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CONTRIB UTORY OBJECTI VE To give the introduction about self. To give the Introduction about group. To give topic introduction to the group.

CONTENT

TEACHING LEARNING ACTIVITY Explanation

A.V.AIDS

EVALUATION

SELF INTRODUCTION : My self Binal joshi, M.Sc. Nursing student at. JG college of nursing, Ahmedabad. GROUP INTODUCTION : I would like to present Health education on Oral Rehydration Therapy in children. TOPIOC INTRODUCTION :

Explanation

By the picture ORS

1 mn

To define oral rehydration therapy

Oral Rehydration Therapy (ORT) is a simple treatment for dehydration associated with diarrhea, particularly gastroenteritis or gastroenteropathy, such as that caused by cholera or rotavirus. ORT consists of a solution of salts and sugars that is taken by mouth. It is used around the world, but is most important in the developing world, where it saves millions of children a year from death due to diarrhea, the second leading cause of death (after pneumonia) in children under five A basic oral rehydration therapy solution is explanation composed of: 30 ml (6 level tsp) of sugar 2.5 ml (1/2 level tsp) of salt, dissolved into

Teaching will explain and group will understand.

What is importance of ORS

Discussion

What are the basic components of ORS

 1 litre (4.25 Cups) of clean water Explanation 3 To enlist scopes of oral rehydration therapy Scope This guideline addresses the oral rehydration of children age 6 months to 17 years Inclusion Criteria:

Discussion

What are the scopes of ORS ?

Children aged 6 months to 17 years old presenting with either vomiting and/or diarrhea fewer than 7 consecutive days, resulting in mild to moderate dehydration.

Exclusion Criteria:

Children presenting with: severe dehydration (unstable vital signs, poor perfusion) Altered level of consciousness (Glasgow Coma Score <15) Persistent lethargy or acute head injury Possible surgical abdomen Chronic health conditions (such as Gastric or Jejunal feeding tubes dependence,etc.) Explanation Poster What are the three levels of dehydration?

To assess dehydration in children

Assessing Dehydration in Children Clinical assessment of degree of dehydration1

and based on that dehydration therapy given to child

Degree of dehydration Fontanelle Mucous membranes Skin turgor Capillary refill time Urine output Mental status

Mild (5-7% body weight) Slightly sunken Slightly sticky Normal Normal (<3 seconds) Normal Normal

Moderate (7-9% body weight) Very sunken Dry Slightly decreased Normal (<3 seconds) Slightly decreased Slightly fussy

Severe (>10% body weight) Very sunken Very dry Markedly decreased Delayed (3 seconds) Decreased or absent Irritable or lethargic

How much amount of ors will you give to your child depending on dehydration?

Based on the degree of dehydration, the following approach to management has been suggested: ORT in the management of diarrhea
No dehydration Mild dehydration Replace stool loses with ORS* Continue age appropriate feeding Repletion phase - Hydration should be restored by administering ORT at a volume

(3-5% volume of 50 mL/kg over four hours. Additional loss) ORS is given to replace ongoing loss of stool*. Reassessment of the patient's hydration status and replacement of ongoing losses should occur at least every two hours. Maintenance phase - Once repletion is completed, feeding and fluids should be started.

Moderate dehydration

Repletion phase - Hydration should be restored by administering ORT at a volume

(6-9% volume of 100 mL/kg over four hours. Additional loss) ORS is given to replace ongoing loss of stool*. At the end of each hour, the patient's hydration status and continuing stool and emesis losses should be calculated, with the total hourly loss added to the amount to be given over the next hour.

Maintenance phase - Once repletion is completed, feeding and fluids should be started. ORT is continued for ongoing diarrheal losses. Severe dehydration ( 10 % or greater Repletion phase - Emergent intravenous therapy with rapid infusion of 20 mL/kg of isotonic saline should be given. As the patient's clinical condition stabilizes and his/her level of consciousness returns to

volume loss.) normal, therapy can be changed to ORT. A nasogastric tube can be used in patients who have a normal mental status but may be too weak to adequately drink the necessary volume of fluid. The intravenous line should remain in place until it is certain there is successful transition to ORT. ORT therapy

is started at a volume of 100 mL/kg over four hours. Additional ORS is given to replace ongoing loss of stool*. At the end of each hour, the patient's hydration status and continuing stool and emesis losses should be calculated, with the total hourly loss added to the amount to be given over the next hour.

