This document discusses diarrhea in children. It defines diarrhea as having more than 3 loose or watery bowel movements per day. Diarrhea can be caused by infections from bacteria, viruses or parasites, malabsorption of nutrients, poor diet, psychological factors, and other infections elsewhere in the body. The pathophysiology involves increased secretion of water and electrolytes into the gut due to infection or malabsorption. Nursing assessments for children with diarrhea include monitoring fluid and electrolyte balance, nutrition status, body temperature, and skin integrity. Nursing care plans aim to prevent dehydration, maintain nutrition, monitor for infection, and prevent skin breakdown.

1. Children
Diarrhea
Emmi Valentina Pardede
Po.71.20.1.11.020
IIB.1

2. Definition
• 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

3. Etiology
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
underdone.
5. Psychological factors: Fear, anxiety.

4. Pathophysiology
Infection
factors
Malabsorption Factors
carbohydrates, proteins,
fats
Food
Factors
Psychologic
al Factors
Entry and
growth in the
intestine
Osmotic Pressure
Rises
The toxin can not be
abscebed
Anxiety
Hyperecretion of
water and
electrolytes
The movement of
water and and
electrolytes into the
gut cavity
Hyper-peristaltic decrease the chance
intestines to absorb food
Diarrhea

5. Nursing Assessment Nursing Care Plan
Children with Diarrhea

6. Identity
• 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.

7. Main complaint
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.

8. 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.

9. Nursing Diagnosis
Nursing Interventions

10. 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
fullest.
Expected outcomes:
- 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
Interventions Rational
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
the waste.
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

11. 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
Expected Outcomes:
- Increased appetite
- Increased body weight, or normal according to age
Interventions Rational
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
intestinal tract.
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

12. 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
Expected outcomes:
- Body temperature within normal limits (36 to 37.5 C)
- There is no sign of infection (rubur, dolor, color, tumors, fungtio leasa)
Interventions Rational
1. Monitor the body temperature every 2
hours
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
brain

13. 4. Risk for impaired skin integrity related to increased frequency of diarrhea.
Objectives : after nursing actions while in hospital, skin integrity is not compromised
Expected outcomes:
- No irritation: redness, abrasions, cleanliness maintained
- Families are able demonstrate perianal care properly
Interventions Rational
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.

14. Thank You..