NUR 660 Team Week 12 Discussion 1 Case Study Discussion A: Gastroenteritis

NUR 660 Team Week 12 Discussion 1 Case Study Discussion A: Gastroenteritis

Baby K., age 14 months, has vomiting and diarrhea and is crying continuously because of what appears to be severe abdominal pain. As part of your history, you discover Baby K. had some milk custard that may not have been properly stored. The most likely diagnosis is gastroenteritis, secondary to Staphylococcus aureus from the milk custard.

Briefly describe how S. aureus in the custard could cause vomiting and diarrhea.

According to Hubert & VanMeter (2018), inflammation of the gastric mucosa stimulates vomiting and diarrhea results from when the inflammation of the intestines causes increased motility, impaired absorption, and increased secretions. Due to the inadequate storage of the custard, enterotoxin invaded the body. The body’s natural defense is to get rid of the infectious agent, which manifested as vomiting and diarrhea.

What fluid and electrolyte imbalances would you expect in Baby K.? Please describe how at least one fluid and one electrolyte imbalance could develop in this situation.

The loss of fluid, particularly water, from vomiting and diarrhea can lead to dehydration. The vomiting of gastric or intestinal contents most commonly involves the loss of fluid that contains chloride, potassium, sodium, and bicarbonate. Diarrhea can also result in hypokalemia (Tello et al., 2017). Hypovolemia, hyponatremia, hypernatremia, and hypokalemia are common and significant concerns for patients with profound fluid loss, like in Baby K.

Describe the signs of dehydration that can be expected in a child of this age. What about in an older child?

In babies, cardinal signs of dehydration include fewer than six wet diapers per day (for infants), no wet diapers or urination for eight hours (in toddlers), as well as sunken soft spots (fontanel) on the infant’s head. In children of all ages, other signs of dehydration include dry tongue and dry lips, no tears when crying, sunken eyes, dry and wrinkled skin, deep/ rapid breathing, and cool and blotchy hands and feet (Cleveland Clinic, 2021).

Explain the process and factors involved by which a young child can quickly develop vascular collapse if vomiting and diarrhea are severe.

If vomiting and diarrhea are severe, severe dehydration will occur. Vega & Avva (2021) discuss how severely dehydrated patients can present with vascular collapse. These signs include altered mental status, lethargy, tachycardia, hypotension, signs of poor perfusion, weak thready pulses, and delayed capillary refill. The body’s natural response is to protect the vital organs, such as the heart, brain, kidneys, and lungs. Poor perfusion, weak thready pulses, and delayed capillary refill are a result of the blood and remaining fluid protecting the vital organs. Tachycardia and hypotension are a result of the body pumping blood and fluids to the organs to compensate for the losses.

Explain why water alone would not be adequate treatment for Baby K.

Water alone is not an adequate treatment for Baby K because it does not replace the electrolytes lost through vomiting and diarrhea. Oral rehydration therapy, which includes fluids, salts, and other electrolytes, should be used for moderate dehydration and the initiation of intravenous fluids for severe dehydration.

What other gastrointestinal conditions could cause vomiting and diarrhea in a young child? How will you definitively determine what condition is causing her symptoms?

Other gastrointestinal conditions that can cause vomiting and diarrhea in young children are seasonal viral infections, bacterial, or parasitic infections.  Viral infections include rotavirus, influenza, and the Norwalk virus. Bacterial infections include E. coli, C. difficile, and Salmonella. These can all cause gastrointestinal upset. To help determine what condition is causing the patient’s symptoms, a quick history of the patient’s symptoms, food log, or any recent travels can be discussed. Blood and stool specimens may also be needed to help diagnose the specific infectious agent.

Important information for writing discussion questions and participation

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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed

• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• The is a great resource

References: 

Cleveland Clinic. (2021). Dehydration in Children: Signs, Treatments. 

Hubert, R. J., & VanMeter, K. C. (2018). Pathophysiology Online for Gould’s Pathophysiology for the Health Professions (Access Code and Textbook Package) (6th ed.). Saunders.

Tello, L., & Perez-Freytes, R. (2017). Fluid and Electrolyte Therapy During Vomiting and Diarrhea. The Veterinary clinics of North America. Small animal practice, 47(2), 505–519. 

Vega R. M., & Avva U. (2021). Pediatric Dehydration. StatPearls. Treasure Island (FL): StatPearls Publishing

Team A: Gastroenteritis

Baby K., age 14 months, has vomiting and diarrhea and is crying continuously because of what appears to be severe abdominal pain. As part of your history, you discover Baby K. had some milk custard that may not have been properly stored. The most likely diagnosis is gastroenteritis, secondary to Staphylococcus aureus from the milk custard.

• Briefly describe how S. aureus in the custard could cause vomiting and diarrhea.
• What fluid and electrolyte imbalances would you expect in Baby K.? Please describe how at least one fluid and one electrolyte imbalance could develop in this situation.
• Describe the signs of dehydration that can be expected in a child of this age. What about in an older child?
• Explain the process and factors involved by which a young child can quickly develop vascular collapse if vomiting and diarrhea are severe.
• Explain why water alone would not be adequate treatment for Baby K.
• What other gastrointestinal conditions could cause vomiting and diarrhea in a young child? How will you definitively determine what condition is causing her symptoms?