Case Study Ona Age

8/9/2019 Case Study Ona Age

1/22


2/22

II. Nursing Assessment

A. PERSONAL DATA

1. Demographic data

In order to keep the life of our patient in private and to keep confidentiality let us just callhim Butad, 46 year old; male separated with his wife. He is 11th among the 12 children he

currently residing in Dolores Angeles city. He was admitted on April 15, 2010 and diagnosed as

AGE and discharge last April 20, 2010.

2. Socio-Economic and Cultural Factors

He is a jeepney driver and work 6 days a week with one day rest. His daily income

300/day most of his income is spends on food. Butad stop schooling when he was on his 1 st year

high school. He is a roman catholic. He was not able to attend mass regularly because of hiswork. Butad doesnt believe in faith healers and albularyo he directly goes to the hospital when

he feels sick.

History of Past Illness

Butad had fever and cough months before the admission.

History of Present Illness

Butad experience dizziness and vomiting at 3:00 pm on April 15, 2010. He went

straightly to ONA and got admitted on the same date.

F. Diagnostic and Laboratory Procedure

Diagnostic /

laboratory

procedure

Date

ordered

Date

results in

Indications or

Purposes

Results

(1st,2nd,3rd)

Normal

Values

(units used in

hospital)

Analysis and

Interpretations

of Results

(book-based)

Fecalysis Date

ordered

April 15,

2010

Date

To determine

the presence

of parasites

andcharacteristic

of stool.

Color: brown

Consistency:

soft

Color: brown

Consistency:

soft

Brown stools

and soft in

consistency

indicate normal

bowel

movement.


3/22

results in

April 16,

2010

Others: no

ova or

parasite seen

No ova or

parasite seen

No eggs or

parasite seen

indicates that the

patient is freefrom intestinal

parasite

infestation.

1. PHYSICAL EXAMINATION (IPPA Cephalocaudal Approach)Initial Assessment upon Admission (April 15, 2010)Lifted from the chart .

a. Physical Assessment

Head / EENT: sclera pink conjunctiva

Chest: (-) retractions,

Cardiovascular: normal rate, regular rhythm

Abdomen: flabby, mass, soft, non tender

Extremities: fall and equal pulses

Nurse-Patient Interaction #1 (April 19, 2010)

Vital Signs as follows:

T: 36 C

P: 89bpm

R: 16cpm

BP:110/90 mmHg

Appearance and Mental Status


4/22

Butad was received sitting on bed, conscious and coherent, afebrile, wearing short and t-

shirt. He was able to perform full ROM. He is able to understand and comprehend spoken

words.

Integumentary

Skin: (-) jaundice with good skin turgor; brown in color

Hair: black, long, straight and oily; with equal distribution;

Nails: pale nail beds; with no evidence of clubbing or unusual dryness or cracking;

convex nail curve; good capillary refill of 2 seconds; normal angle

Color: brown

Head

Skull: normocephalic, well-rounded and symmetrical in shape; no nodules or masses; no

abnormal prominence noted

Face: symmetrical facial movement; symmetrical facial feature; no lesion; no masses,

nodules and abnormal prominence

Eyes and Vision: iris are black in color; eyes are symmetrical; evenly distributed thin

eyebrows are symmetrically aligned; (-) ptosis; (+) PERRLA; pupils appears black and

equal in size, round; pink palpebral conjunctiva

Ear and Hearing: (+) whisper test; no lesions or abnormal discharges or swelling noted;

with minimal cerumen; hears normal conversation; pinna can be easily folded

Nose: symmetrical and straight; no evidence of deviated nasal septum; no tenderness;

uniform in color; presence of clear secretion; no flaring noted

Mouth: (-) halitosis; no teeth missing, teeth are white and shiny lips is pinkish in color;

tongue can move freely

Neck: no pain; no abnormal distention of jugular vein; trachea is located in the normal

position-midline; lymph nodes are not palpable and not swollen

Lymph Nodes:

anterior and posterior lymph nodes are not palpable; no generalized enlargement of lymph nodes

Thorax and Lungs: no abnormal shape and symmetry of the thorax; spine is vertically

aligned; spinal column is straight; there is full and symmetric chest expansion; no

tenderness; rales noted on both lung fields

Peripheral Pulses: there is a symmetrical pulse volume with full and regular pulsations

Abdomen: Hyperactive bowel sounds 40, mass rounded and flabby.


