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XIV. INTRODUCTION
Acute Gastroenteritis (AGE)
Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the
stomach and intestine. It is frequently referred to as the stomach or intestinal flu, although the
influenza virus is not associated with this illness. Major symptoms include nausea and
vomiting, diarrhea, and abdominal cramps. These symptoms are sometimes also accompanied
by fever and overall weakness. Gastroenteritis typically lasts about three days. Adults usually
recover without problem, but children, the elderly, and anyone with an underlying disease are
more vulnerable to complications such as dehydration.
Gastroenteritis arises from ingestion of viruses, certain bacteria, or parasites. Food that has
spoiled may also cause illness. Certain medications and excessive alcohol can irritate the
digestive tract to the point of inducing gastroenteritis. Regardless of the cause, the symptoms
of gastroenteritis include diarrhea, nausea and vomiting, and abdominal pain and cramps.
Sufferers may also experience bloating, low fever, and overall tiredness. Typically, the
symptoms last only two to three days, but some viruses may last up to a week.
A usual bout of gastroenteritis shouldn't require a visit to the doctor. However, medical
treatment is essential if symptoms worsen or if there are complications. Infants, young
children, the elderly, and persons with underlying disease require special attention in this
regard.
The greatest danger presented by gastroenteritis is dehydration. The loss of fluids through
diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life-
threatening problems such as heart beat abnormalities (arrhythmia). The risk of dehydration

2. increases as symptoms are prolonged. Dehydration should be suspected if a dry mouth,
increased or excessive thirst, or scanty urination is experienced.
If symptoms do not resolve within a week, an infection or disorder more serious than
gastroenteritis may be involved. Symptoms of great concern include a high fever (102 ° F
[38.9 °C] or above), blood or mucus in the diarrhea, blood in the vomit, and severe abdominal
pain or swelling. These symptoms require prompt medical attention.
Gastroenteritis is a self-limiting illness which will resolve by itself. However, for comfort and
convenience, a person may use over-the-counter medications such as Pepto Bismol to relieve
the symptoms. These medications work by altering the ability of the intestine to move or
secrete spontaneously, absorbing toxins and water, or altering intestinal microflora. Some
over-the-counter medicines use more than one element to treat symptoms.
XV. Patient’s Profile
S.Q. is a female, 11/12 months old, residing at P2 Blk1 L38 Pabahay Nanadero,
Calamba City, Laguna. Her mother is J.Q., works part time in a shop and her father
is R.Q., factory worker. She has one sibling older than her, K.Q., 3 years old. S.Q.
was born on March 6, 2009, and born at Calamba, Laguna, Filipino in nationality.
Their whole family is Born Again in religion. She weighs 8.7 kg. She’s admitted on
January 30, 2010 at room 103-C, pedia ward with chief complaint of high fever for
2 days with emesis and has a diagnosis of Acute Gastroenteritis. And she was
discharged on January 6, 2010, Saturday at 1:30 pm. Their attending physicians
were Campos, Angelie, M.D. and Bonagua, Aireen, M.D.
XVI. Health History & Chief Complain
Chief Complaint
She was admitted for having high fever for 2 days with vomiting.
Present Illness
S.Q. was only admitted to the hospital due to gastrointestinal problem now and was also
suspected of urinary tract infection by Dra. Campos. Aside from the diagnosis, no other
disease or complication was seen or diagnosed.

