I.

INTRODUCTION Background Study We, the group A2, have chosen to present a case of Intestinal Parasitism because we want to broaden our knowledge in this kind of disease and on how to prevent this in our own special way. Significance of the study  As a student nurse This study will enable the students to understand better about Intestinal Parasitism and will explain the different risk factors for developing the disease, including consumption of improperly prepared foods or contaminated water and travel or residence in areas of poor sanitation Since we are client-centered, we really should consider our patient s comfort and this study will give the students sufficient knowledge that will help them to plan and implement nursing care plans that will satisfy patient s needs.  To the patient This study will enable the patient to recognize factors affecting her health status and be able to inform everything that will be helpful in the prevention of the disease. Scope and Limitations This study includes the collection of information specifically to the patient s health condition. The study also includes the assessment of the physiological and psychological status, adequacy of support systems and care given by the family as well as the other health care provider. Goal and Objectives Goal: This study aims to convey familiarity and to provide an effective nursing care to a patient diagnosed with Intestinal Parasitism through understanding the patient history, disease process and management. Objectives: 1. To discuss the anatomy and physiology, pathophysiology of the patient s condition, usual clinical manifestations and possible complications of this condition. 2. To have knowledge to the client medication and be familiar to that medication. 3. To formulate a workable nursing care plan on the subjective and objective cues gathered through nurse-patient interaction to be able to help the patient recover. Overview of Disease Intestinal Parasitism- Infestation of the intestinal lumen and wall by nematodes, cestodes and immature trematodes. Signs and Symptoms Gastrointestinal complaints such as pain, diarrhea, nausea, and perianal itching are common in many intestinal parasitic infestations. Parasites cause morbidity in humans in different ways, by: affecting nutritional equilibrium

 inducing intestinal bleeding inducing malabsorption of nutrients competing for absorption of micronutrients reducing growth reducing food intake causing surgical complications such as obstruction, rectal prolapse and abscess affecting cognitive development. The GI tract may be inhabited by many species of parasites. Their cycles may be direct, in which eggs and larvae are passed in the feces and stadial development occurs to the infective stage, which is then ingested by the final host. Alternatively, the immature stages may be ingested by an intermediate host (usually an invertebrate) in which further development occurs, and infection is acquired when the intermediate host or free-living stage shed by that host is ingested by the final host. Sometimes, there is no development in the intermediate host, in which case it is known as a transport or paratenic host, depending on whether the larvae are encapsulated or in the tissues. Clinical parasitism depends on the number and pathogenicity of the parasites, which depend on the biotic potential of the parasites or, when appropriate, their intermediate host and the climate and management practices. In the host, resistance, age, nutrition, and concomitant disease also influence the course of parasitic infection. Anatomy and Physiology of Affected Organ System DIGESTIVE SYSTEM The human digestive system is a complex series of organs and glands that processes food. In order to use the food we eat, our body has to break the food down into smaller molecules that it can process; it also has to excrete waste. Most of the digestive organs (like the stomach and intestines) are tube-like and contain the food as it makes its way through the body. The digestive system is essentially a long, twisting tube that runs from the mouth to the anus, plus a few other organs (like the liver and pancreas) that produce or store digestive chemicals.

The Digestive Process: The start of the process - the mouth: The digestive process begins in the mouth. Food is partly broken down by the process of chewing and by the chemical action of salivary enzymes (these enzymes are produced by the salivary glands and break down starches into smaller molecules). On the way to the stomach: the esophagus After being chewed and swallowed, the food enters the esophagus. The esophagus is a long tube that runs from the mouth to the stomach. It uses rhythmic, wavelike muscle movements (called peristalsis) to force food from the throat into the stomach. This muscle movement gives us the ability to eat or drink even when we're upside-down. In the stomach The stomach is a large, sack-like organ that churns the food and bathes it in a very strong acid (gastric acid). Food in the stomach that is partly digested and mixed with stomach acids is called chyme.

