ACUTE GASTROENTERITIS WITH
MODERATE DEHYDRATION
PREDISPOSING PRECIPITATING
Age (very young and elderly) Primarily Viruses (e.g., Rotavirus,
Immunosuppression (e.g., HIV, Norovirus)
chemotherapy)
Bacteria (e.g., E. coli, Salmonella,
Malnutrition
Poor Sanitation/Hygiene Shigella)
Lack of safe drinking water Less commonly, Parasites (e.g.,
Crowded living conditions. Giardia).
INGESTION OF CONTAMINATED FOOD/WATER OR FECAL-ORAL
TRANSMISSION.
PATHOGEN REACHES THE SMALL INTESTINE.
VIRUSES BACTERIA
(most common): (Toxigenic, e.g., Vibrio cholerae): Pathogen
Invade and releases enterotoxins that bind to the
destroy the intestinal wall, stimulating the enzyme
mature epithelial adenylate cyclase.
cells of the villi (Invasive, e.g., Shigella): Pathogen invades
in the small the epithelial cells, causing mucosal
intestine. inflammation and destruction
INCREASED FLUID AND ELECTROLYTE SECRETION
AND/OR DECREASED ABSORPTION IN THE BOWEL.
DIARRHEA AND VOMITING
DEHYDRATION METABOLIC
ACIDOSIS
EXCESSIVE FLUID LOSS FROM
DIARRHEA/VOMITING EXCEEDS FLUID INTAKE.
CLINICAL
MANIFESTATIONS
LOSS OF INTRAVASCULAR VOLUME AND
ELECTROLYTES Watery/loose, foul-smelling, may be
bloody/mucoid stool
Vomiting
Abdominal Cramping
LEADS TO HEMOCONCENTRATION AND
Anorexia
COMPENSATORY MECHANISMS
Sunken fontanelle (infants)
Sunken eyes
Fever
ELECTROLYTE IMBALANCE Malaise
Irritability/Restlessness
Tachycardia
ACID-BASE IMBALANCE Prolonged Capillary Refill Time (2-3
seconds)
Oliguria
Decreased skin turgor
Dry mucous membranes
Thirst (e.g., eager to drink)
Lethargy
Weakness
DIAGNOSTIC MEDICAL NURSING
PROCEDURES MANAGEMENT MANAGEMENT
Continual monitoring of vital signs,
Clinical Assessment Fluid and Electrolyte Replacement: Oral Intake and Output (I&O), weight,
- History of acute onset Rehydration Solutions (ORS) is the and dehydration signs (e.g., skin
of diarrhea/vomiting, recent cornerstone for moderate dehydration. turgor, urine output/color, mucous
travel, contaminated Administer ORS rapidly (e.g., 50-100 membranes, consciousness level).
food/water exposure, and mL/kg over 3-4 hours) in small, frequent Educate on and administer ORS
physical exam to assess amounts. correctly; track amount consumed
dehydration status (e.g., skin Intravenous (IV) Fluids: Used if ORS fails, if and stools/vomitus.
turgor, mucous membranes, vomiting is intractable, or if dehydration is Strict Hand Hygiene (use of soap
weight change). severe/shock is suspected (e.g., Isotonic and water for C. diff or Norovirus,
Culture & Sensitivity solutions like Normal Saline or Lactated alcohol-based for others) to prevent
(C&S) Ringer's solution). spread; proper disposal of
Rotavirus/Norovirus Antibiotics: Rarely needed. Prescribed only contaminated diapers/linens.
Antigen Test for specific bacterial pathogens (e.g., Perineal skin care to prevent
Complete Blood Count Shigella, Cholera) or parasitic infections, breakdown from frequent, acidic
(CBC) after culture results. stools.
Serum Electrolytes & Antiemetics/Antidiarrheals: Generally not Resume age-appropriate feeding
Blood Urea Nitrogen recommended, especially in children, as as soon as possible (avoid
(BUN)/Creatinine they can mask symptoms or prolong prolonged fasting); breastfed
Arterial Blood Gas (ABG) illness. infants continue feeding.
Teach signs of worsening
dehydration (e.g., lethargy,
inability to drink), correct ORS
preparation, and preventative
measures (food safety,
handwashing).