3. Past Health History
Mrs. Q says “ eto first time nya ma-admit after nya ipanganak.” S.Q. gets seasonal
cough and colds at times but never serious because it usually last only for a few days. They
always consult their doctor once sick. She is complete in her vaccinations except those which
would be taken on her 1 year of age.
Family Health History
No one in the family had any respiratory illness or allergies. On her father’s side,
almost all have hypertension. One member of their family died on a heart attack.
XVII. Gordon’s Pattern
Health Perception
As Mrs Q. stated, “lagi naman kami nagpapacheck up ni stephani. Napunta
talaga kami kay Dra. Campos. Malikot lang talaga yan pero inaalagaan yan sa bahay.”
S.Q. has a mannerism of sticking anything on her mouth. Whatever she touches she
directs it toward her mouth. Although, she doesn’t practice hand washing every now
and then. There are some medications she takes easily but there are also those
medications which is hard for her because of the taste.
Nutritional-Metabolic
S.Q. weighs 8.7 kg. She eats soft foods. She drinks 6-7 bottles of milk in a day.
Mrs. Q provides her daughter milk and food in accordance to age and doctor’s advise.
She drinks formula milk. She stop being breastfed when she was 10 ½ moths. She has
no allergy.
Elimination
She defecates once or twice a day in her usual days. She changes diaper 3-5
times in a day when full or had defecated. She was advise to use Lactacid for her
perennial wash and calmoseptin ointment on her diaper rash.
Activity-Exercise
S.Q. is a very playful and active girl. She has lots of energy but cries when she
doesn’t like something. She smiles and laughs a lot. Her coordination, gait, balance is
not yet stable due to age. Her daily living activities were provided by her parents. There
is no musculoskeletal impairment. She usually plays after she wakes up in the morning.
Sleep-Rest

4. She sleeps at 8 P.M. in the evening and usually gets up 7 A.M. – 8 A.M. in the
morning. After playing or eating she takes a nap. She has straight undisturbed sleep at
night.
Cognitive Perceptual
S.Q. has no sensory deficits. She response well to verbal stimulus by looking at
you or having facial expressions. “Bibo nga yan bata nay an, makulit pero mabilis mo
naman makuha attention,” as her mother stated.
Self-Perception
S.Q. is not afraid of new people around her. She is friendly and is easy to
accommodate.
Sexual-Reproduction
Prior to age, S.Q. is not yet oriented with any sexual matters.
Coping Stress
In her age, she usually cries when something is wrong about her. Simple smile or
cry is a sign of her comfort, distress or feelings. She is familiarized to her family
members and long for them when she doesn’t want the situation like giving of
medications or other procedures.
Role-Relationship
She doesn’t know the concept of death yet due to age. Forms words like “dede”
and “dada”. She knows her family members and can easily familiarize the people
around her.
Value-Belief
The family is Born Again. They regularly attend church together with all the
members of the family. They don’t usually believe in “hilot”. Once one is sick in the
family, they go immediately to the hospital or for check-up.
XVIII.Head-to-Toe Assessment
General Assessment: Playful and active, neat
Initial Vital Sign: T=36.4°C RR=27 PR=118

5. Area Assessed Technique Normal Findings Actual Findings Evaluation

6. Skin
Color Inspection Light brown,
tanned skin (vary
according to race)
brown skin Normal
Lips, nail beds,
soles and palms Inspection
Lighter colored
palms, soles, lips
and nail beds
Lighter colored
palms, soles, lips and
nail beds
Normal
Moisture Inspection/
Palpation
Skin normally dry Skin normally dry Normal
Temperature Palpation Warm to touch 36.4 o
C, warm to
touch
Normal
Texture Palpation
Smooth, soft and
flexible palms and
soles (thicker)
Smooth, soft and
flexible palms and
soles (thicker)
Normal
Turgor Palpation Skin snaps back
immediately
Skin snaps back
immediately 1-2
seconds
Normal
Skin appendages
a. Nails
Inspection Transparent,
smooth and
convex cut and
clean
Transparent, smooth
and convex
Uncut and dirty
Poor
grooming
Nail beds Inspection Pinkish Pinkish Normal
Nail base Inspection Firm Firm Normal
Capillary refill Inspection/
Palpation
White color of
nail bed under
pressure should
return to pink
within 2-3
seconds
White color of nail
bed under pressure
returned to pink
within 2-3 seconds
Normal
b. Hair
Distribution Inspection Evenly distributed Evenly distributed Normal
Color Inspection Black Black Normal
Texture Inspection/
Palpation
Smooth Smooth and curly Normal
Eyes
Eyes Inspection Parallel to each
other
Parallel to each other
but slightly sunken
May be a
sign of
dehydration
Visual Acuity Inspection
(penlight)
PERRLA- Pupils
equally round
react to light and
PERRLA- Pupils
equally round react to
light and
Normal

