Pediatricians' BEST Guide to Treating Diarrhea скачать в хорошем качестве

Pediatricians' BEST Guide to Treating Diarrhea

🍼 DIARRHEA IN BABIES (PEDIATRIC DIARRHEA) ✅ Definition Diarrhea is the passage of: 3 loose or watery stools/day, or More frequent stools than normal for that child 👉 In infants, even increase in frequency with watery consistency is considered diarrhea. ✅ Normal Stool Pattern (Exam point) Age Normal stool Breastfed baby 5–8 loose stools/day (normal) Formula fed 1–3 semi-solid stools/day ⚠️ Important: Loose stool in breastfed baby ≠ diarrhea unless watery/foul smelling/dehydration. ✅ Types of Diarrhea 1. According to duration Type Duration Acute 14 days Persistent 14 days Chronic 1 month 2. According to cause (Very common MCQ) Type Cause Example Infectious Bacteria/virus/parasite Most common Non-infectious Food allergy, drugs Lactose intolerance Osmotic Malabsorption Milk intolerance Secretory Toxin secretion Cholera Dysenteric Blood + mucus Shigella ✅ Causes of Diarrhea 🔹 Infectious (MOST COMMON in exam) Viral (most common overall) Rotavirus Norovirus Bacterial E. coli Salmonella Shigella Vibrio cholerae Parasitic Giardia Entamoeba histolytica 🔹 Non-infectious Overfeeding Teething (mild only) Antibiotics Food allergy Lactose intolerance Worm infestation ✅ Risk Factors (Exam frequently asked) Bottle feeding Poor hygiene Contaminated water Malnutrition Lack of breastfeeding Low immunity ✅ Pathophysiology (Simple Flow) Infection → Intestinal mucosa damage → ↓ Absorption of water & electrolytes → ↑ Secretion → Loose stools → Dehydration + electrolyte imbalance ✅ Clinical Features 🔹 Mild Loose stool Mild fever Vomiting 🔹 Moderate Frequent watery stool Sunken eyes Thirst Irritability 🔹 Severe Lethargy No tears Dry mouth Sunken fontanelle Tachycardia Hypotension Shock ⭐ SIGNS OF DEHYDRATION (VERY IMPORTANT FOR EXAM) WHO Classification Sign Some dehydration Severe dehydration Thirst Drinks eagerly Unable to drink Eyes Sunken Very sunken Skin pinch Slow return Very slow return Behavior Irritable Lethargic/unconscious Memory trick: “DRY BABY” D – Dry mouth R – Reduced urine Y – Sunken eyes B – Body weight loss A – Absent tears B – Bulging/sunken fontanelle Y – Yawning/lethargy ✅ Complications Dehydration (most dangerous) Electrolyte imbalance Hypovolemic shock Acidosis Malnutrition Death (if untreated) ✅ Diagnosis Usually clinical Investigations only if severe: Stool exam Serum electrolytes CBC Blood urea/creatinine ✅ MANAGEMENT (MOST IMPORTANT FOR NCLEX & AIIMS) 1️⃣ ORAL REHYDRATION THERAPY (FIRST LINE) ORS composition Glucose Sodium Potassium Chloride Citrate ORS Plan (WHO) 🟢 Plan A (No dehydration) Home care ORS after each stool Continue feeding Dose: 2 years → 50–100 ml 2–10 years → 100–200 ml 🟡 Plan B (Some dehydration) ORS 75 ml/kg over 4 hours Observe in hospital 🔴 Plan C (Severe dehydration) IV fluids immediately: Ringer lactate or Normal saline 100 ml/kg 2️⃣ Zinc Therapy (VERY COMMON MCQ) Why? Reduces duration Prevents recurrence Dose: Age Dose 6 months 10 mg/day 6 months 20 mg/day Duration: 14 days 3️⃣ Diet Therapy Continue feeding (DON’T STOP) Breastfeeding Rice water Khichdi Banana Curd Coconut water ❌ Avoid: Junk food Fatty food Sugary drinks Soda 4️⃣ Medications Antibiotics → only bacterial infection Probiotics Antipyretics ❌ No anti-diarrheal drugs in infants ✅ Nursing Management (Very important for exams) Assessment Stool frequency Dehydration signs Weight Intake-output chart Interventions Give ORS IV fluids Maintain hygiene Skin care Record vitals Monitor electrolytes Education Hand washing Safe water Breastfeeding Proper feeding ORS preparation at home ✅ ORS Home Preparation (Exam favorite) 1 liter boiled water 6 tsp sugar ½ tsp salt Mix well ✅ Prevention Exclusive breastfeeding (6 months) Hand hygiene Safe drinking water Rotavirus vaccination Proper sanitation Food hygiene