Emmi Valentina Pardede
• Diarrheais a bowel movement (defecation) by the number of stools more
than normal (normal 100-200 cc / hr feces). With the stool is liquid / solid half,
may be accompanied by an increased frequency.
• WHO (1980)
Diarrhea is watery bowel movements more than 3 times a day
• Mansjoer (1999)
Diarrhea is divided into two based on the onset and duration, namely
acute and chronic diarrhea
1. Infection factor: bacteria (Shigella, Shalmonella, Vibrio cholera), virus
(enterovirus), parasites (worms), Candida (Candida Albicans).
2. Parenteral factors: infections of other parts of the body (OMA often
occurs in children).
3. Malabsorption factors: Carbohydrates, fats, proteins.
4. Dietary factors: Food stale, poisonous, too much fat, cooked vegetables
5. Psychological factors: Fear, anxiety.
growth in the
The toxin can not be
The movement of
water and and
electrolytes into the
Hyper-peristaltic decrease the chance
intestines to absorb food
Nursing Assessment Nursing Care Plan
Children with Diarrhea
• Noteworthy is the age. Episodes of diarrhea occurred in the first 2 years of
life. The incidence is highest age group 6-11 months.
• Most intestinal bacteria stimulate the immune response to infection, it
helps explain the decreased incidence of disease in older children.
• At the age of 2 years or more active immunity begins to form.
• Most cases are due to asymptomatic intestinal infection and enteric
bacteria spread mainly clients are not aware of the infection.
• Economic status are also influential, especially from diet and treatment.
Defecate more than 3 times
Disease History Now
Defecation: greenish yellow color, mixed with mucus and blood or mucus
only. Watery consistency, frequency of more than 3 times, spending time: 3-5
days (acute diarrhea), more than 7 days (persistent diarrhea), more than 14
days (chronic diarrhea).
In the past history of disease
Previous history of diarrhea, use of antibiotics or corticosteroids long term
(changes in Candida albicans from saprophyte to parasites), food allergy,
respiratory infection, UTI, OMA, measles.
History of Nutrition
In children ages toddler foods given as in adults, the share of a given 3 times
per day with additional fruit and milk. Malnutrition in children toddler age are
particularly vulnerable. Good food management, food hygiene and sanitation,
hand washing habits.
Family Health History
There was one family who had diarrhea.
Environmental Health History
Food storage at room temperature, lack of hygiene, neighborhood.
1. Fluid And Electrolyte Imbalances related to fluid loss secondary to diarrhea.
Objectives : after nursing action for 3 x 24 hours, fluid and electrolyte balance is maintained to the
- Vital signs are within normal limits
- Turgor elastic, mucous membranes moist lips, the eyes do not cowong, the crown is not concave.
- Consistency of bowel movements soft, frequency 1 time per day
1. Monitor signs and symptoms of
fluid and electrolyte
2. Monitor intake and output
3. Measure weight every day
4. Encourage the family to drink lots of
2-3 liters / day
1. decrease the volume of fluid circulation causing
mucosal dryness and urinary concentration. Early
detection allows immediate fluid replacement
therapy to correct the deficit
2. Dehydration can increase the glomerular filtration
rate was adequate to make the output to remove
3. Detecting loss of fluid, decrease of 1 kg of body
weight equal to 1 liter of fluid loss
4. Replacing the lost fluids and electrolytes orally
2. Imbalanced Nutrition Less Than Body Requirements related to diarrhea or
excessive output and intake of less.
Objectives: after the action at home on hospital care for nutritional needs are met
- Increased appetite
- Increased body weight, or normal according to age
1. Discuss and explain about the restriction diet
(high fiber foods, fatty foods and water is too
hot or cold)
2. Create a clean environment, away from the
smell that odor or waste, serve food in warm
3. Give the patient time to rest - sleep and
reduce the excessive activity
4. Monitor intake and output in 24 hours
1. high fiber, fat, water is too hot / cold can
stimulate irritate the stomach and
2. situation a comfortable, relaxed will
stimulate the appetite.
3. Reduce excessive energy consumption
4. Knowing the amount of output can plan
the amount of food
3. Risk for Imbalanced Body Temperature related to the process of infection
secondary to diarrhea.
Objectives : After making maintenance actions performed for 3 x 24 hours, there was no
increase in body temperature
- Body temperature within normal limits (36 to 37.5 C)
- There is no sign of infection (rubur, dolor, color, tumors, fungtio leasa)
1. Monitor the body temperature every 2
2. Give a warm compress
3. Collaboration of antipirektik
1. Early detection of abnormal changes in
body function (an infection)
2. stimulates the central thermostat to lower
the body's heat production
3. Stimulate the central thermostat in the
4. Risk for impaired skin integrity related to increased frequency of diarrhea.
Objectives : after nursing actions while in hospital, skin integrity is not compromised
- No irritation: redness, abrasions, cleanliness maintained
- Families are able demonstrate perianal care properly
1. Discuss and explain the importance of
maintaining a bed
2. Demonstrate and involve the family in
caring for perianal (if wet clothing and
replace the bottom and base)
3. Adjust bed or seated position with an
interval of 2-3 hours
1. hygiene prevents germs breeding
2. Prevent the occurrence of skin irritation is
not expected, because of humidity and
acidity of the stool
3. Smooth vascularization, reducing the
emphasis of the old so that does not
happen ischemia and irritation.