7. accommodation accommodation
Eyebrows Inspection Symmetrical in
size, extension,
hair texture and
movement
Symmetrical in size,
extension, hair texture
and movement
Normal
Eyelashes Inspection Distributed evenly
and curved
outward
Distributed evenly
and long curved
outward
Normal
Eyelids Inspection Same color as the
skin
Blinks
involuntarily and
bilaterally up to
20 times per
minute
Do not cover the
pupil and the
sclera, lids
normally close
symmetrically
Same color as the
skin
Blinks involuntarily
and bilaterally up to
16 times per minute
Do not cover the
pupil and the sclera,
lids normally close
symmetrically
Normal
Normal
Normal
Conjunctiva Inspection Transparent with
light pink color
Transparent with light
pink color
Normal
Sclera Inspection Color is white Color is white Normal
Cornea Inspection Transparent,
shiny
Transparent, shiny Normal
Pupils Inspection Black, constrict
briskly
Black, constrict
briskly
Normal
Iris Inspection Clearly visible Clearly visible Normal
Ears
Ear canal
opening
Inspection Free of lesions,
discharge of
inflammation
Canal walls pink
Free of lesions,
discharge of
inflammation
Canal walls pink
Normal
Normal
Hearing Acuity Inspection Client normally
hears words when
whispered
Client normally hears
words when
whispered
Normal
Nose
Shape, size and
skin color
Inspection Smooth,
symmetric with
same color as the
face
Smooth, symmetric
with same color as
the face
Normal

8. Nasal septum Inspection Close to midline,
thicker anteriorly
than posteriorly
Close to midline,
thicker anteriorly than
posteriorly
Normal
Nares Inspection Oval, symmetric
and without
discharge
Oval, symmetric and
without discharge Normal
Mouth and
Pharynx
Lips Inspection Pink, moist
symmetric
Pink, moist
symmetric
Normal
Buccal mucosa Inspection Glistening pink
soft moist
Glistening pink soft
moist
Normal
Gums Inspection Slightly pink
color, moist and
tightly fit against
each tooth
Slightly pink color,
moist and tightly fit
against each tooth
Normal
Tongue Inspection Moist, slightly
rough on dorsal
surface medium
or dull red
Moist, slightly rough
on dorsal surface
medium or dull red
Normal
Teeth Inspection Firmly set, shiny Firmly set, shiny
No tooth decay, milk
tooth present
Normal
Hard and soft
palate
Inspection Hard palate-
dome-shaped
Soft Palate- light
pink
Hard palate- dome-
shaped
Soft Palate- light pink
Normal
Neck
Symmetry of
neck muscles,
alignment of
trachea
Inspection
Neck is slightly
hyper extended,
without masses or
asymmetry
Neck is slightly hyper
extended, without
masses or asymmetry
Normal
Neck Rom Inspection Neck moves
freely, without
discomfort
Neck moves freely,
without discomfort
Normal
Thyroid gland Palpation Rises freely with
swallowing
Rises freely with
swallowing
Normal
Trachea Inspection Midline Midline Normal
Thorax and
Lungs
Auscultatio
n
Clear breath
sounds
Clear breath sounds Normal

9. Abdomen
Bowel sounds
Inspection
Auscultatio
n
Skin same color
with the rest of
the body
Clicks or gurling
sounds occur
irregularly and
range from 5-35
per minute
Skin same color with
the rest of the body
Clicks or gurling
sounds occur
irregularly and range
from 5-35 per minute
Normal
Normal
Neurology
system
Level of
consciousness
Inspection Fully conscious,
respond to
questions quickly,
perceptive of
events
Fully conscious,
respond quickly to
stimulus
Unstable gait, balance
and coordination
Normal
Normal for
age (11
months)
Behavior and
appearance
Inspection Makes eye
contact with
examiner,
hyperactive
expresses feelings
with response to
the situation
Makes eye contact
with examiner,
hyperactive expresses
feelings with
response to the
situation
Normal
XIX. Anatomy & Physiology
Digestion is the process by which food is broken down into smaller pieces so that the body
can use them to build and nourish cells and to provide energy. Digestion involves the
mixing of food, its movement through the digestive tract (also known as the alimentary
canal), and the chemical breakdown of larger molecules into smaller molecules. Every
piece of food we eat has to be broken down into smaller nutrients that the body can absorb,
which is why it takes hours to fully digest food.
The digestive system is made up of the digestive tract. This consists of a long tube of
organs that runs from the mouth to the anus and includes the esophagus, stomach, small
intestine, and large intestine, together with the liver, gall bladder, and pancreas, which
produce important secretions for digestion that drain into the small intestine. The digestive
tract in an adult is about 30 feet long.
Mouth and Salivary GlandsDigestion - begins in the mouth, where chemical and
mechanical digestion occurs. Saliva or spit, produced by the salivary glands (located under