5/22

Muscles: (-)tremors with good muscle tone and with equal size on both sides of the body; can

perform full range of motion

Bones: there are no deformities; no tenderness or swelling; minimal joint movements

Upper Extremities: symmetrically aligned (-) edema

Lower Extremities: symmetrically aligned; (-) edema

Reflexes: Patellar reflex is present as evidence by the extension or kicking out of the leg was

elicited by Mr. Jaundice

Motor Function: Kimi can perform range of motion with full resistance applied.

Pain Sensation: Kimi is able to discriminate sharp and dull sensations.

Position and kinesthetic sensation: Kimi is able to determine the position of fingers and toes.

Cranial Nerves:

CN I: able to distinguish isopropyl alcohol and chocolate drink

CN II: able to see far objects and texts, functional peripheral vision

CN III, IV, VI: (+)PERRLA, (-)ptosis, (-)nystagmus

CN V: able to feel and distinguish pinprick, wisp of cotton, hot and cold

CN VII: able to purse lips, raise the eyebrows and forehead and tightly close the eyes,

CN VIII: could hear a whispering voice.

CN IX, X: (+) gag reflex, (+) cough reflex; able to speak clear and loud

CN XI: able to elevate shoulders; turn head side to side, push head forward with resistance

CN XII: (-) tongue deviation,

Nurse-Patient Interaction #1 (April 20, 2010)

Vital Signs as follows:

T: 35.4 o C

P: 93bpm

R: 18cpm

BP:100/70mmHg

Appearance and Mental Status

Butad was received sitting on bed, conscious and coherent, afebrile, wearing

short and t-shirt. He was able to perform full ROM. He is able to understand and

comprehend spoken words.

Integumentary


6/22

Skin: (-) jaundice with good skin turgor; brown in color

Hair: black, long, straight and oily; with equal distribution;

Nails: pale nail beds; with no evidence of clubbing or unusual dryness or cracking;

convex nail curve; good capillary refill of 2 seconds; normal angle

Color: brown

Head

Skull: normocephalic, well-rounded and symmetrical in shape; no nodules or masses; no

abnormal prominence noted

Face: symmetrical facial movement; symmetrical facial feature; no lesion; no masses,

nodules and abnormal prominence

Eyes and Vision: iris are black in color; eyes are symmetrical; evenly distributed thin

eyebrows are symmetrically aligned; (-) ptosis; (+) PERRLA; pupils appears black and

equal in size, round; pink palpebral conjunctiva

Ear and Hearing: (+) whisper test; no lesions or abnormal discharges or swelling noted;

with minimal cerumen; hears normal conversation; pinna can be easily folded

Nose: symmetrical and straight; no evidence of deviated nasal septum; no tenderness;

uniform in color; presence of clear secretion; no flaring noted

Mouth: (-) halitosis; no teeth missing, teeth are white and shiny lips is pinkish in color;

tongue can move freely

Neck: no pain; no abnormal distention of jugular vein; trachea is located in the normal

position-midline; lymph nodes are not palpable and not swollen

Lymph Nodes:

anterior and posterior lymph nodes are not palpable; no generalized enlargement of lymph nodes

Thorax and Lungs: no abnormal shape and symmetry of the thorax; spine is vertically

aligned; spinal column is straight; there is full and symmetric chest expansion; no

tenderness; rales noted on both lung fields

Peripheral Pulses: there is a symmetrical pulse volume with full and regular pulsations

Abdomen: Hyperactive bowel sounds 40, mass rounded and flabby.

Muscles: (-)tremors with good muscle tone and with equal size on both sides of the body; can

perform full range of motion

Bones: there are no deformities; no tenderness or swelling; minimal joint movements

Upper Extremities: symmetrically aligned (-) edema

Lower Extremities: symmetrically aligned; (-) edema


7/22

Reflexes: Patellar reflex is present as evidence by the extension or kicking out of the leg was

elicited by Mr. Butad

Motor Function: Butad can perform range of motion with full resistance applied.

Pain Sensation: Butad is able to discriminate sharp and dull sensations.

Position and kinesthetic sensation: Butad is able to determine the position of fingers and

toes.

