Diarrhea is a clinical conditio
Diarrhea is a clinical condition, which is marked by having loose stools or loose bowel movements, at least three times in a day. The stool formed is watery and hence leads to massive dehydration in the body. Due to diarrhea there is severe loss of essential electrolytes in the body, which leads to sodium and potassium imbalance, which may be detrimental to the health of an individual. As the body becomes dehydrated, the body will try to absorb more water leading to decreased urine formation. Since, it is the condition of stress it may lead to increased heart rate. However, the blood pressure often reduces in the case of diarrhea. This is due to a reduction in blood volume, which occurs due to loss of fluids from the body.
The pathophysiological basis of diarrhea is often related to malabsorption. When the digested foods fail to get absorbed in the intestine, it leads to the formation of osmotically active particles in the gastrointestinal tract (GI). As a result water is pulled into the gastrointestinal tract, from the interstitial spaces in the GI epithelium cells. The excess water is egested out of the GI tract. This is the cause of fluid loss in diarrhea. The failure in absorption is often related to an infection in the GI tract, which may be caused y viruses or bacteria. This type of diarrhea is called osmotic diarrhea (malabsorptive diarrhea) and is the most common form of diarrhea.
Various other types of diarrhea can also occur in our body. Secretory diarrhea is a condition when the active secretion occurs against the concentration gradient. Such form of diarrhea may be caused by cholera toxin. The active secretion of chloride ions causes pulling of water from the GI epithelial cells. Another form of diarrhea called exudative diarrhea occurs due to the presence of blood and pus in the stool and is caused due to ulcerative colitis or inflammatory bowel diseases. Inflammatory diarrhea is caused due to the disruption of the mucosal lining of the intestine. This leads to the release of proteins and protein rich fluids. Such inflammation may be caused by bacteria, viral or parasitic infections. In the case of motility diarrhea, the GI tract may be prone to increased movements in the small intestine and large intestine. The excess motility may be increased by an increase of the basal electrical rhythm of the intestine or due to excess secretion of motilin.
According to Bisanz et al. (2010),“The premise of diarrhea management is that if all the causative factors are not treated, diarrhea will persist” (p. 268). The information gathered will help me to intervene with fluid supplementation to the patient. I would ensure she is adequately rehydrated by oral rehydration therapy. This will improve her electrolyte balance within the body and will retrieve the blood volume. If the blood volume resumes to normal, the blood pressure will also be normalized. The increase in blood pressure is necessary, to ensure perfusion of blood in various end organs. Since she is also suffering from an infection of the urinary bladder, I would administer an appropriate antibiotic to her therapeutic regime. From evidence-based literature, I would administer norfloxacin or ciprofloxacin, due to a suspected Escherichia Coli infection.
According to Sabol & Carlson (2007), “Diarrhea is one of many symptoms that may complicate the hospitalization of the critically ill patient. Diarrhea is caused by a variety of etiologies; identifying the etiology aids in the appropriate selection of interventions. Care of the patient with diarrhea should be guided by the evidence and best practices available in literature” (p. 32). The conservative treatment that I need to ensure is to train her on the aspects of consuming safe and healthy drinking water. Moreover, she should have a healthy diet that would not only prevent any form of infection but will lead to enhancement of her immune status.
Bisanz, A., Tucker, A., Amin, D., Patel, D., Calderon, B., Joseph, M., & Curry EA, I. (2010).
Summary of the causative and treatment factors of diarrhea and the use of a diarrhea
assessment and treatment tool to improve patient outcomes. Gastroenterology
Nursing, 33(4), 268-283
Sabol, V., & Carlson, K. (2007). Diarrhea: applying research to bedside practice. AANC
Advanced Critical Care, 18(1), 32-44.