10. the tongue and near the lower jaw), is released into the mouth. Saliva begins to break down
the food, moistening it and making it easier to swallow. A digestive enzyme (called
amylase) in the saliva begins to break down the carbohydrates (starches and sugars). One
of the most important functions of the mouth is chewing. Chewing allows food to be
mashed into a soft mass that is easier to swallow and digest later.
Esophagus - Once food is swallowed, it enters the esophagus, a muscular tube that is about
10 inches long. The esophagus is located between the throat and the stomach. Muscular
wavelike contractions known as peristalsis push the food down through the esophagus to
the stomach. A muscular ring (called the cardiac sphincter) at the end of the esophagus
allows food to enter the stomach, and, then, it squeezes shut to prevent food and fluid from
going back up the esophagus.
Stomach - a J-shaped organ that lies between the esophagus and the small intestine in the
upper abdomen. The stomach has 3 main functions: to store the swallowed food and liquid;
to mix up the food, liquid, and digestive juices produced by the stomach; and to slowly
empty its contents into the small intestine.
Small Intestine - Most digestion and absorption of food occurs in the small intestine. The
small intestine is a narrow, twisting tube that occupies most of the lower abdomen between
the stomach and the beginning of the large intestine. It extends about 20 feet in length. The
small intestine consists of 3 parts: the duodenum (the C-shaped part), the jejunum (the
coiled midsection), and the ileum (the last section). The small intestine has 2 important
functions. First, the digestive process is completed here by enzymes and other substances
made by intestinal cells, the pancreas, and the liver. Glands in the intestine walls secrete
enzymes that breakdown starches and sugars. The pancreas secretes enzymes into the small
intestine that help breakdown carbohydrates, fats, and proteins. The liver produces bile,
which is stored in the gallbladder. Bile helps to make fat molecules (which otherwise are
not soluble in water) soluble, so they can be absorbed by the body. Second, the small
intestine absorbs the nutrients from the digestive process. The inner wall of the small
intestine is covered by millions of tiny fingerlike projections called villi. The villi are
covered with even tinier projections called microvilli. The combination of villi and
microvilli increase the surface area of the small intestine greatly, allowing absorption of
nutrients to occur. Undigested material travels next to the large intestine.
Large intestine - forms an upside down U over the coiled small intestine. It begins at the
lower right-hand side of the body and ends on the lower left-hand side. The large intestine
is about 5-6 feet long. It has 3 parts: the cecum, the colon, and the rectum. The cecum is a
pouch at the beginning of the large intestine. This area allows food to pass from the small
intestine to the large intestine. The colon is where fluids and salts are absorbed and extends
from the cecum to the rectum. The last part of the large intestine is the rectum, which is
where feces (waste material) is stored before leaving the body through the anus. The main
job of the large intestine is to remove water and salts (electrolytes) from the undigested
material and to form solid waste that can be excreted. Bacteria in the large intestine help to
break down the undigested materials. The remaining contents of the large intestine are

11. moved toward the rectum, where feces are stored until they leave the body through the
anus as a bowel movement.
XX. Pathophysiology