In the small intestine After being in the stomach, food enters the duodenum, the first part of the small intestine. It then enters the jejunum and then the ileum (the final part of the small intestine). In the small intestine, bile (produced in the liver and stored in the gall bladder), pancreatic enzymes, and other digestive enzymes produced by the inner wall of the small intestine help in the breakdown of food. In the large intestine After passing through the small intestine, food passes into the large intestine. In the large intestine, some of the water and electrolytes (chemicals like sodium) are removed from the food. Many microbes (bacteria like Bacteroides, Lactobacillus acidophilus, Escherichia coli, and Klebsiella) in the large intestine help in the digestion process. The first part of the large intestine is called the cecum (the appendix is connected to the cecum). Food then travels upward in the ascending colon. The food travels across the abdomen in the transverse colon, goes back down the other side of the body in the descending colon, and then through the sigmoid colon. The end of the process Solid waste is then stored in the rectum until it is excreted via the anus. II. BIOGRAPHIC DATA NAME: AGE: BIRTHDAY: GENDER: CIVIL STATUS: Child X 4 yrs. old June 25, 2005 female child

ADDRESS: EDUCATIONAL LEVEL: RELIGION: o o

Tala, Caloocan City Pre-school Catholic CHIEF COMPLAINT: Vomiting

MEDICAL DIAGNOSIS: Intestinal Parasitism Dehydration secondary to Vomiting and Malnutrition

III.

NURSING HISTORY A. Past Health History In past health history of the patient she completed all vaccines including 1 dose of BCG, 3 doses of OPV, DPT and Hep B and a dose of measles. And are all given at Rural Health Unit in their Barangay. Child X doesn t have any record of accidents, surgeries, and allergies, but she was hospitalized last year with the same diagnosis. The patients haven t taken any medication and herbal medicine. B. History of Present Illness The patient brought by her mother in Dr. Jose Rodriguez Memorial Hospital (Tala, Caloocan City) last August 27, 2009 with a chief complaint of watery stool accompanied by vomiting and headache. Two days prior to admission the mother of the patient noticed that her daughter Child X was not feeling well as evidenced by sudden loss of energy, paleness and dryness of skin. The mother observed also that there is a change in Child X bowel habit and form of bowel. The symptoms revealed and got worse that s why the mother decided to brought Child X in the hospital to seek consultation. The diagnosis was Intestinal Parasitism Dehydration secondary to Vomiting and Malnutrition as supported by laboratory findings and diagnostic procedure done. C. Family History According to the mother of Child X, they have no history of any disease like TB, heart disease, Syphilis, Diabetes, etc. They are six in the family including her husband which is a construction worker, her four children (15, 14, 4, and 1 yr. of age) and her. The mother stated also that since her husband has no stable job, their meals daily was not stable also, there are times that they eat 2 times a day or it also happened that they eat only once a day. D. Pediatric Health History The mother of the patient verbalized that she delivered all their children in their house by a Hilot . And she breastfeed all her children though Child X started solid foods like lugaw when she was six mo. old.

IV.

ACTIVITIES OF DAILY LIVING

ADL Nutrition

Before hospitalization eat her meal 3x a

Actual hospitalization Only eat 2x a day

Interpretation and analysis -Before

day

hospitalization, the client takes her meal 3x a day while during hospitalization she only eats 2x a day. -The client experiencing loss of appetite that s why she only takes twice a day for her meal. Reference: Fundamentals of Nursing by Kozier, Chapter 47 pg. 1238 -The client urinate 4x a day regularly and defecate once a day daily while during hospitalization the client urinate 3x a day and defecate 4x a day, she also experiencing vomiting. -The client always demands for water because she was experiencing severe thirst that s why she urinates frequently. And regarding her fecal elimination, the client is experiencing loose watery stool. Reference: Fundamentals of Nursing by Kozier, Chapter 48 -Before hospitalization the client was always playing outside while during hospitalization she was always lying on

Elimination

Urinate 15x a day regularly and defecate once a day regularly.

Urinate 18x a day and defecate 4x a day, she also experiencing vomiting

Activity

Always playing outside barefooted.

Always lying on bed.

bed. - Prior to admission the client always play barefooted that s why she adopt microorganism that cause parasitism. Reference: NANDA -Before hospitalization the client was not taking a bath regularly; she only took 4 times a week. She also frequently eats with her bare hands and sometimes forgot to wash hands before and after meals while during hospitalization the number of days taking a bath was lessen. -Prior to admission the client has poor hygiene that s why she adopt microorganism that cause parasitism. Reference: NANDA -Before hospitalization the client did not take any medication while during hospitalization she was taking the drugs prescribed by doctor.

Hygiene

She was not taking a bath regularly; she only took 4 times a week. She also frequently eats with her bare hands and sometimes forgot to wash hands before and after meals.

She doesn t take bath regularly.

Substance use

No medication taken

She was currently taking Diphenhydramine, Pyrantel Pamoate, Ampicillin, Gentamicin drugs.

