Gastroenteritis Dehydration Exam Questions and Answers Graded A+
Vomiting - Answers Dehydration-biggest problem need to increase H2O in kids. The forceful ejection of
gastric contents through the mouth, regurgitation is not forceful, it is overload. Controlled by CNS
Causes of vomiting - Answers Acute infections- increased ICP, toxic ingestions, food intolerance,
allergies, obstructions of GI track. causing resp acidosis
Primary observations - Answers Assess for: character of emesis (digested, projectile, amount, weight, if
it was after eating), frequency and persistence, amount, force (projectile)
Secondary observations: - Answers Chest or abdominal x-ray, abdominal ultrasound, UGI series,
psychological evaluation.
Implementation -vomiting - Answers Nursing interventions is determined by the cause. KNOWING cause
is key to TX. Antiemetic drugs:
Zofran- blocks receptors in the chemoreceptor trigger zone, Reglan-enhances gastroduodenal
peristalsis. Phenergan-competes for H1 receptor sites. Continually assess for impending dehydration.
Puck=Acid, Poop= base - Answers top-mouth to bottom anus is A-B
Vomiting =Alkalosis
Diarrhea=Acidosis
Diarrhea - Answers Gastric involvement is rarely seen with acute diarrhea, the term acute diarrhea is
preferable to acute gastroenteritis
gastroenteritis - Answers Although the terms the term "acute gastroenteritis" is commonly used
synonymously with "acute diarrhea" it is actually a misnomer. Gastroenteritis implies inflammation of
both the stomach and the small intestine
Diarrhea Patho - Answers Inflammation and tissue damage d/t production of exotoxins caused damage
and inflammation, leading to diarrhea and fluid loss. Invasion and ulceration of the mucosa-causes
bleeding, fluid excaudate, water and electrolyte loss. Inflammation of the GI tract caused by bacteria,
virus, parasite or toxins.
Acute diarrhea- Viral - Answers ROTAVIRUS #1 diarrhea dehydration-most common in children <5 years,
infants 6-12 months are the most vulnerable, peak in winter months, major cause of nosocomial
infections. Hospitalization common from dehydration- need IV support, incubation period is 48 hrs.,
diarrhea may last 5-7 days, Fever, vomiting, watery stools.
Acute diarrhea bacterial-E.Coli - Answers Diarrhea is result of enterotoxin production, adherence, or
invasion, can be hemorrhagic, Spreads easily, comes from FOOD, Highest in SUMMER cause of
TRAVELERS DIARRHEA, severe Abdominal cramping, bloody diarrhea.
, Acute diarrhea bacterial-BOTULISM - Answers Sever life threatening form of food poisoning!! from
home canned foods (must heat to 248 degrees for 30 min to kill bacteria) S/S abrupt onset of bilateral
and symmetric, neurological symptoms Descending paralysis (weakness), visual disturbance, dry mouth,
cramping, N/V can cause weakness in resp. muscles leading to resp. failure/death {DOES NOT CAUSE
DIARRHEA like the others} TX: Botulism antitoxin need to be given with 72 hours of onset of symptoms.
DO NOT USE antidiarrheal agent( u want to increase peristalsis not slow it down)
Acute diarrhea bacterial-Cholera - Answers Contaminated water is major source water contaminated
with FECES 3rd world countries -not in USA, must clean up water source to eradicate. S/S abrupt onset
with acute diarrhea "RICE WATER STOOL"
Acute diarrhea bacterial-C-diff - Answers Gram Positive anaerobic bacillus, ALTERATION of normal flora
in bowel. results for ATB use, chemo & PP inhibitors. Elderly at high risk, S/S bloating, constipation , foul
smelling stool watery diarrhea, abd pain. TX: Vancomycin or Flagyl, fecal transplant (PO or NG) probiotic
therapy can lead to colitis, toxic megacolon, perforation, dehydration, death.
Acute diarrhea bacterial-Salmonella - Answers invades mucosa of small & large intestine, may have
bloody diarrhea, may have cerebral manifestations, i.e.: h/a, seizures, confusion, Found in
UNDERCOOKED POULTRY! Found in PETS (cat, dog, hamster, turtle) encourage kids to wash hands, ATB
available!
Acute diarrhea bacterial-Shigella - Answers Enterotoxins invades epithelium, begins with fever, fatigue,
anorexia, watery, bloody diarrhea. ATB available!!
Acute diarrhea bacterial-Yersinia - Answers Patho not well understood, Mucoid diarrhea-sometimes
bloody common in WINTER transmitted by pets & food
Acute diarrhea bacterial-Staph - Answers AKA food poisoning=bacteria produces enterotoxin,
CONTAMINATED meats, fish, diary, pastries (common recall on food) Sudden onset & abrupt 2-8 hours
after eating, RECOVERY is complete and spontaneous, elderly with chronic diseases more susceptible for
complications, PROFUSE diarrhea, N/V
Acute diarrhea Viral -Norwalk Virus - Answers Adults=most common cause of waterborne epidemics,
year round occurrence, last 2-3 days, cramps, N/V, watery diarrhea
Acute diarrhea -Infestations - Answers Giardiasis-roundworms is the most common intestinal parasite in
US. Larvae mature in lungs, cough them up then swallow, they live in intestines.
Ascaris Lumbricosis-round worm (long white worm)
Acute diarrhea - Answers leading cause of illness in children <5 yrs. sudden change in consistency and
frequency of stools, can be caused by infection in GI tract or any other infection in the body, usually lasts
< 14 days and subsides without specific treatment unless dehydration occurs.