12. XXI. Course in the Ward

13. On day 1, January 30, 2010, at 8:40 am S.Q. is for check up with her attending
physician due to high fever for 2 days associated with vomiting. She was seen and
examined by Dra. Campos and was advised to be admitted for further test and treatment
due to suspected UTI. She was diagnosed with Acute Gastroenteritis. An IVF D5 INM
500 ml x 10cc/hr is hooked and CBC was done. She was brought to pedia ward at
around 11:00 am and received by nurse on charge. Monitoring of input and output was
ordered by the doctor with increase fluid intake. Medications were Paracetamol drops 1
ml every 4 hours for fever. 1 dose was given on admission and following doses for
every 4 hours was given.
On the second day, January 31, 2010, IVF was changed to #2 D5 INM 500 ml x 10cc/hr
at 9:50 am. She was seen by Dra. Campos at 10:15 am and given an order of urinalysis
and fecalysis. She was prescribed with Omeprazole (Omepron) 5mg IV once a day, 1st
dose is given at 8:00 am the next morning. Also, Zinc Sulfate (E-Zinc) drops (0.6 ml)
once daily was ordered. Her fever decreases gradually unitl there administration of
paracetamol every 4 hours for fever was discontinued. She is being given Ceftriaxone
(Xtenda) 750 mg IV once a day side drip every 12 noon. She was playful all through
out the day. The laboratoty results was followed up.
On the third day, February 1, 2010, Monday, she was crying when received. She has
fever of 37.9 °C and administration of Paracetamol drops 1 ml every 4 hours was
resumed. She has been irritable all day. 10:40 am Dra. Campos, examined S.Q. and was
refered to Dr. Zablan due to decreased results of urinalysis. All laboratory results were
seen by Dra. Campos. During the afternoon, her fever subsides to 37.2 °C . IVF #3 D5
INM 500 ml x 10 cc/hr was hooked at 1:00 pm. All medications were given.
On the fourth day, February 2, 2010, Tueasday, she has no fever, negative vomiting and
playful. Dra. Campos had her round at 4:50 pm and checked S.Q. she ondered continue
all medications and treatment and wait for Dr. Zablan’s assessment. IVF #4 D5 INM
500 ml x 10 cc/hr was hooked at 11:30 am.
On the fifth day, February 3, 2010, Wednesday, Dr. Zablan had his round at 11:30 am.
Findings were with positive diaper rash, decrease laboratory results and afebrile, no
vomiting. He ordered repeat UA from AM (clear catch), urine culture and sensitivity,
use of Lactacid pink for perennial wash, and apply Calmoseptin ointment to diaper rash
3x a day. IVF #5 INM 500 ml x 10cc/hr was hooked at 12:15 nn.
On the sixth day, February 4, 2010, Thursday, Dra. Campos ordered continue all
medications and follow order of Dr. Zablan. IVF #6 INM 500 ml x 10cc/hr was hooked
at 11:00 am. S.Q. is received active, playful but cries at times. All medications were
given on time. Dr. Zablan saw laboratory results and advise client to increase fluid
intake and replace loses with PLRS. Follow up urine culture and sensitivity. Repeat
urinalysis and notify him when WBC is 1-3. IVF #7 INM 500 ml x 10cc/hr was hooked
at 1:00am.

14. On the seventh day, February 5, 2010, Friday, Dra Campos ordered continue all
medeications and treatments. Proceed to Dr. Zablan’s orders. All 8:00 am medications
were given. S.Q. is taking a bath, playful and laughing when received. IVF was
regulated. IVF was ordered to shift to D5 IMB ½ L x 20 cc/hr. IVF #8 IMB ½ L x 20
cc/hr was hooked at 11:30 am. Dr. Zablan had his round at 11:45, he checked S.Q. and
the laboratory test. He said all test were now stabilized and normal. He ordered follow
up of urine culture and sensitivity and advised periodic complete emptying of urinary
bladder.
On the eighth day, February 6, 2010, Saturday, all findings were on normal range. S.Q.
is afebrile, no vomiting, diminished diaper rash, and was active and playful. All
morning medications were given. IVF #9 imb ½ l X 20 cc/hr was hooked at 10:45 am.
Dra. Campos, advised that they may go home. S.Q. was discharge at 1:30 pm.
XXII. Laboratory Results
Urinalysis
01/30
/10
Int. 01/31/
10
Int. 02/03/
10
Int. 02/05
/10
Int.
Color Yellow Normal Yellow Normal yellow Normal Light
Yello
w
Normal
Transparenc
y
SI
turbid
increased
urine
concentrati
on
SI
turbid
increased
urine
concentrat
ion
Clear Normal Clear Normal
Reaction 5.5 Decreased 6.0 Normal 6.0 Normal 8.0 Normal
Specific
Gravity
1.025 Normal 1.010 Normal 1.025 Normal 1.010 Normal
Albumin Traces Normal Traces Normal + 1 UTI ( - ) Normal
Sugar ( # ) Increase
sugar
( - ) Normal ( - ) Normal ( - ) Normal
WBC 7-10 Infection 15-20 Infection 28-30 Infection 1-3 Normal