Sleep and rest

She was able to She was -Before consume normal 8- experiencing hospitalization she hour sleeping time. difficulty of sleeping. sleeps normally while during hospitalization she was experiencing difficulty of

sleeping. -The client experienced difficulty of sleeping because of gastric irritability due to her diagnosis. Reference: Fundamentals of Nursing by Kozier, Chapter 45
V. PHYSICAL ASSESSMENT

Normal

Actual findings

Interpretation and analysis

1. General Appearance y Mood and affect

-Normally calm

-Irritable, signs of fatigue, restlessness

-The patient feels uncomfortable, undesirable actions. -The patient has a good posture.

Posture

-Relaxed and coordinated movement -Well cleaned, presentable

-Highly active movement (sign of angered action) -She has unpleasant odor and has no underwear, uncut nails, and uncombed hair. -She wears loose shirts without pants. -she was screaming out loud. -She was not participating and slightly disoriented.

Hygiene and grooming

-The patient lacks proper hygiene.

Types of clothing

-Accurate to the environment

- not presentable

Quantity and quality of speech

-Having a good quality of speech

-She possesses signs of irritability.

Relevance and organization of thought.

-Well good, having good decisions

-She was anxious.

2. Vital signs Body temp 36.5 C-37.5 C 36.5 C Within normal range of body temp. low pulse rate low respiratory rate

Pulse rate Respiratory rate

80-160bpm 30-60cpm

70bpm 24cpm

Height Weight

Before: 13kgs. Current: 9kgs.

-Active weight loss that leads to malnutrition

Body Parts Skin

Normal Findings -The skin is normally uniform, whitish pink or brown in color depending on the race of the patient. -The head should be normocephalic and symmetrical, normal skull is smooth, non tender and w/o masses and depressions. -The eyes are normally aligned; there should not be excessive discharge from the lacrimal duct. -The ear color should match the color of the rest of the body. Should be positioned centrally in proportion to the head. -It is located symmetrically in the middle of the face and must not have presence of lesions and masses.

Actual Findings -She has rough, and dry skin, has lesions in her left leg.

Interpretation and Analysis - Not normal, accdg. To Kozier it is signs of dehydration bec. Of active loss of body fluids.

Head

-Normal

Eyes

- Sunken eyeball

-Not normal accdg. To Kozier, It is sign of dehydration, restlessness

Ears

-No discharges noted

-Normal

Nose

-No discharges noted

- Normal

Mouth

- Dry mucous -The lips and membranes should be membrane

- Not normal, accdg. To Kozier it is a sign of dehydration

pink and moist and to show no evidence of lesions or inflammation Chest -Antero-posterior diameter is equal to transverse diameter shape is -Abdominal contour is flat and no abdominal pain - Chest is symmetrical -Normal

Abdomen

-Bloated

-Not normal, accdg. To Kozier, this sign is caused by decrease absorption of food bec. The GI tract are dysfunctional.

VI.

Laboratory and diagnostic Examination result Normal Range 3:50 : 5:50 Result 4.13 Interpretation and analysis Within normal range Below normal range, it may indicate anemia Within normal range Above normal range, it may indicate a particular disorder Within normal range Within normal range Above normal range, it may indicate Within normal range

Procedure RBC

HCT

38.0 : 48.0

L37.3

PLT

150 : 450

255

WBC

5.0 : 10.0

#17.2DE

HGB

12.0 : 14.0

12.8

LYM %

25.0 : 40.0

L24.3

GRA %

45.0 : 6.0

68.4

MID %

2.0 : 15.0

7.3

VII.

DR

VIII.

UG STUDY

Generic / Trade name

Dosage / Frequency

Classification

Indication

Contraindication

Side effects

Nursing Responsibilities

Ampicillin (AMPICIN)

TIVP 320 mg. Q8

Antibiotic Penicillin

Treatment of infection caused by Gr (+) and Gr () bacteria

Hypersensitivity to penicillins

-CNS: lethargy, hallucinations, seizures. -GI: glossitis, stomatitis, gastritis, sore mouth, furry tongue, black hairy tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, non-specific hepatitis. -GU: nephritis -Hematologic: Anemia, thrombocytopenia, leucopenia, neutropenia, prolonged bleeding time. -Hypersensitivity: Rash, fever, wheezing, anaphylaxis. -Local: Pain,

-Check IV site carefully for signs of thrombosis or drug reaction -Do not give IM injections in the same site. - administer oral drug on an empty stomach, 1 hr. before or 2 hr. after meals with a full glass of water; do not give with fruit juce or softdrinks.