Cranial Nerves:

CN I: able to distinguish isopropyl alcohol and chocolate drink

CN II: able to see far objects and texts, functional peripheral vision

CN III, IV, VI: (+)PERRLA, (-)ptosis, (-)nystagmus

CN V: able to feel and distinguish pinprick, wisp of cotton, hot and cold

CN VII: able to purse lips, raise the eyebrows and forehead and tightly close the eyes,

CN VIII: could hear a whispering voice.

CN IX, X: (+) gag reflex, (+) cough reflex; able to speak clear and loud

CN XI: able to elevate shoulders; turn head side to side, push head forward with resistance

CN XII: (-) tongue deviation,

F. Diagnostic and Labolatory Procedure

Diagnostic /

laboratory

procedure

Date

ordered

Date

results in

Indications

or Purposes

Results

(1st,2nd,3rd)

Normal

Values

(units used in

hospital)

Analysis and

Interpretations

of Results

(book-based)

Fecalysis Date

ordered

July 15,

2009

Date

results in

Color: brown

Consistency:soft

Color: brown

Consistency:soft

Brown stools and

soft in

consistencyindicate normal

bowel movement.

No eggs or


8/22

July 16,2009

Others: no ova

or parasite

seen

No ova or

parasite seen

parasite seenindicates that the

patient is free

from intestinal

parasite

infestation.

Nursing Responsibilities:

Prior:

a. Explain the procedure to the patient as well as to the SO.

b. Prepare the materials needed a clean leak proof container with cap, applicator sticks

and tissue or paper towel for wiping.

c. Instruct patient, or SO, on how to obtain stool sample, or assisting them to the bathroom,

providing privacy and proper draping.

d. Maintain aseptic technique, using clean gloves in obtaining the stool sample.

During:

a. Obtain stool sample using applicator stick.

b. Ensure that no urine water or soil or other material gets in the container.

After:

a. Cover the specimen cup and label.

b. Document the procedure, the time and date performed, and the patients response to the

procedure.

c. Assist the patient in returning to bed.

d. Leave the area clean and in order.


9/22


10/22

Document the time and procedure done. Then, obtain results and secure it in

the patients chart. Refer


11/22

III. Anatomy and Physiology

Digestion is the break down of food to molecules that are small enough to be absorbed

into the circulation. Mechanical digestion breaks the large foods particles down into smaller ones.

Chemical digestion involves the breaking down of covalent chemical bonds in organic molecules

by digestive enzymes. Absorption begins in the stomach, where some small, lipids-soluble

molecules, such as alcohol and aspirin, can diffuse through the stomach epithelium into the

circulation. Most absorption occurs in the duodenum, and jejunum, although some occurs in the

ileum. Some molecules can diffuse through the intestinal wall. Others must be transported across

the intestinal wall. Transport requires carrier molecules and includes facilitated diffusion, co


12/22


13/22


14/22

Duodenum

A hollow jointed tube about 25-30

cm long connecting the stomach to the jejunum. It is the first and shortest part

of the small intestine and it is where most chemical digestion takes place. The duodenum is

largely responsible for the breakdown of food in the small intestine. Brunner's glands, which

secrete mucus, are found in the duodenum. It also regulates the rate of emptying of the stomach

via hormonal pathways. Secretin and cholecystokinin are released from cells in the duodenal

epithelium in response to acidic and fatty stimuli present there when the pyloris opens and

releases gastric chyme into the duodenum for further digestion

Jejunum

the central of the three divisions of the small intestine and lies between the duodenum

and ileum. The inner surface of the jejunum, its mucous membrane, is covered in projections

called villi, which increase the surface area of tissue available to absorb nutrients from the gut

contents. The epithelial cells, which line these villi, possess even larger numbers of microvilli.

The transport of nutrients across epithelial cells through the jejunum and ileum includes the

passive transport of sugar fructose and the active transport of amino acids, small peptides,

vitamins, and most glucose. The villi in the jejunum are much longer than in the duodenum or

ileum.

Ileum

Is the final section of the small

intestine. It is about 2-4 m long in humans,

follows the duodenum and jejunum. The

pH in the ileum is usually between 7 and

8 (neutral or slightly alkaline). Its function is

mainly to absorb vitamin B12 and bile salts

and whatever products of digestion that

were not absorbed by the jejunum. The


15/22

wall itself is made up of folds, each of which has many tiny finger-like projections known as villi,

on its surface. In turn, the epithelial cells which line these villi possess even larger numbers of

microvilli.

