Diarrhea

Domain 3. Elimination and exchange
Class 2. Gastrointestinal function
Diagnostic Code: 00013
Nanda label: Diarrhea
Diagnostic focus: Diarrhea

Diarrhea is a common yet potentially dangerous condition that affects people of all ages and can stem from many different causes, including infections, dietary oversights and/or food allergies, as well as conditions like irritable bowel syndrome. A nursing diagnosis for diarrhea helps a healthcare practitioner distinguish between a short-term acute syndrome and a long-term chronic condition. It also aids practitioners in determining an appropriate course of action for a particular patient based on their individual needs and health condition.

Nursing Diagnosis: Diarrhea

Not every case of diarrhea calls for medical intervention, but Practioners should pay close attention when it is persistent or accompanied by other symptoms such as fever or abdominal pain. It is important to establish an accurate diagnosis so appropriate treatment can be pursued. A nursing diagnosis helps a physician assess the particular needs of a patient and determine any necessary interventions.

NANDA Nursing Diagnosis Definition

The National Association of Nurses Defining Characteristics (NANDA-I) defines diarrhea as a state in which liquid stools are observed more than three times a day or in amounts greater than 200g daily. It may be associated with general men indices such as decreased absorption or malabsorption, inflammation, infection or other systemic disturbances as well as disturbances in sodium, potassium or pH levels in some cases. In any form of diarrhea there may be dehydration, electrolyte imbalance and an increased loss of fluids.

Defining Characteristics

Diarrhea is usually recognized by the following characteristics:

Subjective Indicators:

• Abdominal cramps, pain, bloating or distention
• An urge to defecate
• A sudden and frequent need to go to the bathroom
• The presence of loose or watery stool

Objective Indicators:

• Presence of abnormally frequent and large stools
• Stools may contain undigested material
• Abdominal pain
• Weight loss
• Native dysentery (inflammation of the large intestine)
• Fever
• Vomiting

Related Factors

The underlying cause of the diarrhea can vary depending on the case. Possible related factors are dietary indiscretions or food allergies, or due to a gastrointestinal infection caused by a virus, bacteria or parasites. Stress or medications like opioids or antibiotics can also contribute to the development of diarrhea. In some cases, the exact cause may remain undetermined.

At Risk Population

Although anyone can develop diarrhea, certain populations are at greater risk, including travelers to developing countries, children under the age of five, persons whose immune systems are compromised, such as those with HIV, cancer or diabetes, and seniors over 65 years old. Additionally, people who regularly consume alcohol or are abusing opioids are more likely to develop diarrhea.

Associated Conditions

In addition to dehydration and electrolyte imbalances, several other conditions may be associated with diarrhea, including inflammatory bowel diseases, irritable bowel syndrome and malabsorption syndromes. Hemorrhagic colitis, an inflammatory disorder that cause vomiting and can lead to severe and often bloody diarrhea, is also associated with diarrhea.

Suggestions of Use

• Monitor stools for color, consistency and frequency, and report changes to the practitioner
• Educate the patient and family about proper diet and intake; encourage foods that are high in fiber, such as fruits and vegetables, and low in fat
• Provide water and electrolyte replacements as directed
• Monitor the patient’s weight to assess fluid status
• Maintain skin and perianal area hygiene
• Monitor the patient’s vital signs

Suggested Alternative NANDA Nursing Diagnosises

Other possible nursing diagnoses for diarrhea include Risk for Infection and Fluid Volume Deficit. Risk for Infection is used when the patient has a weakened immune system and therefore is more prone to infectious agents. On the other hand, Fluid Volume Deficit is used when the patient has experienced extensive losses of both fluids and electrolytes as a result of diarrhea.

Usage Tips

When determining a course of action for a patient with diarrhea it is important to assess initial symptoms thoroughly and discuss dietary habits, medication use, and travel history if applicable. Additionally, include laboratory tests, such as a stool culture, or even radiological studies, such as an abdominal ultrasound, to narrow down the possible causes and reach an accurate diagnosis.

NOC Outcomes

Nursing interventions for patients with diarrhea are typically included in the Nursing Outcomes Classification (NOC). These outcomes include:

• Resilience: Ability to cope with stress and recover from stress-related illnesses
• Nutrition: Metabolic, Storage and Utilization: Knowledge for meeting metabolic needs
• Bowel Elimination: Ability to move bowels on schedule.
• Hydration Status: Hydration balance between intake and output.
• Oxygenation Status: Ability to increase oxygen saturation.

Evaluation Objectives and Criteria

To evaluate the effectiveness of nursing interventions for patients with diarrhea, the objectives should include monitoring patient responses to prescribed treatments, including medications and fluids. The criteria include evaluation of bowel movements, hydration status, oxygenation levels, response to nutrition therapy, and resilience levels.

NIC Interventions

The Nursing Interventions Classification (NIC) includes evidence-based interventions for patients with diarrhea.

These include:

• Fluid/Electrolyte Management: Provision of fluids and electrolytes to help restore and maintain balance in the system.
• Nutrition Therapy: Development of a nutritional plan that includes nutrient-dense, high-fiber foods, limiting sugar intake and avoiding potentially allergenic foods.
• Comfort Measures: Promotion of comfort by providing rest, monitoring for signs of dehydration and providing emotional support.
• Education: Instruction and counseling about diet, food preparation and other lifestyle modifications required for managing the condition.

Nursing Activities

Nursing activities for patients with diarrhea include monitoring patient status via observation and assessment of vital signs, lab tests and patient reports. Additionally, nurses provide guidance regarding diet, food choices and meal planning to facilitate better digestion. Lastly, it is important to counsel family members about proper hygiene and the need for bed rest when necessary.

Conclusion

A nursing diagnosis for diarrhea is an important tool for helping healthcare practitioners recognize the nature of a particular case and determine an appropriate course of action. It requires a thorough evaluation of the patient's history and various signs and symptoms to reach a determination. By properly assessing and treating a patient's diarrhea, a practitioner can ensure the most effective and appropriate care for the patient's condition.

FAQs

• Q: What is a nursing diagnosis for diarrhea?
  A: A nursing diagnosis for diarrhea is a comprehensive assessment of the signs and symptoms along with any related factors to help practitioners accurately diagnose and treat the condition.
• Q: What are the defining characteristics of diarrhea?
  A: The defining characteristics of diarrhea include abdominal cramps, pain or distention, a sudden and frequent need to use the bathroom, and stools that are abnormally large and watery. Additionally, there may be vomiting, fever or native dysentery present, depending on the case.
• Q: What are some related factors that can cause diarrhea?
  A: Dietary indiscretions or food allergies, viral, bacterial or parasitic infections, opioid or antibiotic use, and stress, as well as anatomical changes to the intestine in some cases, may all contribute to the development of diarrhea.
• Q: What populations are at increased risk for diarrhea?
  A:Travelers to developing countries, children under the age of five, those with weakened immune systems, seniors over 65, and individuals who regularly consume alcohol or abuse opioids are more likely to develop diarrhea.
• Q:What interventions are recommended for patients with chronic diarrhea?
  A: Some recommended interventions for patients with chronic diarrhea include fluid/electrolyte management, nutrition therapy, comfort measures, education and monitoring patient status via observation and assessment of vital signs, lab tests and patient reports.