Serious infections when causative organisms are not known (often conjunction with a penicillin or cephalosporin)

phlebitis, thrombosis at injection site (parenteral) -Other: Superinfections, oral and rectal moniliasis, vaginitis. contraindicated with allergy to any aminoglycoiside -CNS: tinnitus, dizzinesss, vertigo, deafness, vestibular paralysis, confusion, disorientation, depression, lethargy, nystagmus, visual disturbances, headache, numbness, tingling, tremor, paresthesies, muscle twitching, seizures, muscular weakness -CV: palpitations, hypotension, hypertension -GI: hepatic toxicity, nausea, vomiting, anorexia, weigth -avoid longterm therapies because of increased risk of toxicities -ensure adequate hydration of patient before and during theraphy

Gentamicin (PEDIATRIC GENTAMICIN SULFLATE)

TIVP 25mg q12

Aminoglycoside

loss, stomatitis, increased salivation -GU: nephrotoxicity -HEMATOLOGIC: leukemoid reaction, agranulocytosis, granulocytosis, leucopenia, leukocytosis, thrombocytopenia, eosinophelia, pancytopenia, anemia, hemolytic anemia, electrolyte disturbances -HYPERSENSITIVITY: purpura, rash, urticaria, exfoliative dermatitis, itching -LOCAL: pain, irritation, aruchnoiditis at IM injection sites -OTHER: fever, apnea, splenomegaly, joint pain, superinfections

Allergic conjunctivitis due to inhalant allergens and foods; mild uncomplicated allergic skin manifestations of urticaria and angioedema;

Diphenhydramine Oral: 1tsp TID (BENADRYL)

Antihistamine Anti-motionsickness drug Sedativehypnotic Antiparkinsonian Cough suppressant

amelioration of allergic reactions of blood; dermatographism; anaphylactic reactions adjunctive to epinephrine, motion sickness, parkinson and in combination with centrally acting anit-cholinergic agents.

Lower respiratory tract symptoms including asthma. Hypersensitivity. Lactation. Newborn or premature infants.

-CNS: Drowsiness, sedation, dizziness, disturbed coordination, fatigue, confusion, restlessness, excitation, nervousness, tremor, headache, blurred vision, diplopia. -CV: Hypotension, palpitations, bradycardia, tachycardia, extrasystoles. -GI: Epigastric distress, anorexia, increased apetite and weight gain, nausea, vomiting, diarrhea or constipation. -GU: Urinary frequency, dysuria, urinary retention, early menses, decreased libido, impotence. -HEMATOLOGIC:

-Administer with food if upset occurs. -Monitor patient response and arrange for adjustment of dosage to lowest possible effective dose.

Hemolytic anemia, hypoplastic anemia, thrombocytopenia, leucopenia, agranulocytosis, pancytopenia. Treatment of enterobiasis and ascariasis -RESPIRATORY: Thickening of the bronchial secretions, chest tightness, wheezing, nasal stuffiness, dry mouth, dry nose, dry throat, sore throat. Contraindicated with allergy to pyrantel pamoate. -CNS: Headache, dizziness, drowsiness, insomnia. -DERMATOLOGIC: Rash -GI: Anorexia, nausea, vomiting, abdominal cramps, diarrhea, gastralgia, tenesmus. -Administer drug with fruit juice or milk; ensure that entire dose is taken at once.

Pyrantel Panloate (COMBANTRIN)

Oral: 1 tsp Anthelmintic Single dose at bedtime morning/night

IVF PLR

CLASSIFICATION Isotonic

BOTTLE# 1L

FLOW RATE 30gtts/min

DRUG INCORPORATED None

NSG RESPONSIBILITY y y
y y

Check IV order Explain/Teach pt. Keep record of amt. Infused Record: Type, Amount, Rate, Site Calculate drop rate and check frequently

D5 0.3 Nacl

Hypotonic

1L

21gtts/min

None

D5 IMB

Hypertonic

500cc

30gtts/min

Amoxicillin Gentamicin
y

IX.

PRIORITIZATION NSG Problem

Cues Nanghihina siya As verbalized by the mother.

Justification 1. According to Maslow s Hierarchy of needs, fluids are the 2nd important on physiological needs. 2. According to Maslow s Hierarchy of needs, fluids are the 2nd important on physiological needs. 3. According to Maslow s

1. Deficient Fluid Volume

2. Diarrhea

Nagtatae siya As verbalized by the mother.

3.

Malnutrition

Wala siyang ganang kumain As verbalized by the mother.