Large Intestines

The large intestine is responsible for the elimination of food materials that cannot be

digested and assimilated by the body. It is also

responsible for the re-absorption of water used

during the digestive process. As food materials

pass through the large intestine, friendly

bacteria that live in the colon act upon this

waste, producing vitamin K and some of the

B-vitamins.

IV. The Patient and His Illness

Synthesis of the Disease (Book-based)

a. Definition of the Disease

Gastroenteritis (also known as gastro, gastric flu, tummy bug in some countries,

and stomach flu, although unrelated to influenza) is inflammation of the gastrointestinal tract,

involving both the stomach and the small intestine and resulting in acute diarrhea. The

inflammation is caused most often by an infection from certain viruses or less often bybacteria,

theirtoxins,parasites, or an adverse reaction to something in the diet or medication. These agents

cause diarrhea by adherence, mucosal invasion, enterotoxin production, and/or cytotoxin

production. These mechanisms result in increased fluid secretion and/or decreased absorption.

This produces an increased luminal fluid content that cannot be adequately reabsorbed, leading to

diarrhea. The epithelium of the digestive tube is protected from insult by a number of

mechanisms constituting the gastrointestinal barrier, but like many barriers, it can be breached.

Disruption of the epithelium of the intestine due to microbial pathogens is a very common cause

of diarrhea in all species. Destruction of the epithelium results not only in exudation of serum and

blood into the lumen but often is associated with widespread destruction of absorptive epithelium.

In such cases, absorption of water occurs very inefficiently and diarrhea results. Aside from that a

large volumes of water are normally secreted into the small intestinal lumen, but a large majority

of this water is efficiently absorbed before reaching the large intestine. Diarrhea occurs when

secretion of water into the intestinal lumen exceeds absorption.
http://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Stomachhttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Acute_(medicine)http://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Toxinhttp://en.wikipedia.org/wiki/Parasiteshttp://en.wikipedia.org/wiki/Adverse_reactionhttp://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Stomachhttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Acute_(medicine)http://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Toxinhttp://en.wikipedia.org/wiki/Parasiteshttp://en.wikipedia.org/wiki/Adverse_reaction


16/22

This infectious agent also triggers the body to release chemical mediator which serves as

the guard system of the body. These chemical mediator releases endogenous pyrogens that

stimulate the hypothalamus, which is the heat regulator of the brain to reset the body temperature

resulting to an increased in body temperature.

A child with gastroenteritis experiences not only decreased absorption of water but also nutrients

needed by the body, a condition resulting to weakness and pallor. Since the disease condition

mainly involves the inflammation of the gastrointestinal tract, certain gastrointestinal

disturbances are manifested by the patient, this include: nausea, vomiting, loss of appetite,

abdominal cramps and abdominal pain. The child may be lethargic, suffer lack of sleep, or run a

high fever and have signs of dehydration, which include dry mucous membranes, reduced skin

turgor, sunken fontanelles and sunken eyeballs, poor perfusion resulting to pallor.

At least 50% of cases of gastroenteritis due to foodborne illness are caused by norovirus.

Another20% of cases, and the majority of severe cases in children, are due to rotavirus. Other significant

viral agents include adenovirusand astrovirus.

Different species of bacteria can cause gastroenteritis, including Salmonella, Shigella,

Staphylococcus,Campylobacter jejuni,Clostridium,Escherichia coli,Yersinia, and others. Some

sources of the infection are improperly prepared food, reheated meat dishes, seafood, dairy, and

bakery products. Each organism causes slightly different symptoms but all result in diarrhea.

Risk factors include consumption of improperly prepared foods or contaminated water and travel

or residence in areas of poor sanitation. It is also common for river swimmers to become infected

during times of rain as a result of contaminated runoff water.