Vomiting - Answers Dehydration-biggest problem need to increase H2O in kids. The forceful ejection of
gastric contents through the mouth, regurgitation is not forceful, it is overload. Controlled by CNS
Causes of vomiting - Answers Acute infections- increased ICP, toxic ingestions, food intolerance,
allergies, obstructions of GI track. causing resp acidosis
Primary observations - Answers Assess for: character of emesis (digested, projectile, amount, weight, if
it was after eating), frequency and persistence, amount, force (projectile)
Secondary observations: - Answers Chest or abdominal x-ray, abdominal ultrasound, UGI series,
psychological evaluation.
Implementation -vomiting - Answers Nursing interventions is determined by the cause. KNOWING cause
is key to TX. Antiemetic drugs:
Zofran- blocks receptors in the chemoreceptor trigger zone, Reglan-enhances gastroduodenal
peristalsis. Phenergan-competes for H1 receptor sites. Continually assess for impending dehydration.
Puck=Acid, Poop= base - Answers top-mouth to bottom anus is A-B
Vomiting =Alkalosis
Diarrhea=Acidosis
Diarrhea - Answers Gastric involvement is rarely seen with acute diarrhea, the term acute diarrhea is
preferable to acute gastroenteritis
gastroenteritis - Answers Although the terms the term "acute gastroenteritis" is commonly used
synonymously with "acute diarrhea" it is actually a misnomer. Gastroenteritis implies inflammation of
both the stomach and the small intestine
Diarrhea Patho - Answers Inflammation and tissue damage d/t production of exotoxins caused damage
and inflammation, leading to diarrhea and fluid loss. Invasion and ulceration of the mucosa-causes
bleeding, fluid excaudate, water and electrolyte loss. Inflammation of the GI tract caused by bacteria,
virus, parasite or toxins.
Acute diarrhea- Viral - Answers ROTAVIRUS #1 diarrhea dehydration-most common in children <5 years,
infants 6-12 months are the most vulnerable, peak in winter months, major cause of nosocomial
infections. Hospitalization common from dehydration- need IV support, incubation period is 48 hrs.,
diarrhea may last 5-7 days, Fever, vomiting, watery stools.
Acute diarrhea bacterial-E.Coli - Answers Diarrhea is result of enterotoxin production, adherence, or
invasion, can be hemorrhagic, Spreads easily, comes from FOOD, Highest in SUMMER cause of
TRAVELERS DIARRHEA, severe Abdominal cramping, bloody diarrhea.
, Acute diarrhea bacterial-BOTULISM - Answers Sever life threatening form of food poisoning!! from
home canned foods (must heat to 248 degrees for 30 min to kill bacteria) S/S abrupt onset of bilateral
and symmetric, neurological symptoms Descending paralysis (weakness), visual disturbance, dry mouth,
cramping, N/V can cause weakness in resp. muscles leading to resp. failure/death {DOES NOT CAUSE
DIARRHEA like the others} TX: Botulism antitoxin need to be given with 72 hours of onset of symptoms.
DO NOT USE antidiarrheal agent( u want to increase peristalsis not slow it down)
Acute diarrhea bacterial-Cholera - Answers Contaminated water is major source water contaminated
with FECES 3rd world countries -not in USA, must clean up water source to eradicate. S/S abrupt onset
with acute diarrhea "RICE WATER STOOL"
Acute diarrhea bacterial-C-diff - Answers Gram Positive anaerobic bacillus, ALTERATION of normal flora
in bowel. results for ATB use, chemo & PP inhibitors. Elderly at high risk, S/S bloating, constipation , foul
smelling stool watery diarrhea, abd pain. TX: Vancomycin or Flagyl, fecal transplant (PO or NG) probiotic
therapy can lead to colitis, toxic megacolon, perforation, dehydration, death.
Acute diarrhea bacterial-Salmonella - Answers invades mucosa of small & large intestine, may have
bloody diarrhea, may have cerebral manifestations, i.e.: h/a, seizures, confusion, Found in
UNDERCOOKED POULTRY! Found in PETS (cat, dog, hamster, turtle) encourage kids to wash hands, ATB
available!
Acute diarrhea bacterial-Shigella - Answers Enterotoxins invades epithelium, begins with fever, fatigue,
anorexia, watery, bloody diarrhea. ATB available!!
Acute diarrhea bacterial-Yersinia - Answers Patho not well understood, Mucoid diarrhea-sometimes
bloody common in WINTER transmitted by pets & food
Acute diarrhea bacterial-Staph - Answers AKA food poisoning=bacteria produces enterotoxin,
CONTAMINATED meats, fish, diary, pastries (common recall on food) Sudden onset & abrupt 2-8 hours
after eating, RECOVERY is complete and spontaneous, elderly with chronic diseases more susceptible for
complications, PROFUSE diarrhea, N/V
Acute diarrhea Viral -Norwalk Virus - Answers Adults=most common cause of waterborne epidemics,
year round occurrence, last 2-3 days, cramps, N/V, watery diarrhea
Acute diarrhea -Infestations - Answers Giardiasis-roundworms is the most common intestinal parasite in
US. Larvae mature in lungs, cough them up then swallow, they live in intestines.
Ascaris Lumbricosis-round worm (long white worm)
Acute diarrhea - Answers leading cause of illness in children <5 yrs. sudden change in consistency and
frequency of stools, can be caused by infection in GI tract or any other infection in the body, usually lasts
< 14 days and subsides without specific treatment unless dehydration occurs.