Hierarchy of needs, fluids are the 3rd most important need. 4. According to Henderson 14 fundamental needs, Hygiene is 8th most important needs.

4. Hygiene

Hindi madalas napapaliguan as verbalized by the mother.

X.

NURSING CARE PLAN DIAGNOSIS INFERENCE PLANNING STG: After 8hrs of nsg intervention the patient will be able to: INTERVENTION RATIONALE EVALUTION

ASSESSMENT S: Nanghihina siya as verbalized by the mother. O: -dry skin -restlessness -sunken eyeballs V/S: T: 36.4 C PR: 70bpm RR: 24cpm

Deficient fluid volume r/t to Active fluid volume loss as manifested by diarrhea and vomiting.

Active fluid volume loss Vomiting Abdominal Irritability Intake of contaminat ed of food and water Diarrhea Deficient fluid volume

After 8hrs of nsg intervention the goal was met as evidence by: 1.1Determine effects of age 1.1Children have a relatively high percentage of total body water, are sensitive to loss, and are less able to control their fluid 1. Assessed precipitating factors.

1.Assess Precipitating factors

intake

2.Evaluate degree of fluid deficit

2.1Assess vital signs: note strength of peripheral pulses

2.1To obtain baseline data and to have a compariso n

2.Evaluated degree of fluid deficit.

2.2Determine customary and current weight

2.2To assess the degree of dehydratio n

3.Correct/ replace lossess to reverse pathophysiolo gical mechanism

3.1Establish 24hr of fluid replacement needs and routes to be used

3.1To prevent peaks in fluid level

3.Corrected/ replaced lossess to reversed pathophysiol ogical mechanicm.

3.2Maintain accurate I/O

3.2To determine

and weight daily. Monitor urine specific gravity

the exact route that cause dehydratio n

4.Promote comfort and safety

4.1Change position frequently

4.1To prevent skin breakdown

4.Promoted comfort and safety.

4.2Provide frequently oral care as well as eye care

4.2To prevent injury from dryness

LTG: After 72hrs of nursing intervention the patient will be able to: 1.Demonstrat e behaviors or lifestyle changes to prevent development 1.1Stress need for mobility or frequent position changes 1.1To prevent stasis and reduced risk of tissue

of fluid deficient

injury

S: Nagtatae as verbalized by the mother. O: -dry skin and lips -body malaise

Diarrhea r/t infectious processes as manifested by dry skin and lips.

Infectious processes Presence of parasite Poor hygiene Intake of contaminat ed food or water Diarrhea

STG: After 8hrs of nsg intervention the patient will be able to:

After 8hrs of nsg intervention the goal was met as evidence by: 1.1 Auscultate the abdomen 1.1 For presence, location and characteris tics of bowel sounds. 1. Assessed causative factors or etiology.

1. Assess causative factors or etiology.

V/S: T: 36.4 C PR: 70bpm RR:24cpm

1.2 Determine recent exposure to different/ foreign environmen t, change in drinking water/ food intake,

1.2 It may help identify causative environme ntal factors.

similar illness of others. 1.3 Assess for fecal impaction. 1.3 Where impaction maybe accompani ed diarrhea.

2. Eliminate causative factors.

2.1 Restrict solid food intake as indicated.

2.1 To allow for bowel rest/ reduce intestinal workload.

2. Eliminated causation factors.

2.2 Provide for changes in dietary

2.2 To avoid foods/

intake.

substances that precipitate diarrhea.

2.3 Promote use of relaxation techniques (progressive relaxation exercise)

2.3 To decrease stress/ anxiety.

3. Maintain hydration or electrolyte balance.

3.1Administ er ant diarrheal medications as indicated.

3.1 To decrease gastrointes tinal motility and minimized

3.Maintained hydration or electrolyte balanced.

fluid losses.

4. Maintain skin integrity.

4.1 Provide prompt diaper change and gentle cleansing.

4.1Because skin breakdown can occur quickly when diarrhea occurs.

4.Maintained skin integrity.

4.2 Apply lotion/oint ment skin barrier as needed.

4.2To prevent dryness of the skin.

5. Promote return to normal bowel functioning.

5.1 Recommen d products such as natural fiber, plain natural yogurt.

5.1To restore normal bowel flora.

5. Promoted returned to normal bowel function.

5.2 Give medication as ordered.

5.2To treat infectious process, decrease motility, and or absorb water.

