Diarrhea

Definition

Diarrhea is the passage of three or more loose or liquid stools per day, or more frequent passage than normal for the individual. It may be acute (less than 14 days) or chronic (greater than 30 days).

Causes

• Viral (rotavirus, norovirus)
• Bacterial (C. difficile, Salmonella, E. coli, Shigella)
• Parasitic (Giardia)
• Inflammatory bowel disease
• Medications (antibiotics, laxatives)
• Food intolerances (lactose)
• Enteral feedings

Complications

Dehydration, hypokalemia, metabolic acidosis (bicarbonate loss), skin breakdown, and in infants and elderly, life-threatening fluid shifts.

Nursing Interventions

Assess fluid status (skin turgor, mucous membranes, I&O), replace fluids and electrolytes orally (ORS) or IV, protect perianal skin (barrier cream), collect stool cultures as ordered. For C. difficile: contact precautions and SOAP-AND-WATER hand hygiene. Avoid antidiarrheals in suspected infection (can worsen toxin retention).

NCLEX Relevance

High-priority risk: metabolic acidosis and hypokalemia. Pediatric and elderly dehydration is serious.