Discuss: Gastroenteritis in Children

What are 5 questions you would ask the mother next?

1. How high was the temperature and how was it taken (eg, rectal, temporal, axillary, or not taken at all, just by touch)?

2. Any home meds given for fever or is the patient taking any medication OTC or prescribed?

3. How much is the patient feeding and wetting diapers daily?

4. Any recent exposure to anyone sick or does patient attend daycare?

5. How many times did the patient have diarrhea in a day and describe stool for any blood and color?

What additional signs/symptoms would alert you that this infant may need to be transferred to the ER?

-Dehydration

– Failure to Thrive

-Continuous vomiting and labs as indicated

-Any child with fever and petechiae and who appears very ill.

According to Burns ,Dunn, Brady, Starr, Blosser, & Garzon (2017) symptoms that would prompt emergency care include: a change in or new rash, duskiness, cyanosis, or mottling of the skin. Coolness of the extremities, poor feeding or vomiting, irritability, cries with positional changes, difficulty in comforting or arousing, seizure activity and bulging anterior fontanelle.

What are your top 3 differential diagnoses

1. Rotavirus

2. Acute Gastroenteritis

3. Bacterial Gastroenteritis

Rotavirus has an acute onset of fever, vomiting and watery diarrhea occur 2 to 4 day later in children <5 years old, especially those between 3 to 24 months old (Burns et al., 2017).

Reference

Burns, C. E., Burns, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care(6th ed.). St. Louis, MO: Elsevier.

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Shana Henderson posted Mar 12, 2019 3:06 PMSubscribe

A 6 month old male patient presents to your clinic with his mother. The mother’s chief complaint is that the baby has had a fever and diarrhea for several days and is not nursing as much as usual. The infant is quiet and warm, lung sounds are clear, heart sounds normal. No medical history, born healthy at 39 weeks 5 days via uncomplicated vaginal delivery, he is exclusively breast fed and is up-to-date on his vaccinations.

5 questions to you would ask the mother?

1. How high was the temperature and what have you been giving to treat the temperature?

2. Anyone else in the family sick?

3. Does the child attend daycare?

4. How many episodes of diarrhea does the child have per day? Is there any blood in the diarrhea?

5. How many wet diapers per day are you changing?

What additional signs/symptoms would alert you that this infant may need to be transferred to the ED?

Additional signs and symptoms that would alert me that the infant may need to be transferred to the ED would include a high fever >39C, the infant is lethargic or difficult to arouse, the infant is not producing any tears/dry mucus membranes, persistent vomiting, tachycardia, increased or decreased respirations, decreased urine output, poor muscle tone, delayed capillary refill, pale cool skin, irritability, sunken eyes and sunken fontanelles.

Top 3 differential diagnosis:

1. Viral gastroenteritis

2. Bacterial gastroenteritis

3. Parasitic gastroenteritis

Gastroenteritis in children is a major cause of morbidity in the United States (Churgay, C., & Aftab, Z., 2012). It is defined as the onset of diarrhea in the absence of chronic disease, with or without fever or pain. It is common in children under the age of 5. The rotavirus is the number one cause of diarrhea and hospitalization in young children. After rotavirus, bacteria such as salmonella and shigella are also responsible for acute gastroenteritis in children under 5 years of age. A small percentage of gastroenteritis are caused by parasites such as Giardia intestinalis and Cryptosporidium. It is important that children who are suffering from acute diarrhea be treated as soon as possible to prevent dehydration. Oral rehydration should be the initial treatment if the child is mildly dehydrated. If oral hydration can be tolerated, commercially prepared oral hydration would be appropriate, as long as the child is not vomiting. The caregiver should start out by giving small amounts of liquid then increase as the child tolerates it. In cases where the child has severe dehydration, the infant should be taken to the ER where intravenous fluids can be administered and the child can be monitored for hemodynamic stability (Cochran, W., 2017). Prevention of gastroenteritis starts with proper hand washing. It is important to teach children and caregivers how to properly wash their hands and inform them to avoid improperly stored food as well as contaminated water.

Reference:

Gastroenteritis in Children – Children’s Health Issues. (n.d.). Retrieved from https://www.merckmanuals.com/home/children-s-health-issues/digestive-disorders-in-children/gastroenteritis-in-children

Gastroenteritis in Children: Part 1. Diagnosis. (n.d.). Retrieved from https://www.aafp.org/afp/2012/0601/p1059.pdf

Assignment: Gastroenteritis in Children

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

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The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread)	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
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	0 points lost				-5 points lost
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Discuss: Gastroenteritis in Children