Adenovirus are particularly prevalent in children younger than 2 years.Astrovirus and Norovirus  usually infect children younger than 5 years.Yersina enter colitis typically infect children younger than 1 year and the Aero monas organisms is a significant cause of diarrhea in young children. Very young children are susceptible to secondary dehydration and secondary nutrients malapsorbtion. Age and nutritional status appears to be the most important host factor in determining the severity and the duration of the diarrhea. In fact, the younger the child, the risk of the child of severe, life threatening dehydration is as a result of high body-water turnover and limited renal compensatory capacity of very young children. Whether younger, age also means a risk of running a prolong course is an unsettled issue. In developing countries persistent postenteritis diarrhea has a strong inverse correlation with age (lubbert et al 2012).

1.2   OBJECTIVES

1.2.1 General objectives

To provide holistic nursing management to a patient with diarrhea at the Buea road integrated center

1.2.2 Specific objectives

1. To asses and care for patients with severe diarrhea
2. To implement and evaluate the effectiveness of this care.

1.3 RATIONALS

Ths work is going to create awareness on the better management technique of childhood diarrhea disease. This work will also help the ministry of public health to reshape their policies and lay more emphasis on the management of childhood diarrhea

1.4 Significance

• This study will serve as a guidelines for the treatment, prevention and recommendations towards improving diarrhea care.
• To share my experience in managing diarrhea so that others can learn and adopt some strategies from it.

1.5 DEFINATION OF TERMS

ELECTROLYTES: This are electrical substances in the blood that helps to regulate the proper balance of body fluids.

DIARRHEA: This is the frequent passage of 3 or more loose of liquid stools per day (W.H.O 2017).

STOOLS: This are solid matters discharged in bowel movements. Stools are made up of undigested food, bacterial, mucus, and cells from the lining of the intestines.

MORBIDITY: This is how often a disease occurs in a specific area or is a term use to describe a focus on death.

DEHYDRATION: This is the excessive loss of body fluids more than what someone can take in.

BOWEL: This is a long tube that carries solid wastes from the stomach out of the body.

EPISODE: This is a related event or group of related events.

NUTRITION: This is the intake of food, considered in relation to the body’s dietary need (W.H.O 2013).

INFECTION: The invasion and multiplication of microorganism such as bacterial, viruses, and parasites that is not normally present in the body. Royal college of nursing (RCN 2006)

BACTERIALS; A single cell organism that can exist independently (free living) organism or as parasites (dependent on another organism for life).

VIRUS; A microorganism that is smaller than a bacterial but cannot grow or replicate out of living cells.

VACCINATION: Injection of an attenuated microbe in order to stimulate the immune system against the microbe thereby preventing disease vaccination or immunization work by stimulating the immune system.

COMPLICATION: An unanticipated problem that arises following the result of a procedure, treatment and illness.

NURSING MANAGEMENT OF A PATIENT (3YEARS) WITH DIARRHOEA AT THE BUEA ROAD INTEGRATED HEALTH CENTRE FROM THE 13TH MARCH TO THE 13TH APRIL 2019