Gastroenteritis Diagnosis in Children

Gastroenteritis Diagnosis in Children

1. Three Appropriate Therapeutic Communication Techniques That the Pediatric Nurse Could Apply to Build a Relationship with Yasmin and Her Aunt

• Active listening is a practical therapeutic communication approach that involves paying attention and carefully listening to patient medical history (Potter et al., 2018). This technique helps to build trust between the pediatric nurse and the patient
• The pediatric nurse could also utilize sharing observation technique by commenting on Yasmine’s physical appearance. For instance, the nurse could comment on why the baby looked fatigued, and Yasmine’s aunt would give a detailed explanation that the baby had not been sleeping. This technique assists nurses in avoiding unnecessary questioning and clarification but allows patients to open up about their medical condition fully (Potter et al., 2018).
• According to Potter et al. (2018), the pediatric nurse could use touch to detect whether the child is in pain by gently touching her abdomen. If the child is in pain, the nurse could feel guarding against the child’s abdomen. Similarly, touching can apply to demonstrate affection to the child and allow the child to relax for further assessment.

2. Three Safety Concerns Related to Yasmin’s Hospital Admission and Development Stage

• Yasmin is prone to electric shock because of the poke and probes with fingers characteristic. In the clinical setting, toddler-like Yasmine should be kept safe from all electric appliances to avoid accidental electrocution. While at home, the same safety measure should apply by ensuring all open sources of electricity are covered and kept out of reach to keep Yasmine from electric shock (Leifer & Keenan-Lindsay, 2019).
• Drowning is another safety concern since toddlers lack in-depth perception and may not realize the danger of playing around with water. According to Leifer and Keenan-Lindsay (2019), a toddler can drown in a tiny amount of water if left unsupervised. Therefore, it is recommended that parents should begin teaching their young children swimming skills as soon as possible to avoid drowning and always cover open sources of water.
• Oral poisoning is another concern that needs mitigations for child health and safety. For instance, Yasmine may get food poisoning by consuming unhygienic food. Also, a toddler can easily access drug cabinets and consumer drugs which could lead to severe consequences. To avoid such incidences, nurses and parents should always keep drugs and medicine in safe cabinets away from the reach of children. In addition, unsafe food contaminants must get eliminated to avoid food poisoning in the child (Leifer & Keenan-Lindsay, 2019).

3. Four Abnormal Assessment Findings and Explain the Pathophysiology of How These Findings Are Related to Dehydration.

• Yasmine was examined with a fever of 39^oC, which was way above the normal range of between 36-38^o High body temperature meant the baby lost excessive water by sweating and diarrhea (Stuempfig & Seroy, 2021).
• Yasmine’s aunt mentioned that the baby had fewer wet diapers after the onset of gastroenteritis symptoms. It meant that the patient was experiencing electrolyte abnormalities such as acid-base disturbances caused by loss of transporter functionality. This condition develops into an extracellular fluid deficit hence dehydration (Stuempfig & Seroy, 2021).
• Tachycardia is another factor that depicts dehydration since a typical toddler exhibit a heart rate of between 70-110 beats per minute. But in Yasmine’s situation, she had a heart rate of 115 beats per minute above the normal range. This clinical finding suggests the baby is dehydrated, and a high fever triggers tachycardia (Stuempfig & Seroy, 2021).
• Sunken eyes and sticky mucus membrane represent baby dehydration. These symptoms revealed that the baby could not absorb food from the intestinal tract, or the kidney was impaired in excreting or reabsorbing water and electrolytes (deWit and Williams, 2014).

4. Two Early and Two Late Signs and Symptoms of Dehydration in the Pediatric Patient

• Two early signs and symptoms of dehydration include less urine excretion and a sticky mucus membrane. In contrast, the late signs include sunken eyeballs and skin turgor-high elasticity for several seconds after pinching (deWit and Williams, 2014).

