NCP Cholera - 6 Nursing Diagnosis and Interventions

Care Plan Nursing

Nursing Care Plan for Cholera

Cholera, a severe diarrheal disease caused by the bacterium Vibrio cholerae, has plagued human populations for centuries. This waterborne illness poses significant public health challenges, particularly in regions with inadequate sanitation and limited access to clean water. This article explores the causes, symptoms, transmission, and global efforts in the prevention and management of cholera.

Causes and Transmission:

1. Vibrio cholerae, the bacterium responsible for cholera, typically thrives in contaminated water and food sources. The primary mode of transmission is through the ingestion of contaminated water or food, often via the consumption of raw or undercooked seafood, or contaminated fruits and vegetables.
2. Once ingested, the bacterium releases a toxin that affects the small intestine, leading to rapid and profuse watery diarrhea—a hallmark symptom of cholera. The severity of the disease can range from mild to severe, with severe cases potentially progressing to life-threatening dehydration without prompt intervention.

Symptoms:

1. Watery Diarrhea: Cholera is characterized by the sudden onset of profuse, painless, and watery diarrhea, often described as "rice-water stool."
2. Vomiting: Individuals with cholera may experience vomiting, contributing to fluid loss and dehydration.
3. Dehydration: Rapid fluid loss can lead to severe dehydration, accompanied by symptoms such as sunken eyes, dry mucous membranes, lethargy, and a rapid heart rate.
4. Muscle Cramps: Dehydration can cause muscle cramps and weakness.

Nursing Assessment for Cholera

1. Assess the status of dehydration (skin color, temperature, acral, skin turgor, mucous membranes, eyes, crown, body temperature, pulse, respiration, behavior, weight loss).
2. Observe for manifestations of acute diarrhea
   • A sudden attack of diarrhea
   • Fever
   • Anorexia, nausea, vomiting
   • Weight loss
   • Pain and abdominal cramps, abdominal distension
   • Increased bowel sounds / hyper-peristaltic
   • Malaise
   • Bowel movements more than 3 times a day, liquid stool consistency, with / or without mucus and blood
3. Assess the psychosocial status of families
4. Assess the level of knowledge of family
   • Knowledge of diarrhea at home
   • Knowledge of dietary
   • Knowledge about the prevention of recurrent diarrhea

Nursing Diagnosis for Cholera

1. Deficient fluid volume related to excessive fluid loss through the stool or emesis
2. Imbalanced Nutrition: Less Than Body Requirements related to loss of fluids through diarrhea, inadequate intake
3. Risk for infection related to microorganisms that penetrate the gastrointestinal tract.
4. Impaired Skin Integrity: perianal, related to irritation from diarrhea
5. Anxiety related to separation from parents, unfamiliar environment, a stressful procedure.
6. Interrupted Family Processes related to crisis situations, lack of knowledge about diseases, treatment of clients.

Nursing Interventions for Cholera


Deficient fluid volume related to excessive fluid loss through the stool or emesis

Goal :

• Maintain adequate hydration

Expected outcomes:

No signs of dehydration: elastic skin turgor, sunken fontanel not, the patient is not agitated, mucous membranes moist, no weight loss.

Nursing Interventions and Rational:
1) Record Intake Output every 24 hours.
R / Knowing the status of dehydration and evaluate the effectiveness of interventions.

2) Measure the child's weight every day.
R / observe dehydration.

3) Measure vital signs and evaluation of skin turgor, mucous membranes, mental status.
R / observe dehydration.
4) Tell the family to give the child a drink gradually.
R / improve hydration.

collaboration:
5) Give oral rehydration solution (ORS).
R / rehydration and replacement of fluid loss through the stool.

6) Provide and monitor IV fluids as indicated (collaboration).
R / replacement fluid loss.

7) Observe the results of the electrolyte.
R / know the level of hydration and the effectiveness of interventions.


Imbalanced Nutrition: Less Than Body Requirements related to loss of fluids through diarrhea, inadequate intake

Goal :

• consume adequate nutrition intake.

Expected outcomes:

• No weight loss (weight stable)
• Eating out 1 serving.
• No nausea, vomiting.

Nursing Interventions and Rational:

1) Evaluation of nutritional status and weight loss
R / Identifying the need for further intervention.

2) Notify and motivation of mothers / families to continue breast-feeding.
R / breast milk reduces the severity and duration of disease and provide additional nutrients.

3) Tell the mother to give the child to eat small meals but often
R / increase food intake.

4) Observe and record the response to feeding.
R / know the tolerance of feeding.

 

 

Bibliography:

1. Ali, M., Nelson, A. R., Lopez, A. L., & Sack, D. A. (2015). Updated global burden of cholera in endemic countries. PLoS Neglected Tropical Diseases, 9(6), e0003832. doi: 10.1371/journal.pntd.0003832
2. Clemens, J. D., Nair, G. B., Ahmed, T., Qadri, F., Holmgren, J., & Cholera Symposium Participants. (2017). Cholera. The Lancet, 390(10101), 1539-1549. doi: 10.1016/S0140-6736(17)30559-7