00013 Diarrhea

Domain 3: elimination and exchange
Class 2: gastrointestinal function
Diagnostic Code: 00013
Nanda label: diarrhea
Diagnostic focus: diarrhea
Approved 1975 • Revised 1998, 2017, 2020 • Level of evidence 3.1

NANDA Nursing Diagnosis Definition

The Nanda nursing diagnosis « diarrhea » is defined as: evacuation of three or more soft or liquid deposits daily.

Definite characteristics

  • Abdominal colic
  • Abdominal pain
  • Intestinal urgency
  • Dehydration
  • Hyperactive intestinal noises

Related factors

  • Anxiety
  • Early artificial nutrition
  • Inappropriate access to safe drinking water
  • Inappropriate access to safe foods
  • Inappropriate knowledge about the rotavirus vaccine
  • Inappropriate knowledge about hygienic food preparation
  • Inappropriate knowledge about hygienic food storage
  • Inadequate personal hygiene practices
  • Increase in stress level
  • Inappropriate use of laxatives
  • Malnutrition
  • Inappropriate use of substances

Risk population

  • Frequent travelers
  • People with extreme ages
  • People exposed to toxins

Associated problems

  • Severe condition
  • Endocrine system diseases
  • Enteral nutrition
  • Gastrointestinal diseases
  • Immunosuppression
  • Infections
  • Pharmacological preparations
  • Therapeutic regime

Suggestions of use

  • The liquid feces that accompany fecal retention, from true diarrhea should be differentiated. Liquid feces usually occur suddenly in patients with chronic constipation. When there is impact, the rectal touch will reveal a hard mass of dry feces in the rectum.
  • It must also be differentiated from fecal incontinence which does not necessarily manifest itself as liquid or without form.

Suggested alternative diagnostics

  • Constipation
  • Fecal incontinence

NOC Results

  • Intestinal continence: Control of the passage of feces through the intestines
  • Intestinal elimination: formation and evacuation of feces
  • Symptoms severity: severity of adverse changes perceived in physical, emotional and social functioning

Evaluation objectives and criteria

  • Diarrhea disappears or controls, as evidenced by intestinal continence, intestinal elimination and severity of symptoms
  • It demonstrates an effective intestinal elimination, as manifested by the following indicators (specify from 1 to 5: severely, substantially, moderately, slightly or not compromised):
    • Elimination guideline
    • Intestinal movements control
  • It demonstrates an effective intestinal elimination, as stated by the following indicators (specify from L to 5: severe, substantial, moderate, mild, none):
    • Diarrhea
    • Blood and mucus in the feces

Other examples

The patient will be able to:

  • Follow the prescribed diet to relieve diarrhea
  • Practice adequate hygiene to avoid skin problems
  • Verbally express that it includes the causes of your diarrhea
  • Maintain electrolytic balance in normal limits
  • Maintain acid-base balance in normal limits
  • Stay well hydrated (wet mucous membranes, Afebril, with good turgidity of eyeballs, BP, hematocritos and urine production in normal limits)

NIC Interventions

  • Diarrhea management: control and relief of diarrhea
  • Medication management: Facilitate the harmless and effective use of drugs with and without recipe
  • Liquid management: Promote water balance and prevention of complications resulting from anomal or unhappy concentrations of liquids
  • Intestine management: Establishment and maintenance of a regular pattern of the passage of stool through the intestines

Nursing Activities

Valuations

  • Perform the hidden blood test in feces
  • Make the patient identify their usual defecation pattern
  • Monitor laboratory values ??(electrolytes, complete blood count) and communicate anomalies
  • Weigh the patient daily
  • Evaluate and register:
    • Frequency, color, consistency and quantity (measure) of feces
    • Turgity of the skin and the state of the oral mucosa as dehydration indicators
  • (NIC) Diarrhea management:
    • Obtain stool for cultivation and sensitivity if diarrhea persists
    • Evaluate the drug profile to determine the gastrointestinal side effects
    • Evaluate the registered intake to verify its nutritional content
    • Monitor whether there is irritation or ulceration in the skin of the perianal area

Patient and family education

  • Inform the patient of the possibility of diarrhea caused by medications
  • Teach him to avoid milk, coffee, spices and irritating foods for the gastrointestinal tract
  • (NIC) Diarrhea management:
    • Teach the patient the proper use of antidiarrheal medication
    • Ask the patient and family members to record the color, volume, frequency and consistency of feces
    • Ask the patient to notify all the episodes of diarrhea to the staff
    • Teach stress reduction techniques to the patient, if necessary

Collaboration activities

  • Consult with a dietitian for a diet adjustment
  • (NIC) Diarrhea management: consult the doctor if the signs and symptoms of diarrhea persist

Others

  • Help the patient identify stress factors that can contribute to diarrhea
  • Provide care with an attitude of acceptance and without criticism
  • Offer the liquids that the patient prefers (specify)
  • Offer privacy and safety during defecation
  • (NIC) Diarrhea management:
    • Perform actions to rest the intestines (for example, liquid diet or not orally)
    • Promote frequent food, with small portions, and gradually increase it

At home

  • The above interventions are appropriate for home care
  • Evaluate patient medications, including those who do not need a recipe and phytotherapy
  • Evaluate hygiene and cleaning methods at home (handwashing, food preparation, etc.)
  • Teach to handle and prepare food safely
  • Teach universal precautions to family caregivers, in case of infectious diarrhea
  • Teach the signs and symptoms of dehydration

Babies and Children

  • Monitor the signs of dehydration [for example, increased thirst, dry mucous membranes, reduction of skin turgidity, sunken eyeballs, sunken fontanelles (in infants); Severe diarrhea signs also include rapid pulse, taquiapnea, cyanosis, lethargy and delay in capillary replacement]
  • Consult with the pediatrician an alternative feeding type
  • Offer treatment for oral rehydration (Pedialyte, Lytren, etc.), as indicated by
  • Infants must continue breastfeeding; others should avoid milk and liquids rich in carbohydrates
  • Carefully monitor fluid and electrolyte losses

Older people

  • The loss of muscle tone of the anal sphincter and the perineum can cause incontinence, which must be differentiated from diarrhea
  • Older people have a higher risk of dehydration when they suffer diarrhea; monitor the signs
  • Carefully monitor water and electrolytic loss
  • Carefully evaluate impact; eliminate it according to order