5. The Differences Between Mild, Moderate, and Severe Dehydration in the Pediatric Patient

• A mildly dehydrated patient exhibits weight loss of about 5%, slightly sunken eyes, sticky mucus membrane, irritability when touched, thirst, decreased tears, and restlessness. Mild dehydration is preferably treated using oral rehydration therapy (deWit and Williams, 2014). On the other hand, the moderately dehydrated patient presents weight loss of more than 6%, sunken eyes, restlessness, thirst, and skin turgor with skin elasticity of fewer than two seconds. Recommended moderate rehydration therapy is by enteral rehydration using low osmolality oral rehydration solutions. Conversely, severe dehydration is characterized by weight loss of 15%, irritability, parched mucous membrane, absence of tears, sunken eyes, decreased skin turgor, less urine output, and thirst. Suggested rehydration therapy for severe dehydration is intravenous fluids (deWit and Williams, 2014; Stuempfig & Seroy, 2021).

6. Four Priority Nursing Actions Based Upon Yasmin’s Assessment

• First, the pediatric nurse quickly focuses on the patient’s past medical history, which entails diarrhea in the last two days and less urine output in the diapers (deWit and Williams, 2014).
• Second, the physical assessment is essential as it reveals a child with sunken eyes and sticky mucus membrane (deWit and Williams, 2014).
• Third, the nurse evaluates the diagnostic results of the vital signs such as body temperature, pulse rate, blood pressure, respiratory rate, urinary, integumentary, and neurological findings against the expected normal clinical parameters (deWit and Williams, 2014).
• Lastly, the nurse decides the severity of the dehydration for appropriate rehydration therapy (deWit and Williams, 2014).

7. Pathophysiological Relationship Between Diarrhea, Fluid and Electrolyte Imbalance, and Dehydration

• Patients with viral gastroenteritis have a virus that interferes with brush border enzyme production, leading to malabsorption and osmotic diarrhea. Diarrhea occurs due to transudative loss of fluid into the intestine leading to electrolyte abnormalities such as acid-base disturbance. This fluid deficit condition causes water loss from the cell by osmosis to equalize the concentration, and in the process, cells shrivel, a process called dehydration (Potter et al., 2018).

8. . Three Standard Methods of Treatment for Dehydration and Diarrhea in Young Children

• Oral rehydration solutions are preferably used to treat dehydration. However, avoid fluids high in sugar such as apple juice and cola because they may exacerbate diarrhea. Breastfeeding can supplement oral rehydration solutions (Potter et al., 2018).
• Intravenous and nasogastric fluids are effective in treating moderate-severe dehydration. However, intravenous therapy is more expensive than oral rehydration therapy and can lead to iatrogenic complications (Potter et al., 2018).
• Potassium and sodium replacement can treat excessive dehydration caused by urinary and high fever (Potter et al., 2018).

9. Proper Drug Administration Technique to Assist Yasmine’s Aunt Effectively Administers Oral Antipyretic to Yasmin With No Risk of Spitting It.

• The pediatric nurse suggests that Yasmine’s aunt hold the baby in a comfortable position where the child can quickly put one arm behind her aunt to bind the other by hugging. This method will allow improved control during drug administration and keep the child from spitting it (Potter et al., 2018).

10. Three Assessment Findings That Indicate Improvement in the Dehydrated Child

• The nurse will notice an improvement in skin turgor, and the moist mucus membrane will rehydrate (Potter et al., 2018).
• The child’s moods will also improve, accompanied by a good appetite and regular daily urinary cycles (Potter et al., 2018).
• Fever dropping and diarrhea stopping is a sign that dehydration subsides, and vital signs such as pulse rate can get detected as usual (Potter et al., 2018).

References

1. deWit, S., & A. Williams, P. (2014). Fundamental Concepts and Skills for Nursing. Google Books. Retrieved 13 July 2022, from https://books.google.co.ke/books?hl=en&lr=&id=JSQYnpstgjAC&oi=fnd&pg=PP1&dq=related:IxlrKWSgZg0J:scholar.google.com/&ots=KK9cVRwZ1p&sig=SE2qxBSlCTE0QWnERkI3AOOJPTQ&redir_esc=y#v=onepage&q&f=false.

Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A., Astle, B. J., & Duggleby, W. (2018). Canadian Fundamentals of Nursing-E-Book. Elsevier Health Sciences.

Stuempfig, N. D., & Seroy, J. (2021). Viral gastroenteritis. In StatPearls [Internet]. StatPearls Publishing.