Disorders of Motility: Gastroenteritis (Nursing)

00:01 Hi, I'm Dr. Jackie Calhoun.

00:03 And today we're going to talk about pediatric gastroenteritis.

00:08 So we'll cover all of these in the lecture which include the definition, the causes, the epidemiology, or who gets it.

00:15 The signs and symptoms, which we'll also call cues, the diagnosis, the prevention, and then finally the treatment of gastroenteritis.

00:26 So let's start with the definition.

00:29 It's important to remember that the suffix -itis means inflammation.

00:34 So gastroenteritis is the inflammation of the gastrointestinal tract or the GI tract.

00:41 And this can really be anywhere along that track.

00:43 So stomach, intestine, whether it be the small or the large, any of that can be inflamed.

00:51 Symptoms of gastroenteritis include vomiting, diarrhea, or a combination of both.

00:58 Sometimes the vomiting or diarrhea is accompanied by fever, abdominal cramps, because their intestines are working a little harder with the inflammation.

01:08 And that leads us into the causes. So what causes gastroenteritis? It can be caused by viruses, bacteria, parasites, or medications.

01:21 All children are at risk, but some children are more risk than others.

01:26 So children who are more likely to get gastroenteritis include those who have younger age, especially infants and toddlers, kids who don't have immune systems that function normally.

01:40 And then kids with chronic illnesses.

01:43 We talked about who gets it, but let's dive into that a little bit more with epidemiology.

01:49 So if the illness is caused by a virus, the virus is usually passed from child to child, and it's very contagious.

01:59 So if one child gets this, especially in a school setting, or childcare setting, they're almost definitely going to spread it to someone else.

02:08 These types of settings include schools, childcare centers, and other crowded places.

02:15 Anywhere where kids are in close contact with one another.

02:18 This transmission can occur with sneezing one child actually sneezes onto another child and the droplets move from a mouth to someone else's mouth.

02:29 It can be from spitting so the same idea where it's going into the spit goes from one kid into the other kid's mouth.

02:38 And then lastly, from a fecal oral route, and this is, you know, if kids are wearing diapers, especially toddlers, it's hard to sometimes keep everything as clean as possible, or if there's not good hand washing, which I don't know if they're really ever is with toddlers.

02:58 So let's talk more about the bacterial causes of gastroenteritis.

03:02 There are several kinds of bacteria that can cause this illness.

03:06 These include, Campylobacter, Clostrdioides difficile or C. diff, These include, Campylobacter, Clostrdioides difficile or C. diff, These include, Campylobacter, Clostrdioides difficile or C. diff, Escherichia coli or E. Coli, Salmonella, Shigella, Yersinia and staphylococcus.

03:21 These bacteria can be acquired in a number of different ways, including from drinking unpasteurized milk or juice by eating contaminated shellfish, by swallowing contaminated water, by touching or eating certain contaminated foods and into this category goes like the raw or undercooked meat or eggs, or touching animals that can carry certain bacteria.

03:49 And these are often you know, common pets like either mice or turtles actually are big carrier of salmonella.

03:58 There are parasites that can cause gastroenteritis.

04:01 These include giardia, and Cryptosporidium.

04:06 And now we can talk about the medications that can cause this condition.

04:10 These include antacids with magnesium as the main ingredient, antibiotics and chemotherapy.

04:15 antibiotics and chemotherapy.

04:18 Other treatments and medications that can cause this include radiation therapy, digoxin, which is a certain type of heart medication, and then laxatives.

04:28 So now let's talk about the signs and symptoms or cues of gastroenteritis.

04:35 So as we touched on a little bit in the beginning, this includes vomiting, diarrhea, abdominal cramps, or abdominal pain or both, a fever, and poor appetite because no one wants to eat when their belly hurts and they're having vomiting and diarrhea.

04:56 If gastroenteritis is severe enough, dehydration can develop.

05:00 Because what a child is taking in is not enough to keep up with the amount of vomiting or diarrhea that they're having.

05:08 So let's review those signs of dehydration.

05:11 And those include a sunken anterior fontanelle.

05:13 So the space between the sutures in the top of their head, and it's not closed yet in infants. That can actually feel.

05:20 It's usually in line with the rest of the skull or like flush with it.

05:24 And if they're dehydrated, it's actually sunken or it's lower than the rest of their skull bones.

05:29 They can have sunken eyes. They can have poor skin turgor.

05:33 So skin turgor is where if you pull up on the skin, really anywhere between their hand or their abdomen or by their shoulder, you pull it up and it doesn't snap back or go back into place very quickly.

05:48 It's called Skin tenting when they're dehydrated.

05:52 They could have decreased tear production where they're making few or even no tears.

05:57 May have tacky or dry mucous membranes.

06:00 There's maybe not enough saliva because of the dehydration.

06:04 And then now let's move on to symptoms that are specific to gastroenteritis that's caused by different things.

06:11 So viral gastroenteritis, often has watery diarrhea that is associated with it.

06:17 It's important to note that with viral diarrhea and viral gastroenteritis that this diarrhea rarely contains blood or mucus.

06:26 Viral gastritis can last from one to two days, up to two weeks.

06:32 And that two weeks can seem like a very long time, but virus could sometimes take a while to clear from the body.

06:40 And in viral gastroenteritis, the vomiting usually resolves or stops before the diarrhea does.

06:47 It kind of works its way through the GI tract.

06:49 Children with bacterial gastroenteritis usually have a fever.

06:55 They often have bloody diarrhea because of the presence of those bacteria.

07:01 And they can have painful abdominal cramping.

07:04 It's also important to note that this type of bacterial gastroenteritis is usually the most severe and can actually make the kids the most sick.

07:12 They can result in severe anemia and even acute kidney injury.

07:16 So it's important if this develops in a patient to recognize it as quickly as possible.

07:24 If a child has parasitic gastroenteritis, they'll likely have diarrhea that lasts for a long time, but it can come and go within that time.

07:33 So it might last months it but they might have a couple days of diarrhea within that month, and then they might have a day or two or they don't.

07:41 And then they'll have a few days of diarrhea again and then they won't have it. So it's not consistent.

07:47 It goes up and down the frequency and the volume.

07:52 And like with the viral gastroenteritis, this diarrhea is not usually bloody.

07:57 But because it lasts for so long, this is often accompanied by weight loss due to dehydration, and poor nutrition, and then fatigue.

08:07 Also, because important nutrition.

08:09 So there are several different kinds of medications that can cause gastroenteritis.

08:14 These include antibiotics, anti-parasitic drugs, antiemetic medications.

08:21 So we actually some medications that are used to treat nausea in children, can actually make gastroenteritis worse, and then antidiarrheal medications.

08:31 So if we give medication for kids to stop having diarrhea, it can actually make that gastroenteritis worse as well.