Definition

Increase in frequency,
volume and fluid content of
stool

A symptom rather than a

primary disorder
 Types
Acute – lasts less than a week: often
due to infectious agent

Chronic – persists longer than 3 to 4

weeks: may be caused by
inflammatory bowel disorders,
malabsorption and endocrine disorders
 Etiology
Large volume of diarrhea is caused
by increased water content of stool
from osmotic or secretory processes
Small volume diarrhea is
characterized by small frequent
stool: usually caused by
inflammation or diseases of the
colon
Sign & Symptoms
Affected by cause, duration,
severity, area of bowel affected
and client’s general health
Varies from several large watery
stools daily to very frequent small
stools containing mucus, blood or
exudates.
 Complications
Dehydration, especially in very young and
older or debilitated adult

Severe Diarrhea: leads to vascular

collapse, hypovolemic shock, electrolyte
imbalances such as hypokalemia,
hypomagnesemia, metabolic acidosis
Collaborative Care

Management focuses on identifying

and treating the cause, and
preventing complications.
A. Diagnostic Tests
Stool specimen: gross and microscopic
- examination to detect WBC’s, unabsorbed
fat, parasites (if parasitic infections
suspected, usually get series of 3
specimens at 2-3 day intervals.)
Stool culture: enteric pathogen
Serum electrolytes; osmolality; arterial
blood gases: to asses complications
A. Diagnostic Tests
Sigmoidoscopy: direct examination
of bowel mucosa

Tissue biopsy; identify chronic

inflammatory process and infections
B. Medications:
Used sparingly or not at all until
cause has been identified.
Antidiarrheal medications may
worsen disease if it slows elimination
of toxin from the bowel
Balanced electrolyte solutions, oral or
intravenous potassium replacement.
B. Medications:
Antidiarrheal medications
commonly contain opium or
derivatives, anticholinergics,
absorbants and demulcents
Antibiotics should be used
cautiously since these alter the
bowel’s normal bacterial flora
C. Dietary Management
Fluid replacement: oral glucose/
balanced electrolyte solution that
is commercially prepared or can
be made at home
Solid food should be withheld for
the first 24 hours to rest the
bowel; then begin frequent small
feeding to start with soft diet
C. Dietary Management
Milk and milk products are added
last
Foods with roughage, fried and
spicy, coffee and alcohol are avoided
in the recovery period
Clients with chronic diarrhea may
need to eliminate specific foods found
to aggravate and cause diarrhea
 Nursing Care
Teaching on safe food handling and
measures to take if travelling outside
foreign countries or without safe water
Assess information regarding duration
and extent of diarrhea, risk factors,
abdominal assessments and signs of
dehydration
Nursing Care
Home care: teach regarding
care including proper hand
washing, introduction of food
with constipating effect (i.e.
crackers, bananas, rice,
potatoes)
 Nursing Diagnosis
Diarrhea
Risk for Deficient Fluid Volume: assess
for orthostatic hypotension: drop in BP
> 10 mmHg and pulse increase of ten
when changing from lying to sitting or
standing position
Risk for Impared Skin Integrity:
provide hygiene and protective
ointment for perianal srea.