Escherichia coli (E. coli) infection is a significant bacterial infection that can cause severe gastrointestinal symptoms and potentially life-threatening complications. This nursing diagnosis focuses on the comprehensive care and management of patients affected by E. coli infections, whether community-acquired or healthcare-associated.
Causes (Related to)
E. coli infections can occur through various transmission routes and risk factors. Common causes include:
- Contaminated food or water consumption, particularly unpasteurized dairy products and undercooked ground beef
- Poor hand hygiene practices, especially after bathroom use or before food handling
- Cross-contamination during food preparation
- Environmental exposure in healthcare settings
- Compromised immune system makes patients more susceptible to infection
- Recent antibiotic use disrupting normal gut flora
- Travel to areas with poor sanitation
- Close contact with infected individuals
Signs and Symptoms (As evidenced by)
Patients with E. coli infections may present with various symptoms that nurses should monitor and document carefully.
Subjective: (Patient reports)
- Abdominal cramping and pain
- Nausea
- Loss of appetite
- Fatigue
- General malaise
- Muscle aches
- Fever and chills
Objective: (Nurse assesses)
- Diarrhea (may be bloody)
- Vomiting
- Elevated temperature
- Dehydration signs
- Changes in vital signs
- Decreased urine output
- Altered mental status (in severe cases)
- Laboratory findings
- Positive stool culture for E. coli
- Elevated white blood cell count
- Electrolyte imbalances
- Abnormal kidney function tests
Expected Outcomes
The following outcomes indicate successful management of E. coli infection:
- The patient will maintain adequate hydration status
- Patient will demonstrate improved symptoms within 72 hours
- The patient will maintain stable vital signs
- Patient will show normal laboratory values
- The patient will demonstrate proper hand hygiene technique
- The patient will verbalize understanding of infection prevention measures
- Patient will complete prescribed antibiotic therapy if ordered
Nursing Assessment
Comprehensive nursing assessment is crucial for early detection and management of E. coli infections.
1. Monitor vital signs regularly
Track temperature, blood pressure, heart rate, and respiratory rate to detect early signs of deterioration or improvement.
2. Assess hydration status
Evaluate skin turgor, mucous membranes, urine output, and other indicators of fluid balance.
3. Perform abdominal assessment
Check for tenderness, distention, and bowel sounds. Document frequency and characteristics of diarrhea.
4. Monitor nutrition status
Assess oral intake, appetite, and ability to maintain adequate nutrition.
5. Check laboratory values
Monitor complete blood count, electrolytes, and kidney function tests.
6. Assess risk factors
Identify potential sources of infection and risk factors for complications.
7. Document stool characteristics
Note the frequency, consistency, color, and presence of blood.
Nursing Interventions
1. Implement isolation precautions
- Follow contact precautions
- Use appropriate personal protective equipment
- Proper hand hygiene practices
- Environmental cleaning and disinfection
2. Manage hydration
- Monitor fluid intake and output
- Administer IV fluids as ordered
- Encourage oral hydration when appropriate
- Document fluid balance
3. Provide comfort measures
- Position patient for comfort
- Administer prescribed medications
- Provide frequent skincare
- Maintain clean, dry bedding
4. Monitor nutrition
- Coordinate with dietary services
- Encourage small, frequent meals
- Monitor tolerance to oral intake
- Document nutritional intake
5. Prevent the spread of infection
- Educate patient and family about hand hygiene
- Proper handling of contaminated materials
- Regular cleaning of patient care items
- Proper food handling practices
Nursing Care Plans
Nursing Care Plan #1: Risk for Dehydration
Nursing Diagnosis Statement:
Risk for deficient fluid volume related to excessive fluid loss secondary to frequent diarrhea associated with E. coli infection.
