Diarrhea is a gastrointestinal disturbance that is defined as having a frequent defecation at times wherein the stools’ consistency is unformed and watery. Diarrhea is the opposite of constipation. If constipation prevents an individual to defecate regularly by having hardened stools, diarrhea causes someone to increase frequency of bowel movements per day which may lead to have watery stools.
Diarrhea can be of several causes. It can be caused by hyperperistaltic movements of the intestines, presence of infection, bowel diseases and malabsorption disorders. Diarrhea can be manageable at first but on later stages, it can be life-threatening because it can cause severe dehydration and nutritional problems. So, it is very important to maintain an individual’s normal digestive process to have normal ingestion as well as elimination.
Causative/Related Factors
- Anxiety
- Excessive intake of alcohol
- Effects of chemotherapy
- Improper dietary intake
- viral, bacterial, or parasitic infections
- Gastrointestinal diseases
- Malabsorption disorders
- irritable bowel syndrome
- Crohn’s disease and/ or ulcerative colitis
- Effects of Radiation therapy
- Side effects of medication use
- Stress
Defining Characteristics
- Abdominal pain
- Abdominal Cramps
- Increased in the frequency of stools
- Hyperactive bowel sounds or sensations
- Loose or liquid stools
Desired Outcomes
- Patient understands and explains the causes of diarrhea and the possible treatment
- Patient do not have signs and symptoms of dehydration as evidenced by good skin turgor and having the same weight level
- Patient do not report increase in the frequency of defecation
- Patient defecates formed and soft stools
- Patient has negative stool cultures which indicates no signs of infection
Nursing Assessment/Rationale
| Assessment | Rationales |
| 1. Assess patient for presence of abdominal discomfort, abdominal pain, abdominal cramps, frequency, urgency, and loose or watery stools | · This proves that the patient is having diarrhea |
| 2. Let the patient undergo stool culture examination | · It will determine presence of infection which may be the cause of the diarrhea |
| 3. Assess for fecal impaction. | · It may also be a sign of diarrhea because only the watery part of the stool has been eliminated |
| 4. Assess patient’s hydration status (intake and output; mucus membranes, skin turgor) | · This will determine presence of dehydration in patient who are having diarrhea. It will determine the need for immediate interventions. |
| 5. Ask the patient’s past and present history of bowel disorders, and such treatment | · It will let the nurse determine the possible cause of diarrhea and to direct to the correct intervention |
| 6. Assess the presence of irritations at the perianal area | · This is a probable sign of having frequent and watery stools. |
Nursing Interventions
| Nursing Interventions | Rationale |
| 1. Ask the patient about his/her schedule of bowel movements per day including its frequency, consistency and urgency | · It will serve as a basis for determining if there is presence of diarrhea |
| 2. Know the dietary habits of the patient including his/her oral fluid intake | · It will determine if intake of certain foods can cause diarrhea |
| 3. weigh the patient daily | · It will determine presence of weight loss which can be a sign of dehydration and poor nutritional intake |
| 4. Administer antidiarrheal medications as prescribed. | · It will lessen and stop the urgency in defecating more than the usual. |
| 5. administer bulk fiber as prescribed | · These drugs can absorbed fluid from the stool increasing the bulk of the fecal material. |
| 6. Tell the patient to prevent and avoid drinking of caffeine and carbonated beverages | · These are stimulants and it will worsen the diarrheal episodes |
| 7. check signs of dehydration by checking skin turgor and mucus membranes | · This will treat immediately the patient who is dehydrated through correct rehydration process |
| 8. Advise the patient to increase oral fluid intake per day | · It prevents dehydration by replacing the fluids that was eliminated |
| 7. Monitor and record intake and output of the patient | · It determines the need for rehydration process |
| 8. Encourage patient to eat small, frequent feedings as needed | · It will slow down peristaltic movements by digestion of small particles. |
| 9. Explain the importance of fluid replacement during diarrheal episodes. | · It is for the prevention of dehydration. |
| 10. Educate patient and family members on good sanitation practices and handwashing especially in preparing foods for the patient. | · It prevents acquisition of further infection |