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470360
Gastroenteritis- ix & mx contd
Descrição
Paediatrics (Gastroenterology & nutrition) Mapa Mental sobre Gastroenteritis- ix & mx contd, criado por v.djabatey em 08-01-2014.
Sem etiquetas
gastroenterology & nutrition
paediatrics
paediatrics
gastroenterology & nutrition
Mapa Mental por
v.djabatey
, atualizado more than 1 year ago
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Criado por
v.djabatey
mais de 10 anos atrás
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Resumo de Recurso
Gastroenteritis- ix & mx contd
Ix
usually none indicated
stool culture
if child appears septic
if blood or mucus in stools
if immunocompromised
if recent foreign travel
if diarrhoea hasn't improved by day 7
if diag uncertain
if iv fluids needed or features suggestive of hypernatraemia
U&E
glucose
if Abx started
blood cultures
Mx
fluid management of dehydration
see doc
hypernatraemic dehydration
ORS
to rehydrate kids w/ clinical dehydration
if iv fluids needed
a rapid decrease in plasma [Na+] and osmolality will ->
water moving into cerebral cells->
seizures
cerebral oedema
reduction in plasma [Na+] should be slow
replace fluid deficit over at least 48 h & measure plasma Na+ regularly
aim to reduce plasma Na+ at < 0.5 mmol/L/hr
NO ROLE FOR ANTI-DIARRHOEALS & ANTIEMETICS
ineffective
prolong excretion of bacteria in stools
can be assoc w/ s/es
add unnecessarily to cost
take focus away from ORS
Abx
not routinely required
even if bacterial cause
indications
suspected/confirmed sepsis
extra-intestinal spread of bacterial infection
Salmonella gastritis in <6 months old
malnourished kids
immunocompromised
specific bacterial or protozoal infections
bacteria
C diff assoc pseudomembranous colitis
cholera
shigellosis
protozoa
giardiasis
Mx
nutrition
multiple episodes of diarrhoea predispose to developing malnutrition
in developing countries
increase nutritional intake ff diarrhoea
zinc supplementation in acute diarrhoea & prophylaxis
diarrhoea can be assoc w/ zinc def
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