gastroente
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GastroenteritisGastroenteritis
Jeanne Marie Camille N. Reyes, SN
Erica May Tudayan, SN
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Digestive SystemDigestive System
y The human digestive system is a complex
series of organs and glands that processes
food. In order to use the food we eat, our
body has to break the food down into smallermolecules that it can process; it also has to
excrete waste.
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DIGESTIVEDIGESTIVEPROCESSPROCESS
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y Mouth- Food is partly broken down by the
process of chewing and by the chemical actionof salivary enzymes.y Esophagus- It uses rhythmic, wave-like muscle
movements (called peristalsis) to force food
from the throat into the stomach.y Stomach- churns the food and bathes it in a
very strong acid (gastric acid).y Small Intestine- food enters the duodenum,
the first part of the small intestine. It thenenters the jejunum and then the ileum (thefinal part of the small intestine)
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y
Large intestine- some of the waterand electrolytes (chemicals like
sodium) are removed from the food.
y
End of the Process- Solid waste isthen stored in the rectum until it is
excreted via the anus.
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Other parts:Other parts:
y Appendix- Attached to the first portion of
the large intestine is a troublesome pouch
called the (veriform) appendix.
y Gall bladder- active storage shed, which
absorbs mineral salts and water received
from the liver and converts it into a thick,
mucus substance called "bile," to bereleased when food is present in the
stomach.
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y Liver- cleanses the blood and processes nutritional
molecules, which are distributed to the tissuesy Rectum-The rectum is a short, muscular tube that
forms the lowest portion of the large intestine and
connects it to the anus.
y Pancreas- It functions as an exocrine organ byproducing digestive enzymes, and as an endocrine
organ by producing hormones, with insulin being
the most important hormone produced by the
pancreas
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What is Gastroenteritis?What is Gastroenteritis?
yGastroenteritis is a condition
that causes irritation and
inflammation of the stomachand intestines (the
gastrointestinal tract)
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CauseCausey Bacteria and Viruses are most common
y VIRUS: Norovirus - Fifty to seventy percent of cases of gastroenteritis in adults are caused by thenoroviruses (genus Norovirus, family Caliciviridae.
This virus is highly contagious and spreads rapidly.y BACTERIA: Escherichia coli infection can cause
significant complications. E. coli O157:H7(one typeof the bacteria) can cause complications inapproximately 10% of affected individuals (for
example, kidney failure in children [hemolytic-uremic syndrome or HUS), bloody diarrhea, andthrombotic thrombocytopenic purpura (TTP) inthe elderly.
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Disease ProcessDisease Process
y Toxigenic agents, such as some E. coli and
Shigella strains, release an exotoxin that
impairs intestinal absorption.
y Invasive pathogens, such as some Shigella
and Salmonella species and E. coli,
penetrate the mucosa of the small bowel,
causing cellular destruction, necrosis,ulceration, bleeding, and exudation of
protein-rich fluid.
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Signs and Symptoms:Signs and Symptoms:
y The most common symptoms arey diarrhea,
y crampy abdominal pain,y nausea, and
y vomiting.y Many people also refer to gastroenteritis as
"stomach flu." This can sometimes be confusingbecause influenza (flu) symptoms include
y
headache,y muscle aches and pains, andy respiratory symptoms, but influenza does not
involve the gastrointestinal tract.
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ASSESS SEVERITY OFASSESS SEVERITY OF
D
EHYD
RATIO
ND
EHYD
RATIO
NLevel of
Dehydration
%LOSS OF
BODY
WEIGHT
SYMPTOMS SIGNS
SEVERE > 10% Decreased urineoutput
ThirstLethargy
Poor perfusionTachycardia
Reduced skinturgor
Sunken eyes
MODERATE 7-8% Decreased urineoutput
Thirst
Lethargy
TachycardiaReduced skin
turgor
Sunken eyes
MILD 5% Decreased urineoutput
Thirst
Dry mucousmembranes
Mild tachycardi
VERY MILD 3% Decreased urine
outputThirst
No clinical signs
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Diagnostic testsDiagnostic tests
yDiagnosis relies on
identification of the
causative agent throughstool and blood cultures,
Gram·s stain, and directswab rectal cultures.
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ManagementManagement
y Aimed at hydration and home remedies thataddress keeping fluid in the body are key torecovery.
y
Since most causes of gastroenteritis are dueto viruses, replacing the fluid lost because of vomiting and diarrhea allows the body torecuperate and fight the infection.D
ehydration can also intensify the symptomsof nausea and vomiting.
y Encourage intake of protein and fats to helpmeet calorie needs.
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ResponsibilitiesResponsibilities
y Assess the patient's symptoms and administer theprescribed symptomatic relief medications suchas antacids and antiemetics.
y Monitor intake and output closely. Excessive
vomiting or diarrhea may result in severeelectrolyte depletion that will requirereplacement therapy.
y Administer and monitor IV therapy when orderedto replace lost fluids.
y Weigh daily to monitor weight loss.y Encourage the prescribed diet to maintain
nutrition.