TestMyKnowledge1.
Rotavirus is the most important cause of gastroenteritis among children. The virus is spread through the fecal-oral route or by person-to-person contact. Rotavirus is the most common cause of diarrhea-associated hospitalization. Organisms found in raw or undercooked food, and contaminated water may cause a gastrointestinal disorder, like Rotavirus. Lack of clean water, crowding, POOR hygiene, and poor sanitation are MAJOR RISK.
The purpose of this presentation is for the audience to gain efficient knowledge of Rotavirus and its complications with gastroenteritis.
Weight- 6.5 kg (-1.5kg in 24 hours) Length- 75 cm long Temperature-101.3F Respirations- 52 Blood Pressure- 92/57 Heart Rate- 115 O2 saturation- 99% Pain score- 9 out of 10 on FLACC scale Capillary refill- greater than 2 seconds Output- 35ml in 24 hours Sunken anterior fontanel Dry, redden mucous membranes Sunken eyes
Made by detection of the rotavirus antigen in stool specimens.
Trust vs. Mistrust; infants need to have their basic needs met, they can either trust you will provide for them or have a sense of mistrust because their basic needs are not being met.. Infants are unable to use words so they provide nonverbal communication (crying, smiling, cooing).
When the GI tract is invaded by pathogens, it results in an increased production of intestinal secretions or decreased intestinal absorption. Rotavirus is replicated in mature villus epithelial cells of the small intestine which leads to two things: an imbalance in ratio of intestinal fluid absorption to secretion and malabsorption of complex carbohydrates. This is a very contagious virus that can lead to GASTROENTERITIS.
Hepatitis B vaccine at birth, not up to date on immunizations since birth Recent travel outside of United States (Finland) When asked about the recent travel, the mother stated “A.B. had a great time trying new foods and drinks every day. We even took her to the petting zoo there.” When she was asked about hand hygiene she stated, “My family and I don’t believe in hand washing, if God created dirt then he would not create it to harm us.” The mother also stated they are devoted and dedicated Christians with strong belief that God will keep them healthy no matter what.
Nursing Diagnosis: Acute pain related to diaper rash as evidenced by expression of pain (cry).
Patient outcome/goal: Caregiver will express awareness of child’s pain by reporting FLACC pain scales of two.
Interventions: Try to anticipate the onset of pain. Provide prescribed pain medicine as needed. Assess the child’s physical symptoms and behavioral cues.
There is no antiviral medication on the market currently for rotavirus. The major goal is to correct fluid and electrolyte imbalance, rehydration, maintenance fluid therapy and reintroduction of an adequate diet. Oral rehydration solutions (ORSs) enhance and promote reabsorption of sodium and water. In case of severe dehydration and shock, IV fluids are initiated. The use of antibiotics therapy in children with acute gastroenteritis is controversial. Vomiting tends to improve when dehydration is corrected, so antiemetics are not needed. For rash, we check diaper and clean area with warm water every hour. Make sure area is completely dry at all times. Apply thin layer of barrier cream. Occasionally, take the diaper off and leave area open to air.
- Rotavirus may cause severe dehydration. Dehydration is a result of an abnormal loss of fluid such as those that occur in vomiting and diarrhea, both symptoms which A.B experienced. Because of A.B’s age and size she is more prone to dehydration which could lead to shock. The longer intestinal tract in infancy is a great source of fluid loss, hence why when infants have diarrhea it may lead to dehydration.
- A’B’s age required her needs to be met. The rotavirus can cause a diaper rash that causes pain. It’s essential for her pain to be relieved and her diaper to be changed as needed. To ensure this, the parent should be taught how to monitor pain in her infant, and how to provide proper diaper care. If these needs are not met efficiently, A.B will not trust her caregiver.
Infectious agents invade the stomach and intestine lining causing damage to the villous brush border of the intestine, causing malabsorption of intestinal contents and leading to diarrhea.
What is patho of gastroenteritis?
Begin ORT (oral rehydration therapy)
D5 ½ NS @ 40ml/hr
A.B. is an 8-month-old Caucasian female. She was brought in by her mother after she noticed a red rash on her buttocks while changing her diaper. She reports that she has had watery diarrhea for the past 4 days and cries while she is up. Her mother states “I thought she was just fake cry for attention, because she didn’t have any tears.” She also noticed that A.B. started to feel a little warm to touch 2 days ago and refusing to eat or drink, even her favorite foods, because she will throw it up again.
What is patient scenario?
Works, P. A. (2014). Rehydration of Children with Gastroenteritis. Advanced Emergency Nursing Journal, 36(2), 110-113. doi:10.1097/TME.00000000000000
In this study conducted by Works, the purpose was to determine whether children with gastroenteritis (GE) and dehydration would benefit more from intravenous fluid (IVF) that contained 5% dextrose in normal saline (D5NS) as compared with normal saline (NS) alone. (2014) She performed a double-blind, randomized controlled clinical trial with 188 participants. Each participant in the study had a baseline glucose and ketone testing performed. The attending physician reassessed the participants three hours after initiation of the IVF. The results included participants who received D5NS (35%) had fewer hospital admissions than those who were admitted after receiving NS (44%) (Works, 2013). They patients were also less acidotic and had lower serum ketone levels.
- Determine urine specific gravity if dehydration is suspected.
- Obtain CBC – for occult blood
- Serum electrolytes.
- Creatine – elevated
- Blood urea nitrogen (BUN) – elevated.
- Hematocrit – elevated
- Hemoglobin – elevated
Nursing Diagnosis: Deficient Fluid Volume related to active fluid volume loss as evidenced by sudden weight loss.
Patient outcome/goal: Child will exhibit moist mucous membranes, good skin turgor, and flat anterior fontanelle within forty-eight hours.
Interventions: Record input and output. Daily weight. Monitor vital signs every four hours, or as needed.
- Students will be able to define the pathophysiology of Rotavirus.
- Using the pathophysiology of the disorder, students will be able to discuss and identify the appropriate nursing management.
- Students will be able to identify clinical manifestations of rotavirus.
- Students will be able to discuss the labs and diagnostic procedures to properly diagnose this disorder.
Mild to moderate fever , Vomiting followed by onset of watery stools , Fever and vomiting for approximately 2-days, Diarrhea persisting 5-7 days.
- Teach caregiver to monitor for signs of dehydrations
- Assess the frequency and amount
- Educate caregiver relating to rehydration
- Monitor fever
Rotavirus is a viral infection cause by a pathogen invasion of the GI tract. Spreading the fecal to oral route or person-to-person it is highly contagious. Rotavirus eventually leads to gastroenteritis which may cause dehydrations, vomiting, and abdominal pain. It’s essential to wash hands frequently and be aware of undercooked meats. Infection caused by rotavirus may require rehydration therapy and an adequate nutritional diet.