Nursing Care Plan

Loose Stools, Clostridium difficile (C. Diarrhea may result from a variety of factors, including intestinal absorption disorders, increased secretion of liquid by the intestinal mucosa, and hypermotility of the intestine. Problems associated with diarrhea, which might be severe or chronic, include fluid and electrolyte imbalance and altered epidermis integrity. Diarrhea may result from infectious (i.e., viral, bacterial, or parasitic) processes; primary colon diseases (e.g., Crohn’s disease); medication treatments (e.g., antibiotics); increased osmotic loads (e.g., tube feedings); radiation; or increased intestinal motility such as with irritable colon disease. Treatment is dependant on addressing the reason for the diarrhea, replacing electrolytes and fluids, providing diet (if diarrhea is long term and/or severe), and keeping pores and skin integrity.

Health care employees and other caregivers must take safety measures (e.g., diligent hands washing between patients) to avoid dispersing diarrhea from individual to individual, including self. Expected Outcomes Patient passes soft, produced feces no more than three times each day. Assess for abdominal pain, cramping, frequency, urgency, loose or liquid stools, and hyperactive bowel sensations.

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Culture stool. Testing will identify causative organisms. Tolerance to dairy and other dairy products Patients with lactose intolerance have insufficient lactase, the enzyme that digests lactose. The existence of lactose in the intestines raises osmotic pressure and draws water into the intestinal lumen. Medications patient is or has been taking Laxatives and antibiotics may cause diarrhea.

C. difficile can colonize the intestine following antibiotic lead and use to pseudomembranous enterocolitis; C. difficile is a common reason behind nosocomial diarrhea in healthcare facilities. Idiosyncratic food intolerances Spicy, fatty, or high-carbohydrate foods may cause diarrhea. Method of preparing food Fried food or food polluted with bacteria during preparation could cause diarrhea. Osmolality of tube feedings Hyperosmolar food or fluid draws excess fluid in to the gut, stimulates peristalsis, and causes diarrhea. Current stressors Some individuals respond to stress with hyperactivity of the GI tract.

Previous gastrointestinal (GI) surgery Following bowel resection, a period (1 to 3 weeks) of diarrhea is normal. Abdominal radiation Radiation causes sloughing of the intestinal mucosa, reduces usual absorption capacity, and may lead to diarrhea. Assess impact of healing or diagnostic regimens on diarrhea. Preparation for radiography or surgery, and rays or chemotherapy predisposes to diarrhea by changing mucosal transit and surface time through colon.

Input and output Diarrhea can result in profound dehydration and electrolyte imbalance. Assess condition of perianal pores and skin. Diarrheal stools may be corrosive highly, due to increased enzyme content. Explore emotional impact of illness, hospitalization, and/or soiling accidents by providing privacy and chance of verbalization. Give antidiarrheal drugs as ordered.