15. Fecalysis
01/31/10 Interpretation
Color Green Sign of diarrhea
Consistency Soft Sign of diarrhea
Parasites No OVA or parasites seen Normal
Hematology
01/30/10 Results Normal Value Interpretation
Hemoglobin 123 120-150 Normal
Hematocrit 0.38 0.37-0.45 Normal
RBC 4.98 4.6-5.2 Normal
WBC 19.1 5-10 x 10/L Increase, infection
Neutrophils 0.77 0.55-0.65 Increase, acute
bacterial infection
Lymphocytes 0.23 0.25-0.35 Decrease, may cause
severe malnutrition
Platelets 297 140-340 x 10/L Normal
MCV 77.3 86-100 Normal
MCH 26.7 26-31 Normal
MCHC 31.9 31-37 Normal
Blood Chemistry
01/30/10 Results Normal Value Interpretation
BUN 11 7-17 Normal
Creatinine 0.3 0.52-1.04 Decrease,indirectly
proportional to
glomerular filtrate
rate
XXIII.Drug Study

16. Generic Brand Classification Indication Action Nsg.
Responsibilities
Zinc-Sulfate
Drops (0.6
ml) OD
E-Zinc Vitamins &
Minerals
To prevent
individual trace
element
deficiencies in
patient
receiving long-
term total
parenteral
nutrition
Participate in
synthesis &
stabilization
of protein &
nucleic acids
in
subcellular
& membrane
transport
system
> Explain need
for zinc
administration
to patient &
family
> Report signs
of
hypersensitivity
promptly
Omeprazole
5mg IV OD
Omepron Proton Pump
Inhibitor
Gastrointestinal
disturbaces and
irritations
Inhibits
activity of
acid (proton)
pumps &
binds to
hydrogen-
potassium
adenosine
triphosphate
at secretory
surface of
gastric
parietal cells
to block
formation of
gastric acid
> Sodium
restricted diet
should be
cautious
> take 30
minutes before
meals
XXIV.Nursing Care Plan

17. Assessment Nsg.
Diagnosis
Planning Intervention Rationale Evaluation
S > “Oo,
mahilig nga
yan magsubo
ng kahit
anong
mahawakan
nya,” as
stated by
mother
> ”sa halos
1 week
naming na
stay ditto sa
ospital, 3-4
times ko sya
pinaliguan
ditto,” as
stated by
mother
O > very
playful
> does not
wash often
> age =
11/12 moths
old
> dirty nails
Risk for
Infection
The client
will be able
to
demonstrate
no signs of
infection
(fever) until
discharge
>Demonstrate
& teach
proper
handwashing
technique and
stress its
importance
> Instruct in
daily bath/
shower,
regular
cutting of
nails
> Limit
visitors
> Advise to
avoid
opening of
door or going
out the room
too much
> Instruct
mother to
neglect her
child from
putting hands
or objects on
mouth
> first-line of
defense
against
infection/
cross-
contamination
(NANDA 10th
Ed. Pg. 323)
> first-line
defense and
eliminate
rough edges or
long nails,
which can
harbor
microorganism
(Kozier 8th
Ed.
Vol I pg. 682)
> to prevent
exposure of
client
(NANDA 10TH
Ed. Pg. 323)
> same
> One source
of fecal-oral
route mode of
transmission
of pathogens
(Kozier 8th
Ed)
>To avoid
microbial
growth
Goal Met
AEB afebrile
until
discharged

