Question

The long-term care facility where you are doing your clinical rotation has had a norovirus outbreak. Your patient VD, a 79 year-old-male with COPD and HTN recently fell ill. He has been vomiting and has had diarrhea for about 48 hours. He has been prescribed a diet of broth and oral rehydration solution, ondansetron for nausea and loperamide for diarrhea. Your preceptor has told you that she is worried that they may need to send M.B to the hospital for oral rehydration. What signs and symptoms will prompt you to alert your preceptor that VD may need hospitalization? What are the risks of treating M.B with loperamide?

Answer typed please.

Answer 1

1. This norovirus infection affects yound children and elderly adultd because they have weakened immune system. VD need to be hospitalized if any one of the signs or symptoms occur.

• Norovirus infection lasts for more than 2 days
• signs of dehydration
• Malnutrition
• persistent vomitting
• weak pulse
• low BP
• Because VD is 79 years old he is more susceptible to dehydration and poor nutrient absorption

2. Risk of Loperamide :

• Loperamide masks dehydration symptoms in elderly so plenty of fluid intake should be planned.
• Also causes cardiac arrythmias, Prolonged QT interval, cardia arrest and syncope if give over dose. The patient is already hypertensive. so need to take utmost care.