Diarrhea- easy ppt for Nurses definition of Diarrhea types of Diarrhea risk factors of Diarrhea Clinical manifestations of Diarrhea Assessment & Diagnostic tests of Diarrhea Management of Diarrhea Medical management Nursing Management

1. DIARRHEA
PRESENTED BY
SWATILEKHA DAS
M.SC NURSING (MEDICAL-
SURGICAL )
ASST. PROFESSOR

2. DIARRHEA
Diarrhea is a condition defined by an increased
frequency of bowel movements (more than three
per day), increased amount of stool (more than
200 g per day), and altered consistency (liquid
stool). It is usually associated with urgency,
perianal discomfort, incontinence, or a
combination of these factors. Diarrhea can result
from any condition that causes increased intestinal
secretions, decreased mucosal absorption, or
altered (increased) motility.

3. TYPES OF DIARRHEA
Types of diarrhea include secretory, osmotic,
malabsorptive, infectious, and exudative. It
can be acute (self-limiting and often
associated with infection) or chronic (persists
for a long period and may return
sporadically).

4. RISK FACTORS
It can be caused by certain medications
➢Tube feeding formulas
➢Metabolic and endocrine disorders
➢Viral and bacterial infections
➢Other causes are nutritional and malabsorptive
disorders
➢Anal sphincter deficit
➢Zollinger–ellison syndrome
➢Paralytic ileus, acquired immunodeficiency
syndrome (AIDS), and intestinal obstruction

5. CLINICAL MANIFESTATIONS
• Increased frequency and fluid content of stool
• Abdominal cramps, distention, intestinal rumbling (borborygmus), anorexia, and thirst
• Painful spasmodic contractions of the anus and ineffectual straining (tenesmus) with each defecation
• Other symptoms, depending on the cause and severity and related to dehydration and fluid and electrolyte
imbalances, include the following:
• Watery stools, which may indicate small bowel disease
• Loose, semisolid stools, which are associated with disorders of the large bowel
• Voluminous greasy stools, which suggest intestinal malab-sorption
• Blood, mucus, and pus in the stools, which denote inflam-matory enteritis or colitis
• Oil droplets on the toilet water, which are diagnostic of pan-creatic insufficiency
• Nocturnal diarrhea, which may be a manifestation of dia-betic neuropathy

6. ASSESSMENT AND DIAGNOSTIC FINDINGS
When the cause is not obvious: complete blood cell count; serum chemistries; urinalysis;
routine stool examination; and stool examinations for infectious or parasitic organisms,
bacterial toxins, blood, fat, electrolytes, and white blood cells. Endoscopy or barium
enema may assist in identifying the cause.

7. MEDICAL MANAGEMENT
• Primary medical management is directed at controlling symptoms, preventing complications,
and eliminating or treating the underlying disease.
• Certain medications (eg, antibiotics, anti-inflammatory d agents) and antidiarrheals (eg,
loperamide [imodium], diphenoxylate [lomotil]) may reduce the severity of diar-rhea and the
disease.
• Increase oral fluids; oral glucose and electrolyte solution may be prescribed.
• Antimicrobials are prescribed when the infectious agent has been identified or diarrhea is
severe.
• Iv therapy is used for rapid hydration in very young or eld-erly patients.

8. NURSING MANAGEMENT
• Elicit a complete health history to identify character and pattern of diarrhea, and the following: any related signs and symptoms, current medication therapy,
daily dietary patterns and intake, past related medical and surgical history, and recent exposure to an acute illness or travel to another geo-graphic area.
• Perform a complete physical assessment, paying special attention to auscultation (characteristic bowel sounds), pal-pation for abdominal tenderness,
inspection of stool (obtain a sample for testing).
• Inspect mucous membranes and skin to determine hydration status, and assess perianal area.
• Encourage bed rest, liquids, and foods low in bulk until acute period subsides.
• Recommend bland diet (semisolids to solids) when food intake is tolerated.
• Encourage patient to limit intake of caffeine and carbonated beverages, and avoid very hot and cold foods because these increase intestinal motility.
• Advise patient to restrict intake of milk products, fat, whole grain products, fresh fruits, and vegetables for several days.
• Administer antidiarrheal drugs as prescribed.
• Monitor serum electrolyte levels closely.
• Report evidence of dysrhythmias or change in level of con-sciousness immediately.
• • Encourage patient to follow a perianal skin care routine to
• Decrease irritation and excoriation.

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