Question

Develop a three-diagnosis care plan for a 4-year-old client who has gastroenteritis and dehydration. One diagnosis should be related to discharge planning

Answer 1

Nursing diagnoses and care plan for a 4-year-old client who has gastroenteritis and dehydration are:

a) Diarrhea.

b) Fluid volume deficit related to excessive gastrointestinal loss.

c) Imbalanced nutrition, less than body requirements.

2) Care plan:

Nursing Care Plan for Diarrhea

ASSESSMENT 1. Abdominal pain 2. Abdominal cramping. 3. Hyperactive bowel sounds. 4. Increased frequency of stools, more thrice a day 5. Loose stools. 6. Urgency.

INFERENCE Frequent passage of loose unformed stools

PLANNING 1. The patient will have a negative stool culture. 2. The patient will pass soft formed stool no more than 3 times a day.

INTERVENTION 1. Ask the patient about having ingested contaminated water, food, or unpasteurized dairy products. 2. Evaluate the defecation pattern. 3. Assess for abdominal cramping/pain, hyperactive bowel sounds, urgency, frequency, and loose stools 4. Submit the patient's stool for culture. 5. Educate the patient and parents about hygiene after a bowel movement. 6. Encourage increased fluid intake. 7. Encourage the restriction of caffeine and dairy products. 8. Encourage potassium-rich foods. 9. Antidiarrheals should be administered as prescribed.

b) Nursing Care Plan for Fluid Volume Deficit related to excessive gastrointestinal loss

Nursing Care Plan for Fluid Volume Deficit related to excessive gastrointestinal loss

ASSESSMENT Considerably decreased skin turgor.

INFERENCE Experiencing cellular, intracellular, or vascular dehydration.

PLANNING Normovolemic patient with 1. Systolic BP 90 or higher. 2. No orthostasis. 3. Heart rate of 60 to 100. 4. Normal pediatric urine output of 1.5 ml/kg/hour. 5. Normal skin turgor.

INTERVENTION 1. Assessment of skin turgor and mucous membranes for the degree of dehydration. 2. Assessment of the amount and frequency of vomiting. 3. Assessment of the consistency and number of BM. 4. Assessment of the color and amount of urine. 5. Assessment of the patient's BP and pulse rate. 6. Assessment of the patient's temperature

c)

Nursing Care Plan for Imbalanced Nutrition, less than body requirements

ASSESSMENT 1. Anorexia 2. Inadequate food intake 3. Perceived inability to ingest food 4. Lower abdomen rumbling

INFERENCE Intake of food/nutrients inadequate to meet metabolic rates.

PLANNING The patient will have an increased food/nutrition intake and no nausea, vomiting, and diarrhea.

INTERVENTION 1. Measurement of the patient's weight. 2. Monitor and record frequency and amount of vomiting. 3. Monitor the patient's intake. 4. Provide a nutrition-need based diet. 5. Provide fluids as ordered. 6. Refer to a dietician if needed.