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DIARRHOEA

CleansingEfect• Pathogens

Deense

SelLimited

Loss O • Water & Electrolyt• Nutrients

• Water & Electrolytes

•

 Diets

• Dehydration• Hyoglycemia  Star!ation

  "alnutrition

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MANAGEMENT

ASSESSMENT TREATMENT

#$ Degree oDehydration

%$ ssociated '• "alnutrition

• Pneumonia• etc

#$ Water & electrolytes%$ Diets($ Drugs  ) *inc

) antimicro+ial) Symtomatic) antidiarrhoeal

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NO SIGN OFNO SIGN OF

DEHYDRATIONDEHYDRATION

SOMESOME

DEHYDRATIONDEHYDRATION

SEVERESEVERE

DEHYDRATIONDEHYDRATION

CONDITIONCONDITION WELL, ALERTWELL, ALERT RESTLESS /RESTLESS /

IRRITABLEIRRITABLELETHARGIC,LETHARGIC,

FLOPPY, COMAFLOPPY, COMA

EYESEYES NORMALNORMAL SUNKENSUNKEN   SUNKENSUNKEN

THIRSTTHIRST NORMALLY, NOTNORMALLY, NOT

THIRSTYTHIRSTYTHIRSTY, DRINKTHIRSTY, DRINK

EAGERLYEAGERLYDRINKS POORLYDRINKS POORLY

SKIN TURGORSKIN TURGOR QUICKLYQUICKLY SLOWLYSLOWLY VERY SLOWLYVERY SLOWLY

 NB : 1. READING FROM RIGHT TO LEFT

  2. CONSIDERED SEVERE OR SOME DEHYDRATION IF TWO OR MORE

OF THE SIGN ARE PRESENT

DEGREE OF DEHYDRATION (WHO,2005)

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FLUIDS TREATMENT

REHYDRATION MAINTENANCE

INITIAL REPLETION NORMAL + ABNORMAL

HOLLIDAY –

SEGAR

CHOLERA

COT

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HOLLIDAY - SEGAR

  ≤ 10 kg 100 mL / kg 10 - 20 kg 1000 mL + 50 mL/ kg

 for each > 10 kg

  > 20 kg 1500 mL + 20 mL/ kg

 for each > 20 kg

N ! 100 mL ≡ 2"5 mE# Na+

  ≡ 2 mE# $+

≡ 100 ca%or&

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KOMPOSISI MIRIP PLASMA

ASIDOSIS METABOLIK  ALKALOSIS METABOLIK

BASA

DIARE

MUNTAH

TANPA BASA

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REHYDRATION OF DIARRHOEA

ORAL

ORS*

I.V.

• RINGER’S LACTATE

• RINGER’S ACETATEORALIT!

"

' Ora% Reh()ra*&o Sa%*,

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INDICATION OF I.V FLUIDS

1. SEVERE DEHYDRATION

WITH#WITHOUT SHOC$ 

2. SEVERE DIARRHOEA

%. INTA$E BY MOUTH ↓↓ &. GLUCOSE MALABSORPTION

'. ABDOMINAL DISTENSION #

PARALYTIC OBSTR.

(. OLIGURIA # ANURIA FOR

SEVERAL HOURS

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DEHYDRATION

 NO SIGN OF SOME SEVERE

) ' ' 1, - 1,

A B C

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NAMA OSMOLARITAS

MOSM/L

KOMPOSISI ELEKROLIT (mEg/L)

Na K  !a !I" LAKTAT " A!ETAT "

R#$g%& La'a 2* +*0 * +0- 2."

R#$g%& A%a 2* +*0 * +0- "2.

Na!I 0,- *0. +5 " " +5 ""

RINGERSOLUTION

*+0 + 

,5 +55,5 ""

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TABEL II1 LARUTAN RUMATAN NORMAL

NAMAPRODUK 

OSMOLARITAS(mOm/)

KOMPOSISI ELEKTROLITmE3/

DE4TROSE KAL

(g/L) ('!a/L)Na !I

Ka E$ +B 2.5 *.,5 *.,5 *,5 +50

N/ " D 5 *5* *.,5 *.,5 50 200

N/5 " D 2.2 *+ *+ 0 +0

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TABEL III1 LARUTAN RUMATAN ABNORMAL

NAMAPRODUK OSMOLARITASmOm/I KOMPOSISI ELEKTROLITmE3/I  DE4TROSE KA

Na+ K + !I LAKTAT

(g/L) ('!a/L

Ka E$ Mg* -5 50 20 50 20

Ka E$ *A 2-0 0 +0 50 20

Ka E$ *B 2-0 50 20 50 20

Da/2 D2,5 2- + +,5 52 2,5

N/2 D5 2. " "Ka E$ A 2. *0 " 20 +0

Ka E$ B 2. *0 . 2. +0