Specific Nursing Care

 

Diarrhea

  

 

 

Introduction

  
Diarrhea is the frequent passage of loose and watery stools.  Stool is what left after the digestive system (stomach, small intestine, and colon) absorbs nutrients and fluids from what we eat and drink.  Stool passes out from the body through the anus.  If fluids are not absorbed, stools will be loose and watery.  People with diarrhea often have frequent bowel movements and may pass more than 5-10 times a day.
    

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Causes of Diarrhea 

 

Diarrhea can be caused by many microorganisms including bacteria, viruses, or parasites (tiny organisms that live inside a larger organism). The person may have pick up these organisms from other people or from eating and drinking  contaminated food and water.

 

Other causes of diarrhea include:

 

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Reactions to medicines such as antibiotics and antacids

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Food intolerance such as milk

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Stress anxiety

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Impact stool

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Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease and irritable bowel syndrome

 

In some cases the cause for diarrhea is unknown.
 

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When To Seek Help

 

Diarrhea is the body's way of getting rid of foreign substances and toxins.  It usually clears up within a few days.  Indeed this is a natural solution for the body to 'flush' itself clean.  It is recommended that the best medicine is to let the diarrhea "run its course' but the person must drink enough to replace the fluid loss. 

 

However, diarrhea can also be a sign of more serious problem.  It is important that you identify the cause so that appropriate treatments can be rendered .

 

In any case, consult your doctor if the person has the following signs and symptoms:

 

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Diarrhea lasts for more than 2 days with large amount of loose stools.

 

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Severe pain of the abdomen or rectum

 

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Fever (a sign that the body is fighting infection)

 

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Stools that are bloody or black and tarry

 

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Dehydration is developing

 

 

Children younger than 12 become dehydrated much more easily than adults.  If your child does not improve after 24 hours or has any of the above signs and symptoms along with diarrhea, call the doctor.  This is especially important if your child is 6 months old or younger.

 

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Homecare Tips

 

Drink plenty of fluids in the form of  water, clear soups, etc to replace the fluid and salts that are lost.

 

You can prepare your own 'rehydration fluid' by adding 8 teaspoons of sugar with 1 teaspoon of salt in 1 litre of  water.

 

Vomiting often accompany diarrhea.  If the person vomits after drinking, provide him with frequent small sips of water instead.  Alternatively, give him small chips of ice to suck.

 

As the person starts to feel better, starts with a simple diet such as barley water.  When the condition improved, eat food that are easily digested such as bananas, dry cereal, boiled potatoes, and well-cooked vegetables.

 

To allow the bowel to rest and heal:

 

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Do not force the person to eat too much.

 

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Avoid coffee, tea, and alcohol, as they irritate the stomach.

 

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Eliminate protein food and fats from the diet as they are difficult to digest.

 

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Dairy products such as milk, cream, butter and eggs should be avoided for a few days or two weeks after the diarrhea has resolved.

 

 

Anti-diarrheal medicine:

 

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Do not take anti-diarrheal medicine for the first 6 hours after diarrhea begins.  This allows the body to flush away foreign substances and toxins.

 

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Oral medicines that are available without a doctor's prescription include loperamide (Imodium) or charcoal.

 

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Stop taking these medicines if symptoms get worse or if diarrhea lasts more than 2 days.  Consult your doctor.

 

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Do not give a child any medicine to control diarrhea except on doctor's advice.

 

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Discontinue as soon as the diarrhea stops.  Otherwise the person may become constipated.

 

 

Consult your doctor if the person has chronic diarrhea.  He may require a special diet prescription.

 

To prevent the spread of diarrhea:
 

1. The person should wash and dry his hands thoroughly after each visit to the toilet.
 
2. Disallow the person to prepare or cook any food.

 

 

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Diarrhea Cause by Impact Stool

 

Impaction is the collection of hardened stool in the colon or rectum.  It is the consequence of untreated constipation.  Impact stool usually happens in people who are immobile (example bed-ridden) or with central nervous system disorder.  It is also common in elderly due to altered tone and sensation in bowel as a result of aging process.

 

An early sign of impaction is the frequent passage of liquid stool.  The liquid stool flow down from the higher portion of the bowel, passing down around the blockage formed by hardened stool, and leak out from the anus.

 

Medical attention is required to treat impaction.  The usual treatments for diarrhea in this case is not appropriate and can be dangerous
 

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