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HLTAAP003 Analyse Health and Symptoms of Gastroenteritis

Questions 

Case study 

Michael Bates, a 65 year old man, has been admitted with severe gastroenteritis. He is complaining of fatigue and general malaise and feels light headed and nauseous. He has a history of Multiple Sclerosis which has also worsened with his gastroenteritis. He has become occasionally incontinent of urine since his illness. He usually lives at home with his family. His base line observations and vital signs are as below.
HR 66
RR 18
BP 95/56
Poor skin turgor
 
Answer the questions listed in relation to the following case studies.  

Q1. Define gastroenteritis and list some common causes.
Q2. Explain the poor skin turgor in relation to his gastroenteritis.
Q3. Based on the information provided what would be a likely cause of his blood pressure reading? 
Q4. Provide two signs /symptoms of gastroenteritis.
Q5. Describe the pathophysiology of multiple sclerosis?
Q6. Which group of people are likely to develop this illness?
Q7. List some common symptoms that someone might experience who has multiple sclerosis.
Q8. Complete two nursing care plans for Betty. Each nursing care plan should hav

e a one nursing diagnosis, one goal, two interventions supported by two rationale.

Answers     

1. Gastroenteritis, also termed as infectious diarrhoea, is the condition in which the gastrointestinal tract, involving the small intestine and stomach, is inflamed. The common causes of this disease are bacterial, fungal, viral and parasitic infections, while the most prominent infection is those caused by bacteria Escherichia coli and Campylobacters species  (Ahmed et al., 2014).

2. The poor skin turgor of Michael Bates is due to the loss of fluid as a result of dehydration which is difficult to be checked. Dehydration is a common health complication suffered by patients of gastroenteritis. The skin, therefore, loses its elasticity (Payne et al., 2013).

3. The likely cause of the low blood pressure of the patient is dehydration due to severe gasterointeritis. When the body loss water rapidly, the body becomes weak, and the patient suffers fatigue and dizziness.

4. The main signs and symptoms of Gastroenteritis are vomiting and dehydration which might be severe or mild depending on the patient condition (Lu et al., 2015).

5. Multiple Sclerosis is the demyelinating disease wherein the insulating covers of the nerve cells of the body, especially the spinal cord and brain suffer adverse damage. The primary characteristics of the disease are the formation of lesions in the central nervous system, commonly known as plaques, destruction of the neurons and inflammation. Damage is due to the impairment of the nervous system due to the individual’s own immune system (Lublin et al., 2014).

6. Research indicates that multiple sclerosis is more common among individuals living farther from the equator. The disease is more prevalent in regions of norther Europe (Krupp et al., 2013).

7. Multiple Sclerosis results in a wide range of signs and symptoms that encompass mental, physical and psychiatric problems. Specific issues include issues with sensation, blindness in an eye, double vision, muscle weakness and difficulties in coordination. There are different forms of multiple sclerosis, and new symptoms occur in progressive forms or relapsing forms (Lublin et al., 2014).

8. Nursing care plan for the patient

Nursing diagnosis

Nursing goal

Interventions

Rationale

Risk for fluid volume deficit which refers to the risk of experiencing cellcualr, intracellular or vascular dehydration

The goal would be to maintain normovoleemic condition of the patient as indicated by systolic BP 90 mmmHg,  HR 0-100 bpm and normal skin turgor

· The first intervention would be to encourage the patient to increase the fluid intake. The ideal fluid intake for the patient would be 2-2.5 litre/ 24 hours unless contraindicated

· The second intervention would be  to administer antiemetic medications

· The rationale is that increased fluid intake is essential for replacing the loss of fluid due to vomititng. Rehydration gives relief from nausea and weakness.

· Antiemetic medications reduce the chance of vomiting and eliminates risk of fluid volume deficit to a considerable degree (Butcher et al., 2013)

Fatigue due to multiple sclerosis that further worsens Gasteroenteritis. The patient feels sustained and overwhelming sense of exhaustion and reduced capacity to remain mobile

The goal would be to enable the patient report better sense of energy and help him maintain required activity level  

· The first intervention would be assist the patient with physical therapy that increases patient comfort. In addition, the activities of daily living re to be scheduled with intermittent periods of rest.

· The second intervention would be administration of medications such as Amantadine and Mehtylphenidate.  

· Physcial thepraies have been idnciated to reduce fatigue. The other benefit of such therapy is that aggravation of muscle weakenss is checked. Period of rest in between activities promotes sense of wellbeing.

· Amantadine is useful for treating fatigue while Methylphenidate is a CNS stimulant reducing fatigue (Moorhead et al., 2014)

References

Ahmed, S. M., Hall, A. J., Robinson, A. E., Verhoef, L., Premkumar, P., Parashar, U. D., ... & Lopman, B. A. (2014). Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. The Lancet infectious diseases, 14(8), 725-730.

Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2013). Nursing Interventions Classification (NIC)-E-Book. Elsevier Health Sciences.

Krupp, L. B., Tardieu, M., Amato, M. P., Banwell, B., Chitnis, T., Dale, R. C., ... & Rostasy, K. (2013). International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Multiple Sclerosis Journal, 19(10), 1261-1267.

Lu, J., Sun, L., Fang, L., Yang, F., Mo, Y., Lao, J., ... & Guo, L. (2015). Gastroenteritis outbreaks caused by norovirus GII. 17, Guangdong Province, China, 2014–2015. Emerging infectious diseases, 21(7), 1240.

Lublin, F. D., Reingold, S. C., Cohen, J. A., Cutter, G. R., Sørensen, P. S., Thompson, A. J., ... & Bebo, B. (2014). Defining the clinical course of multiple sclerosis The 2013 revisions. Neurology, 83(3), 278-286.

Moorhead, S., Johnson, M., Maas, M. L., & Swanson, E. (2014). Nursing Outcomes Classification (NOC)-E-Book: Measurement of Health Outcomes. Elsevier Health Sciences.

Payne, D. C., Vinjé, J., Szilagyi, P. G., Edwards, K. M., Staat, M. A., Weinberg, G. A., ... & Wikswo, M. (2013). Norovirus and medically attended gastroenteritis in US children. New England journal of medicine, 368(12), 1121-1130.

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