NURS1005A Applied Science In Professional Practice

Introduction

Reginald Bowen is a 76-year-old male suffering from viral gastroenteritis, a medical condition which has among other symptoms, acute abdominal pain, vomiting and passing loose watery stool.  It is quickly spread from one patient to the other thus some considerations should be put in place to minimize this(Durisch and Mueller, 2014). Nursing interventions are required as the infected patient’s health also deteriorates within a short span of time(Zarkotou et al., 2012). The patient is likely to have acute pain and high loss of body fluids through diarrhea. Under this essay, nursing considerations to minimize the spread of the disease will be discussed. Health problems for the patient and appropriate nursing actions to be taken will also be a focus.

Nursing Consideration

Gastroenteritis is transmitted from hand to mouth when a noninfected person touches a contaminated surface(Tao et al., 2013). Therefore, healthcare givers should practice aseptic hand hygiene after handling a patient and before proceeding to attend to another(Australian Commission on Safety and Quality in Health Care, 2016). This is because viral gastroenteritis is usually spread from person to person by the fecal-oral route and by coming in contact with contaminated environmental surfaces(Durisch and Mueller, 2014). Aseptic hand wash involves cleaning entirely every part of one’s hands with an antiseptic soap or solution, rinsing them and drying before and after handling a patient.

Nursing Issues and Interventions

Gastroenteritis is associated with acute abdominal pain and cramping. Inflammation in the gastrointestinal tract makes the body immune response to release cytokines and prostaglandins which causes vascular permeability(Ingle and Hinge Ingle, 2013). This is perceived by the patient as pain in the abdominal region. An important nursing diagnosis, in this case, is acute pain related to viral infection of the gastrointestinal tract as manifested by the patient’s verbalization of pain in the abdominal region(Hooks, 2016). A nurse should review the factors that aggravate or alleviate the pain. This will enable the nurse to plan for the next course of action by lessening the aggravating factors and promoting the alleviating. Appropriate analgesics should also be administered as they alleviate pain(Gundeslioglu et al., 2016). Other pain relief measures such as massage, if not contraindicated, should be used as they promote comfort and alleviate the problem(Zarkotou et al., 2012). A nurse should also instruct the patient to perform constant deep breathing exercise as it reduces pain sensation and promote comfort. Distractive activities such as socialization and entertaining strategies should be put in place as they relieve pain(Hooks, 2016). These activities divert the patient’s mind away from the pain perception thus relieving the problem. The patient should verbalize pain relief after these strategies have been put in place.

Another nursing problem associated with gastroenteritis is deficient fluid volume. Reginald Bowen lost a lot of body fluids through vomiting and passing large amounts of loose watery stool. This causes fluids and electrolytes volume imbalance in the body. This is manifested by the patient in the case study having frequent thirst, diarrhea, and lethargy(Hooks, 2016). Deficient fluid volume related to excessive losses through normal body openings as manifested by the patient passing loose watery stool and vomiting is an appropriate nursing diagnosis in this case study(Durisch and Mueller, 2014). A nurse should ensure adequate hydration by ensuring adequate fluid intake both intravenously and orally(Hooks, 2016). As the patient is reporting of thirst and difficulty in urinating, he should be encouraged to take a lot of oral fluids. This will prevent more dehydration and maintain a high hydration status. Solid food intake should also be restricted in order to reduce intestinal workload and to allow for bowel rest(Ingle and Hinge Ingle, 2013). Frequent oral care should also be provided in order to prevent the mouth from dryness. Very young and extremely old patients, as is the case with Reginald Bowen are susceptible to fluid volume deficit(Gruber et al., 2017). For this reason, nurses should closely monitor the two categories in order to ensure that they are adequately hydrated(Hooks, 2016). Upon the implementation of these interventions, the fluid intake should be approximately equivalent to the fluid output.

Conclusion

Viral gastroenteritis is easily spread from an infected person to other persons and thus various measures should be put in place to prevent this occurrence. It is spread through fecal-oral transmission when a noninfected person comes in contact with contaminated environmental surfaces. For this reason, measures should be put in place to minimize this spread. Among these measures is the aseptic hand washing technique which will ensure that caregivers and noninfected persons do not come in contact with contaminated environmental surfaces. A number of nursing interventions should also be put in place to ensure that the infected patients restore optimal health and prevent further deterioration

References

Australian Commission on Safety and Quality in Health Care (2016) Australian Safety and Quality Framework for Health Care: Putting the Framework into Action: Getting started, National Standards and Accreditation. Available at: https://www.safetyandquality.gov.au/.

Durisch, N. and Mueller, N. (2014) ‘Norovirus gastroenteritis’, Gastroenterologe, 9(4), pp. 360–365. doi: 10.1007/s11377-014-0884-5.

Gruber, J. F. et al. (2017) ‘Risk factors for norovirus gastroenteritis among Nicaraguan children’, American Journal of Tropical Medicine and Hygiene, 97(3), pp. 937–943. doi: 10.4269/ajtmh.16-0799.

Gundeslioglu, Ö. O. et al. (2016) ‘The effects of nosocomial rotavirus gastroenteritis on the length of hospital stay and cost’, Journal of Infection in Developing Countries, 10(2), pp. 163–167. doi: 10.3855/jidc.5591.

Hooks, R. (2016) ‘Developing nursing care plans’, Nursing Standard , 30(45), pp. 64–65. doi: 10.7748/ns.30.45.64.s48.

Ingle, S. B. and Hinge Ingle, C. R. (2013) ‘Eosinophilic gastroenteritis: An unusual type of gastroenteritis’, World Journal of Gastroenterology, pp. 5061–5066. doi: 10.3748/wjg.v19.i31.5061.

Tao, S. Y. et al. (2013) ‘Handwashing behaviour among Chinese adults: A cross-sectional study in five provinces’, Public Health, 127(7), pp. 620–628. doi: 10.1016/j.puhe.2013.03.005.

Zarkotou, O. et al. (2012) ‘Epidemiological and laboratory investigation and effective control of a nosocomial outbreak of gastroenteritis due to Norovirus’, Clinical Microbiology and Infection, 18, p. 812. doi: 10.1111/j.1469-0691.2012.03803.x LK  – https://elinks.library.upenn.edu/sfx_local?sid=EMBASE&issn=1198743X&id=doi:10.1111%2Fj.1469-0691.2012.03803.x&atitle=Epidemiological+and+laboratory+investigation+and+effective+control+of+a+nosocomial+outbreak+of+gastroenteritis+due+to+Norovirus&stitle=Clin.+Microbiol.+Infect.&title=Clinical+Microbiology+and+Infection&volume=18&issue=&spage=812&epage=&aulast=Zarkotou&aufirst=O.&auinit=O.&aufull=Zarkotou+O.&coden=&isbn=&pages=812-&date=2012&auinit1=O&auinitm=.