Nursing Case Study
Managing a possible Case of Gastroenteritis: A Nursing Case Study
The effective delivery of optimal nursing care requires a comprehensive treatment plan that addresses both the patient's symptoms and the security of the immediate environment. This report presents a case study of appropriate evidence-based nursing practices in treating an elderly female patient presenting with abdominal discomfort in a residential care setting.
The client presents with new onset faecal incontinence, diarrhoea and increasing abdominal discomfort and cramps. These symptoms suggest a possible gastrointestinal disturbance (Crisp & Taylor, 2009) and present a number of possible diagnoses. While the client's nursing care plan indicates that she is normally continent, her confidential disclosure to the nurse suggests that her symptoms may be more prolonged. Another relevant client characteristic is her advanced age of 85 years.
The client's proximity to the dirty utility room in the aged care facility and the report of similar symptoms from a patient in the adjoining dementia unit suggests a diagnosis of gastroenteritis. Possible causes for this may be the result of cross contamination via the oral-faecal route of transmission, or through consuming contaminated foods and water (Kirk, Hall, Veitch, Becker, 2010). The physical location of the dirty utility room proximal to the eating and food preparation areas appears inappropriate and may be the source of a possible viral infection through food contamination. This health risk presented by the design of the facility should be reviewed by the appropriate agency (Department of Health and Ageing, 2007). The most often cited causes of gastroenteritis are salmonella infections and clostridium difficile (Andrew & Simor, 2010).
While the symptoms are very evident, they are broad and may apply to other diagnoses that must be considered as part of the nursing care assessment. Inflammatory bowel disease is especially common for clients over the age of 60 (del Val 2011) and even Crohn's Disease, while less likely, must be taken into consideration. Other potential causes of the symptoms may be simple dietary imbalance leading to constipation or adverse drug effects. A recent study conducted by Gurwitz et al. showed the high prevalence of adverse drug effects in long-term care facilities (2005).
Gastroenteritis cases do not generally deteriorate quickly but if...
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