18. > Suggest
techniques
for safe food
preparation
and
presentation
(NANDA 10TH
Ed.)
Assessment Nsg.
Diagnosis
Planning Intervention Rationale Evaluation
S> “Sadyang
malikot nga
yan, maliksi
kumilos,” as
stated by
mother
O > Tantrums
at times
> Age=
11/12 months
old
> Unstable
gait, balance
and
coordination
>Unfamiliar
environment
> Active
and playful
Risk for Fall The client will
be able to
maintain
safety
measure with
free from
injury within
hospitalization
> Provide
assistive
device or
safety device
like side rails
> Encourage
family for
proper
supervision
> Practice
walking with
support /
exercise of
legs and
extremities
> Discuss
safety
measures that
should be in
precautions
> Prevent
from falling
onto one side
or the other,
also helps
stabilize
balance
(Kozier 8th
Ed)
> Supervision
helps one
child to be
safe as well
as gain
courage to be
independent
on activity
(Kozier 8th
Ed.)
> helps mucle
and bones to
stabilize and
gain balance
on
coordination
(Kozier 8th
Ed.)
> To avoid
injury and
lessen the
risk (Kozier
Goal Met
AEB free
from injury
upon
discharge

19. 8th
Ed)
Assessment Nsg. Diagnosis Planning Intervention Rationale Evaluatio
n
S > “
Hinuhugasan
ko naman
kamay nya
pag
nadudumiha
n sya. Ganun
sabi nung
nurse, pero
hindi ko na
minamaya’t
maya ang
hugas, pag
madumi
lang,” as
stated by
mother
O > client
has a habit
of putting
everything to
mouth
> hands are
always wet
with saliva
> nails
uncut and
dirty
>
Unorganized
bed & bed
side table
> No bed
linens
Deficient
Knowledge
(Infection
Control) R/T
information
misinterpretatio
n AEB
verbalized data
The client
will be able
to practice
understandin
g of teaching
after 1-2
hours of
teaching
> Describe
ways to
manipulate the
bed, room &
other facilities
> Instruct to
rinse soiled
cloth in cold
water, wash in
hot water if
possible & add
a cup of bleach
or phenol-
based
disinfectant
> Perform &
teach hand
hygiene
(before & after
handling/eatin
g of foods, or
toileting)
> Promote nail
care
> Instruct not
share personal
items
> to prevent
possible cross-
contamination
(Kozier 8th
Ed.
Vol I pg. 682)
> to induce
death of
microorganis
m
(Kozier 8th
Ed.
Vol I pg. 682)
> first-line
defense
against
infection/
cross-
contamination
(NANDA 10th
Ed. Pg 323)
> eliminate
rough edges or
long nails,
which can
harbor
microorganis
m (Kozier 8th
Ed. Vol I pg.
682)
> Infections
can be
Goal Met
AEB
mother
performed
hygiene
care for
self and
child and
cleaning
of place

20. transmitted
from shared
personal items
through
fomites
(Kozier 8th
Ed.
Vol I pg. 682)
XXV. Prognosis
Medications – Upon discharge client was advised to continue intake of Zinc-Sulfate (E-
zinc) drops 0.6 ml once a day.
Economics – Advised client to buy foods within the budget. The client, prior to admission
present a health insurance card, ( + ) HMO. They had discount on S.Q.’s hospitalization
and also to the doctor’s fee.
Treatment – S.Q. was still advised for increase fluid intake, periodic complete emptying of
urinary bladder, use of lactacid for perinial wash, and keep hands clean. She still have a
follow up check up after 1 week after discharge.
Health Teaching – Proper hygiene of both child and parent are very important as defense
from infection. Proper and strict supervision of child until balance, gait, and coordination is
gained. Advise to restrict child from handling items or objects especially if unfamiliar and
not edible. Emphasize importance of hand washing and nail care.
Out Patient – Client was discharge on January 6, 2010. Last advises and follow up check
ups were reminded. Other treatments were elaborated.
Diet – Client was ordered with diet for age, with increase fluid intake.

21. Calamba Doctors’ College
S.Y. 2009-2010
CASE STUDY
(ACUTE GASTROENTERITIS)
KIRSTEN E. PAPERA
BSN LEVEL 3
GROUP 6