The most important element of assessment in the patient with infectious diarrhea is to determine the hydration status. The goal of rehydration is to correct the dehydration and prevent complications. Assessment includes evaluation of thirst, dryness of the oral mucous membranes, sunken eyes, weakened pulse and loss of skin turgor. Careful observation of any of these signs is especially vital in cases is especially important in cases when of rapidly dehydrating diseases (most notably cholera) and in younger children.
The individual with infectious diarrhea must be constantly monitored for intake and output measurements and it is very crucial that strict monitoring be done especially with children under five years of age. Liquid stool should be recorded noting the characteristics, form and frequency. The consistency and appearance of stools are key indicators that of the type and severity of diarrheal infectious diseases which should never be overlooked by care providers. Moreover, the presence of mucus or blood should also be recorded and endorsed by other members of the health care team involved in the care.
Assessment and history of infectious diarrhea
When conducting an assessment and history of patients suspected to have infectious diarrhea, the health care worker, specifically the nurse should ask the patient his/her recent travel, if the patient is currently on antibiotic medication, if the patient has been in contact with anyone who has recently had diarrheal diseases, and what the patient has recently eaten. Frequently, patients would normally attribute the primary cause of their acute diarrheal episode from their most recent meal eaten.
Incubation period of infectious diarrhea
It is important to note that the incubation period for most diarrheal conditions is longer than the time interval between meals and the nurse should be able to get a full detailed information about the meal preceding the illness and about all food intake in the previous 3-4 days. The nurse should also inquire if the patient is employed in food preparation services, because the local public health departments should be notified about any person with infectious diarrhea who works in the food industry.
Administering Rehydration therapy for infectious diarrhea
When infectious diarrheal losses are very high (>10 ml/kg per hour), the lower sodium concentrations of oral rehydration solutions should be used instead of the normal concentrations for mild and moderate oral rehydration solutions. For the hospitalized child, the diarrheal fluid loss should be weighed and oral rehydration solutions should be administered at a rate of 1 ml for each gram of diarrheal stool. Stoll losses can be estimated so that the child can receive about 10 ml/kg of oral rehydration solution for each diarrheal stool.
It is important for children and adults with acute diarrheal symptoms to
maintain caloric intake. Recommended foods include starches, cereals, yogurt, fruits and vegetable. Foods that are high in simple sugar such as undiluted apple juice or gelatin should be avoided. Because diarrheal episodes can be accompanied by vomiting, rehydration and oral intake of food by mouth can prove to be difficult. Oral rehydration therapy should be delivered frequently only in small amount. When the child persistently vomits, oral rehydration solutions should be administered by spoonfuls rather than by drinking from a bottle or cup. Proper hand washing and use of gloves should be strictly implemented to prevent cross contamination of patients with infectious diarrhea.