Gastroenteritis is an inflammatory condition of the gastrointestinal tract that affects the stomach and intestines, causing acute symptoms such as diarrhea, vomiting, abdominal pain, and potential complications. This nursing diagnosis focuses on identifying symptoms, preventing complications, and managing patient recovery effectively.
Causes (Related to)
Gastroenteritis can develop from various factors that affect patient outcomes and treatment approaches:
- Viral infections (most common):
- Rotavirus
- Norovirus
- Adenovirus
- Bacterial infections:
- Salmonella
- E. coli
- Campylobacter
- Risk factors include:
- Compromised immune system
- Age extremes (very young or elderly)
- Poor hand hygiene
- Contaminated food or water
- Close contact with infected individuals
- Environmental factors such as:
- Poor sanitation
- Crowded living conditions
- Limited access to clean water
- Food preparation practices
Signs and Symptoms (As evidenced by)
Gastroenteritis presents with characteristic signs and symptoms that nurses must identify for accurate diagnosis and treatment.
Subjective: (Patient reports)
- Nausea
- Abdominal cramping and pain
- Loss of appetite
- Fatigue and weakness
- Thirst
- Dizziness
- General malaise
Objective: (Nurse assesses)
- Frequent loose stools
- Vomiting
- Signs of dehydration
- Decreased skin turgor
- Dry mucous membranes
- Tachycardia
- Decreased blood pressure
- Fever (in some cases)
- Decreased urine output
Expected Outcomes
The following outcomes indicate successful management of gastroenteritis:
- The patient will maintain an adequate hydration status
- Diarrhea and vomiting will decrease within 48-72 hours
- The patient will maintain electrolyte balance
- The patient will demonstrate an understanding of disease prevention
- Patient will return to normal eating patterns
- The patient will avoid complications
- The patient will resume normal activities within 5-7 days
Nursing Assessment
Monitor Vital Signs
- Check blood pressure, pulse, respiratory rate, and temperature
- Monitor for signs of dehydration
- Assess for postural hypotension
Evaluate Hydration Status
- Monitor fluid intake and output
- Assess skin turgor and mucous membranes
- Check capillary refill
- Monitor urine output and characteristics
- Assess for signs of dehydration
Gastrointestinal Assessment
- Monitor frequency and characteristics of stools
- Document episodes of vomiting
- Assess abdominal pain and cramping
- Check for signs of bleeding
- Monitor nutritional intake
Evaluate for Complications
- Monitor electrolyte levels
- Assess for signs of severe dehydration
- Check for hemodynamic instability
- Monitor for acute kidney injury
- Assess for metabolic acidosis
Risk Factor Assessment
- Review recent food and water consumption
- Document exposure to infected individuals
- Assess living conditions
- Check hand hygiene practices
- Review medical history
Nursing Care Plans
Nursing Care Plan 1: Fluid Volume Deficit
Nursing Diagnosis Statement:
Fluid Volume Deficit related to excessive fluid loss through diarrhea and vomiting as evidenced by decreased skin turgor, dry mucous membranes, and decreased urine output.
Related Factors:
- Excessive fluid loss
- Decreased oral intake
- Active fluid loss through diarrhea
- Vomiting
- Increased metabolic rate
Nursing Interventions and Rationales:
- Monitor intake and output hourly
Rationale: Ensures accurate fluid balance assessment - Administer IV fluids as ordered
Rationale: Replaces fluid losses and prevents complications - Assess skin turgor and mucous membranes q2h
Rationale: Provides early indication of hydration status
Desired Outcomes:
- The patient will demonstrate improved hydration status.
- The patient will maintain stable vital signs
- The patient will produce adequate urine output
Nursing Care Plan 2: Diarrhea
Nursing Diagnosis Statement:
Diarrhea related to inflammatory processes in the gastrointestinal tract as evidenced by frequent loose stools and abdominal cramping.
Related Factors:
- Inflammatory response
- Infection
- Altered gut flora
- Increased gut motility
Nursing Interventions and Rationales:
- Monitor stool characteristics and frequency
Rationale: Tracks progression of illness - Implement appropriate isolation precautions
Rationale: Prevents spread of infection - Provide perineal care after each bowel movement
Rationale: Prevents skin breakdown and maintains comfort
Desired Outcomes:
- The patient will report a decreased frequency of diarrhea
- The patient will maintain skin integrity
- The patient will demonstrate proper hygiene practices
Nursing Care Plan 3: Risk for Electrolyte Imbalance
Nursing Diagnosis Statement:
Risk for Electrolyte Imbalance related to excessive fluid loss and poor oral intake as evidenced by abnormal electrolyte levels and weakness.
Related Factors:
- Fluid loss through diarrhea
- Vomiting
- Poor nutritional intake
- Altered absorption
Nursing Interventions and Rationales:
- Monitor electrolyte levels
Rationale: Allows early intervention for imbalances - Administer electrolyte replacement as ordered
Rationale: Corrects deficiencies and prevents complications - Monitor for signs of imbalance
Rationale: Enables prompt intervention
Desired Outcomes:
- The patient will maintain normal electrolyte levels
- The patient will demonstrate improved energy levels
- The patient will tolerate oral intake
Nursing Care Plan 4: Imbalanced Nutrition
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to decreased oral intake and malabsorption as evidenced by weight loss and poor appetite.
Related Factors:
- Nausea and vomiting
- Decreased appetite
- Malabsorption
- Fear of eating
Nursing Interventions and Rationales:
- Monitor nutritional intake
Rationale: Ensures adequate nutrition - Provide small, frequent meals
Rationale: Improves tolerance to food - Monitor weight daily
Rationale: Tracks nutritional status
Desired Outcomes:
- The patient will demonstrate an improved appetite
- The patient will maintain a stable weight
- The patient will tolerate a regular diet
Nursing Care Plan 5: Risk for Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to frequent diarrhea and dehydration as evidenced by perineal irritation and decreased skin turgor.
Related Factors:
- Frequent diarrhea
- Moisture exposure
- Poor tissue perfusion
- Nutritional deficits
Nursing Interventions and Rationales:
- Assess skin condition q shift
Rationale: Enables early detection of breakdown - Implement skin protection measures
Rationale: Prevents skin damage - Provide meticulous perineal care
Rationale: Maintains skin integrity
Desired Outcomes:
- The patient will maintain intact skin
- The patient will demonstrate proper skincare
- The patient will report decreased discomfort
References
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- Graves NS. Acute gastroenteritis. Prim Care. 2013 Sep;40(3):727-41. doi: 10.1016/j.pop.2013.05.006. Epub 2013 Jul 19. PMID: 23958366; PMCID: PMC7119329.
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- Stuempfig ND, Seroy J, Labat-Butler JR. Viral Gastroenteritis (Nursing) [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568704/