Classification

Bacterial gastroenteritis

Pseudomembranous colitis is an important cause of diarrhea in patients often recently treated with

antibiotics. If gastroenteritis in a child is severe enough to require admission to a hospital, then it

is important to distinguish between bacterial and viral infections. Bacteria, Shigella and

Campylobacter, for example, andparasites like Giardia can be treated with antibiotics. Traveler's

diarrhea is usually a type of bacterial gastroenteritis.
http://en.wikipedia.org/wiki/Foodborne_illnesshttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Astrovirushttp://en.wikipedia.org/wiki/Salmonellahttp://en.wikipedia.org/wiki/Shigellahttp://en.wikipedia.org/wiki/Shigellahttp://en.wikipedia.org/wiki/Staphylococcushttp://en.wikipedia.org/wiki/Staphylococcushttp://en.wikipedia.org/wiki/Campylobacter_jejunihttp://en.wikipedia.org/wiki/Campylobacter_jejunihttp://en.wikipedia.org/wiki/Campylobacter_jejunihttp://en.wikipedia.org/wiki/Clostridiumhttp://en.wikipedia.org/wiki/Escherichia_colihttp://en.wikipedia.org/wiki/Escherichia_colihttp://en.wikipedia.org/wiki/Yersiniahttp://en.wikipedia.org/wiki/Yersiniahttp://en.wikipedia.org/wiki/Yersiniahttp://en.wikipedia.org/wiki/Pseudomembranous_colitishttp://en.wikipedia.org/wiki/Shigellahttp://en.wikipedia.org/wiki/Campylobacterhttp://en.wikipedia.org/wiki/Parasitehttp://en.wikipedia.org/wiki/Giardiahttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Traveler's_diarrheahttp://en.wikipedia.org/wiki/Traveler's_diarrheahttp://en.wikipedia.org/wiki/Foodborne_illnesshttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Astrovirushttp://en.wikipedia.org/wiki/Salmonellahttp://en.wikipedia.org/wiki/Shigellahttp://en.wikipedia.org/wiki/Staphylococcushttp://en.wikipedia.org/wiki/Campylobacter_jejunihttp://en.wikipedia.org/wiki/Clostridiumhttp://en.wikipedia.org/wiki/Escherichia_colihttp://en.wikipedia.org/wiki/Yersiniahttp://en.wikipedia.org/wiki/Pseudomembranous_colitishttp://en.wikipedia.org/wiki/Shigellahttp://en.wikipedia.org/wiki/Campylobacterhttp://en.wikipedia.org/wiki/Parasitehttp://en.wikipedia.org/wiki/Giardiahttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Traveler's_diarrheahttp://en.wikipedia.org/wiki/Traveler's_diarrhea


17/22

Viral gastroenteritis

Viruses causing gastroenteritis include rotavirus,norovirus, adenovirus and astrovirus. Viruses do

not respond to antibiotics and infected children usually make a full recovery after a few

days.Children admitted to hospital with gastroenteritis routinely are tested for rotavirus A togather surveillance data relevant to the epidemiological effects of rotavirus vaccination

programs.These children are routinely tested also for norovirus, which is extraordinarily

infectious and requires special isolation procedures to avoid transmission to other patients. Other

methods, electron microscopy and polyacrylamide gel electrophoresis, are used in research

laboratories.

B. Modifiable and Non-Modifiable factors

NON-MODIFIABLE FACTORS

o Age- Infants are more likely to acquire Gastroenteritis because their intestinal flora has

not yet fully developed. Lactose intolerance also aggravates the problem.

MODIFIABLE FACTORS

o Poor Environmental Sanitation-The environment plays a vital role in our health. An

unhygienic or poor environmental condition may lead to acquiring such disease.

o Poor Hygienic Practices one does not performed proper hand washing technique

after defecation and before handling food.

o Intake of Drugs

o Intake of food allergens

o Nutrient Deficiencies poor immune system

o Contaminated Food-A person who frequently eats street foods and junk foods is at risk

of having Gastroenteritis.

o Low socio-economic status-Due to low income, the tendency is that the foods that being

bought is less nutritious, hence, not being cautious with the food being consumed.