Maintenance phase - Once repletion is completed, feeding and fluids should be started. ORT is continued for ongoing diarrheal losses. * 1 mL of ORS should be administered for each gram of diarrheal stool or, 10 mL/kg of body weight of ORS should be administered for each watery or loose stool, and 2 mL/kg of body weight for each episode of emesis.

To introduce with the different recipies for preparation of ORS

The "simple solution" - Do-It-Yourself .... Encouraging self-reliance

Explanation

Demonstration

The following traditional remedies make highly effective oral rehydration solutions and are suitable drinks to prevent a child from losing too much liquid during diarrhoea:

How will you prepare ORS at your home ?

Breastmilk Gruels (diluted mixtures of cooked cereals and water) Carrot Soup

Rice water - congee A very suitable and effective simple solution for rehydrating a child can also be made by using salt and sugar, if these ingredients are available. If possible, add 1/2 cup orange juice or some mashed banana to improve the taste and provide some potassium. If none of these drinks is available, other alternatives are: Fresh fruit juice Weak tea Green coconut water

If nothing else is available, give

water from the cleanest possible source (if possible brought to the boil and then cooled).

The "Simple Solution" Preparing a Salt and Sugar Solution at Home Mix an oral rehydration solution using one of the following recipes; depending on ingredients and container availability:

Recipe 1 Making a 1 (one) litre solution using Salt,

Sugar and Water Ingredients:

one level teaspoon of salt eight level teaspoons of sugar one litre of clean drinking or boiled water and then cooled 5 cupfuls (each cup about 200 ml.)

Preparation Method: Stir the mixture till the salt and sugar dissolve.

Recipe 2 Making a 1/2 (half) litre solution using Salt, Sugar and Water Ingredients:

a 3 finger pinch of salt ( approx. 1.75 gms.) a scoop of sugar ( approx. 20 gms.) 1/2 (half) litre of clean drinking or boiled water 2.5 cupfuls (each cup about 200 ml.)

Preparation Method: Pour 1/2 (half) litre of clean drinking or boiled water, after it has cooled, into a large vessel. Add a 3-finger pinch of salt (approx. 1.75gms).

Taste the solution. It shouldn't be more salty than your tears. Add a scoop of sugar ( approx. 20 gms.) Stir the mixture till the salt and sugar dissolve Recipe 3 Making a quart or litre solution using Sugar or Honey, Salt, Baking Soda, and Water Ingredients: 1 quart or liter of drinking or boiled Water 5 cupfuls (each cup about 200 ml.) 1/4 teaspoon of Salt 1/4 teaspoon Baking Soda (bicarbonate of soda). 2 tablespoons of Sugar or Honey Preparation Method: Stir the mixture till the salt and sugar dissolve. Notes: If baking soda is not available, add another 1/4 teaspoon of salt. Advantages of ORT Low cost Elimination of the need for IV line placement Treatment that can be done or continued at home Safe and few side effects

To list advantages and disadvantag es of the ORS therapy

Explanation

Discussion

Limitations of ORT use Altered mental status with concern for aspiration and Abdominal ileus Underlying disorder that limits intestinal absorption of ORT Severe dehydration If stool output continues to be excessive, and ORT is unable to adequately rehydrate the child. If there is severe and persistent vomiting, and inadequate intake of ORS, intravenous therapy is recommended.

 SUMMARY : 1. Definition of ors 2. Scope of ORS 3. Assessment of dehydration and management of ORS 4. Recipe and Preparation of ORS 5. Advantages and limitations of ORS

CONCLUSION : I hearty thankful to my GuideArpan sir, my group member, my colleges and patient and also patients relative. I also thankful to the staff sister who gave us a proper place for give the knowledge about health. I learned and gained knowledge regarding exclusive breast feeding, its advantages, technique, indications and contraindications. This will be able to help me in future.

J G COLLEGE OF NURSING
SUBJECT: PEDIATRIC NURSING TOPIC:HEALTH EDUCATION ON ORS THERAPY

SUBMITTED TO PROF.ARPAN PANDYA PEDIATRIC NURSING J G COLLEGE OF NURSING SUBMITTED BY BINAL JOSHI S Y MSC NURSING J G COLLEGE OF NURSING