LTG: After 72hrs of nsg intervention the patient will be able to normalize her fecal elimination by: 1.Demonstrat e the appropriate behavior to assist with resolution of causative factors. 1.1 Review causativ e factors and appropr iate interven tion. 1.1 To prevent recurrence.

LTG: After 72hrs of nsg intervention the patient was normalized her fecal elimination.

1.2Review food preparation emphasizing adequate cooking time. S: Nagsusuka siya as verbalized by the mother. O: -hyperactive bowel sounds -Weight loss -pale conjunctiva and mucus membrane V/S: T: 36.4 C PR: 70bpm RR: 24cpm STG: After 8hrs of nsg intervention the patient will be able to:

1.2 T o prevent bacterial growth or contaminat ion. After 8hrs of nsg intervention the patient was able to:

Nutrition imbalanced less than body requirement r/t abdominal discomfort as manifested by hyperactive bowel sounds.

Abdominal discomfort Hyperactive Bowel sounds Intestinal irritability Intake of contaminat ed food and water Diarrhea Nutrition imbalanced less than body requirement

1.Evaluate degree of deficit.

1.1Auscultate bowel sounds, noting absence or hyperactive sounds.

1.1Inflamm ation or irritation of the intestine maybe accompani ed by intestinal hyperactivi ty, diminished water absorption and diarrhea.

1. Evaluated degree of deficit.

1.2Eliminate

1.2Reduces

smells from the environment.

gastric stimulation and vomiting response. 2.1 Might increase abdominal cramping. 2.Established a nutritional plan that meets individual needs.

2. Establish a nutritional plan that meets individual needs.

2.1Avoid foods that might cause or exacerbate abdominal cramping like caffeinated beverages, chocolate, orange juice.

LTG: After 72hrs of nsg intervention the patient will be able to: 1.Demonstrat e behaviors, lifestyle changes to regain or maintain appropriate weight. 1.1Encourage the client to choose food and have family member bring foods that seem appealing, 1.2Promote 1.1Stimulat e appetite.

After 72hrs of nsg intervention the patient was able to: 1. Acheived optimum weight.

1.2To

adequate or timely fluid intake, limit fluids 1hr prior to meal. S: Hindi siya madalas napapaliguan . As verbalized by the mother. O: -dry skin -dirty nails -barefooted -untidy body -improper clothing V/S: T: 36.4 C PR: 70bpm RR: 24cpm 2. Assist in dealing the deficit Self-Care Deficit r/t weakness as evidenced by untidy body. Weakness Impaired Mobility Poor Hygiene Self-Care Deficit STG: After 8 hrs. of nsg. Intervention, the pt. will be able to demonstrate changes to meet self-care needs: 1. Note causative factors 1.1 Note the age of the pt.

reduce possibility of early satiety.

After 8 hrs. of nsg. Intervention, the pt. was able to:

1.1 To assess ability of pt. to meet own needs 1.2 To gain and enhance cooperatio n 2.1 Enhances coordinatio n and

1. Causative factors noted and studied

1.2 Assess barriers to participation in regimen

2.Patient assisted on dealing the deficit

2.1 Provide for communication among those who are

involved in caring for/assisting the client 2.2 Encourage food and fluid choices reflecting individuals likes 3. Promote wellness on pt. 3.1 Review safety concern

continuity of care

2.2 To meet nutritional needs

3.1 To reduce risk of injury 3.2 Allow them to realize the situation of the pt. and make lifestyle change as appropriat e

3. Wellness promoted

3.2 Give family information about care.

LTG: 1. Assist in change in lifestyle 1.1 Provide proper health teaching/hygien e teaching in the pt.

1. Assisted changes on lifestyle.

XI. DISCHARGE PLAN

Patients with Int

estinal Parasitism, watchers are instructed to take the following plan for discharge: E- Exercise should be promoted in a way by stretching hand and feet every morning and exercise burping every after meal. T- Treatment after discharge is expected for patients and watcher with Intestinal Parasitism to fully participate in continuous treatment. - Usually supportive, treatment consists of nutritional support and increase fluid intake. H- Health teaching for clients with Intestinal parasitism includes: promotion of personal hygiene should be encouraged such as, daily bathing and always wash hands w/ warm water and soap handling foods, esp. after using the bathroom. O- OPD such as regular follow-up check-ups should be greatly encouraged to client s watcher with Intestinal Parasitism as ordered by physician to ensure the continuing management and treatment. D- Diet should be promoted, such as soft and bland diet that cannot irritate the GI tract.

Submitted to: Mr. Felix SP. Aquino, RN

Submitted by:

BSN 103-A/ Group A2