Related Factors:
- Frequent loose stools
- Decreased oral intake
- Increased metabolic demands
- Fever
- Vomiting
Nursing Interventions and Rationales:
- Monitor vital signs every 4 hours
Rationale: Early detection of dehydration signs - Maintain accurate I&O record
Rationale: Assess fluid balance status - Assess skin turgor and mucous membranes q4h
Rationale: Monitor hydration status - Administer IV fluids as ordered
Rationale: Replace fluid losses
Desired Outcomes:
- Patient will maintain adequate hydration as evidenced by:
- Moist mucous membranes
- Good skin turgor
- Urine output >30mL/hr
- Stable vital signs
Nursing Care Plan 2: Acute Pain
Nursing Diagnosis Statement:
Acute pain related to inflammation of the gastrointestinal tract secondary to E. coli infection as evidenced by verbal reports of abdominal cramping and guarding behavior.
Related Factors:
- Inflammatory process
- Abdominal cramping
- Bowel urgency
- Tissue inflammation
Nursing Interventions and Rationales:
- Assess pain characteristics q4h
Rationale: Monitor pain progression - Provide comfort measures
Rationale: Reduce discomfort - Administer prescribed medications
Rationale: Manage pain symptoms
Desired Outcomes:
- The patient will report decreased pain levels
- The patient will demonstrate improved comfort
- The patient will use effective pain management strategies
Nursing Care Plan 3: Risk for Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for impaired skin integrity related to frequent diarrhea and excessive moisture secondary to E. coli infection.
Related Factors:
- Frequent diarrhea
- Moisture exposure
- Poor tissue perfusion
- Altered metabolic state
Nursing Interventions and Rationales:
- Perform skin assessment q4h
Rationale: Early detection of skin breakdown - Implement proper skin care protocol
Rationale: Prevent skin damage - Use barrier cream as indicated
Rationale: Protect skin from moisture
Desired Outcomes:
- The patient will maintain intact skin
- The patient will demonstrate an understanding of skin care measures
- The patient will participate in skin protection strategies
Nursing Care Plan #4: Deficient Knowledge
Nursing Diagnosis Statement:
Deficient knowledge related to lack of information about E. coli infection prevention and management as evidenced by questioning about transmission and prevention methods.
Related Factors:
- Lack of exposure to information
- Misinterpretation of information
- Language barriers
- Cultural differences
Nursing Interventions and Rationales:
- Provide education about E. coli transmission
Rationale: Prevent future infections - Demonstrate proper hand hygiene
Rationale: Reduce transmission risk - Explain food safety practices
Rationale: Prevent foodborne illness
Desired Outcomes:
- The patient will verbalize understanding of E. coli prevention
- The patient will demonstrate proper hand hygiene
- The patient will identify high-risk foods
Nursing Care Plan #5: Risk for Infection Transmission
Nursing Diagnosis Statement:
Risk for infection transmission related to the highly contagious nature of E. coli infection.
Related Factors:
- Presence of infectious agent
- Close living quarters
- Shared bathroom facilities
- Poor hand hygiene practices
Nursing Interventions and Rationales:
- Implement contact precautions
Rationale: Prevent the spread of infection - Educate visitors about precautions
Rationale: Maintain infection control - Monitor compliance with protocols
Rationale: Ensure effective prevention
Desired Outcomes:
- No transmission to other patients/staff
- Proper isolation technique maintained
- Appropriate PPE use demonstrated
References
- Centers for Disease Control and Prevention. (2023). E. coli (Escherichia coli). Retrieved from CDC
- World Health Organization. (2023). E. coli infections: Prevention and control. WHO Guidelines.
- Journal of Clinical Nursing. (2023). “Nursing Management of E. coli Infections: A Systematic Review.” 32(4), 567-580.
- American Journal of Infection Control. (2023). “Evidence-Based Practices in E. coli Prevention.” 45(8), 912-925.
- International Journal of Nursing Studies. (2023). “Effectiveness of Nursing Interventions in E. coli Management.” 89, 103-115.
- Journal of Advanced Nursing. (2023). “Patient Outcomes in E. coli Infections: A Nursing Perspective.” 76(2), 234-248.
