Ward 23b management of diarrhoea / gastro illness

Signs of diarrhoea/gastro Illness in an infant or child

May include all or some of the following signs/symptoms:

• increased frequency of bowel motions (double the number of normal dirty nappies per day – be guided by caregivers)

• loose stools

• vomiting

• fever

• irritability

• lethargy

• loss of appetite

• weight loss

Nursing actions

Place in contact precautions

Report to medical team:

• changes in nappy/output

• new onset diarrhoea

• new onset vomiting

Monitor:

• Output – nurses to manage all nappy changes to enable output to be assessed and documented on the fluid balance chart.

• Fluid balance – fluid balance chart to be commenced with hourly input/output documented and totalled at the end of the 24-hour period.

• Weight – daily weights to be performed.

• Feed tolerance – document on fluid balance vomits and on a food chart if oral feeding intake.

• Increase frequency of PEWS monitoring to 1-2 hourly or at least 4 hourly if previously reduced due to stability.

Medical team actions

Ward 23b medical team to consider the following with onset of new symptoms:

• Viral panel – to be specified on stool sample request

• Review fluid balance – does the infant/child require additional fluid maintenance (consider via NGT or IV route)

• Review feed type – change to less concentrated feed or Hydralyte

• Review medications – frequency of diuretics, aperients

• Review weight and trend

• Review latest blood tests and adjust frequency of monitoring for electrolytes as required (consider daily electrolytes if diarrhoea present)

• Daily review including physical examination of the infant/child