C. Signs and Symptoms

The condition is usually ofacute onset, normally lasting 16 days, and is self-limiting.

o Nausea and vomiting- stimulation of CTZ
http://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Astrovirushttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Electron_microscopyhttp://en.wikipedia.org/wiki/Polyacrylamide_gel_electrophoresishttp://en.wikipedia.org/wiki/Acute_(medical)http://en.wikipedia.org/wiki/Self-limiting_(biology)http://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Vomitinghttp://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Astrovirushttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Electron_microscopyhttp://en.wikipedia.org/wiki/Polyacrylamide_gel_electrophoresishttp://en.wikipedia.org/wiki/Acute_(medical)http://en.wikipedia.org/wiki/Self-limiting_(biology)http://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Vomiting


18/22

o Diarrhea- this is due to increased luminal fluid content that cannot be adequately

reabsorbed, leading to diarrhea. Destruction of the epithelium results not only in

exudation of serum and blood into the lumen but often is associated with widespread

destruction of absorptive epithelium thus leading to decreased absorption of water. This

manifestation can also be linked to secretion of water into the intestinal lumen which

exceeds the absorption.

o Loss of appetite- Gastrointestinal disturbances are due to the alteration on the function of

the intestinal epithelium that occurred because of the inflammation of the gastrointestinal

tract.

o Fever- inflammatory process

o Abdominal pain- changes in the intestinal lumen or intestinal epithelium led to intestinal

spasm leading to a painful stimulation felt by the patient.

o Bloody stools (dysentery - suggesting infection by amoeba, Campylobacter, Salmonella,

Shigella or some pathogenic strains ofEscherichia coli)

o Fainting and Weakness- another manifestation that occurred due to prolonged

decreased absorption of nutrients needed by the body for energy reserve.

o Signs ofdehydration(which include dry mucous membranes), tachycardia, reduced skin

turgor, skin color discoloration, sunken fontanels, sunken eyeballs, darkened eye circles,

glassy eyes, poorperfusion and ultimately shock.

o Poor feeding- occurs because of the disturbance of gastrointestinal function.

Viral diarrhea usually causes frequent watery stools, whereas blood stained diarrhea may be

indicative of bacterial colitis. In some cases, even when the stomach is empty, bile can be

vomited up.
http://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Dysenteryhttp://en.wikipedia.org/wiki/Dehydrationhttp://en.wikipedia.org/wiki/Dehydrationhttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Turgorhttp://en.wikipedia.org/wiki/Fontanelleshttp://en.wikipedia.org/wiki/Perfusionhttp://en.wikipedia.org/wiki/Shock_(medical)http://en.wikipedia.org/wiki/Colitishttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Dysenteryhttp://en.wikipedia.org/wiki/Dehydrationhttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Turgorhttp://en.wikipedia.org/wiki/Fontanelleshttp://en.wikipedia.org/wiki/Perfusionhttp://en.wikipedia.org/wiki/Shock_(medical)http://en.wikipedia.org/wiki/Colitishttp://en.wikipedia.org/wiki/Bile


19/22


20/22


21/22

Dizziness- defined as disorientation in space; a sense of unsteadiness;

a feeling of movement within the head such as giddiness or a

swimming sensation; lightheadedness; or a whirling sensation.

Hyper active bowels sounds- the patient had 40 bowels sounds

compared to the normal which is 20.

4. Health Promotion and Preventive Aspects

Health promotion actions for avoiding such GI infections involve instructing clients

about (1) good handwashing technique after defacation and before handling food and (2)

obtaining available vaccinations against bacterial and viral gastroenteritis. Encourage cleanliness

and sanitation as well as proper food handling, preparation and storage techniques, such as

cooking meats to 150F, cooking chicken to 170F, and not allowing food to sit at room

temperature for long periods. In developing countries, safe food practices must be done such as

avoiding tap water, ice cubes, milk products, raw meat or seafood, salads and foods that cannot

be cooked or peeled

CLIENT BASED PATHOPHYSIOLOGY

Non-ModifiableFactors

Age

Modifiable Factors

Poor EnvironmentalSanitation

Poor hygienic Practices Low socio-economic

status

Entrance of Microorganisms in the digestive tract via oral route

Mucosal InvasionEndotoxin ProductionAttachment to the villi

Toxins/Viruses/bacteria/

parasites enter theintestinal epithelium

Triggers the immune

response of the bodyInflammator Process

Release of Chemical

Mediators

Destruction of the

absorptive epithelium

Destroyed intestinal

epithelium are replacedwith immature cells


22/22

Release of EndogenousPyrogens

Body increase heatproduction and decrease

heat loss

Fever & dizziness 04-15& 16-10

Gastrointestinaldisturbances

Vomiting04-15-10

Hyperactivebowel sounds

04-15-10

Case Study Ona Age

Documents

Transcript of Case Study Ona Age