CAGAYAN COLLEGES TUGUEGARAO

COLLEGE OF HEALTH

A CASE STUDY

ON

ACUTE GASTROENTERITIS
(AGE)

Submitted by: Dennis Gallardo

 INTRODUCTION

Acute gastroenteritis (AGE) is an acute infectious process affecting

gastrointestinal tract caused by virus, bacteria and parasites. The disease is transmitted by
ingestion of contaminated food, water, or by contaminated hands, linens, equipments, and
supplies. Most serious complication is dehydration and electrolyte losses which may lead
to metabolic acidosis and death. The primary manifestation of gastroenteritis is diarrhea,
but it may be accompanied by nausea, vomiting, and abdominal pain. The vomiting
usually settles in a day or so. The diarrhea may last for up to 10 days, but usually lasts
only to 2 or 3 days. If there is fever, or blood and mucus in the stools it is more likely to
be contagious. Gastroenteritis is contagious as the organism lives in the gastrointestinal
tract, so it is important to wash hands thoroughly after going to the toilet and before
preparing food.

Acute gastroenteritis is associated with significant morbidity in developed

countries and each year is the cause of death of several million children in developing
countries. Estimates of the overall incidence of acute gastroenteritis range from 1.3 to 2.3
episodes of diarrhea per year in children under five years of age. Each year, more than
300 U.S. children die from this illness. In the United States alone, gastroenteritis accounts
for more than 220,000 hospital admissions per year in children less than five years of age,
or approximately 10 percent of hospitalizations in this age group.

Acute gastroenteritis is a common and costly clinical problem in children. It is a

largely self-limited disease with many etiologies. The evaluation of the child with acute
gastroenteritis requires a careful history and a complete physical examination to uncover
other illness with similar presentations. Minimal laboratory testing is generally required.
Treatment is primary supportive and is directed at preventing or treating dehydration.
When positive, an age-supportive diet and fluids should be continued. Oral rehydration
therapy using a commercial pediatric oral rehydration solution is preferred approach to
mild or moderate dehydration. The traditional approach using “clear liquids” is
inadequate. Severe dehydration requires the prompt restoration of intravascular volume
through the intravenous administration of fluids followed by oral rehydration therapy.
When rehydration is achieved, an aged-appropriate diet should be promptly resumed.
Anti-emetic and anti-diarrheal medications are generally not indicated and may
contribute to complications.

On its mortality and morbidity, AGE is a leading cause of infant mortality

throughout the world. By age 3 years, virtually all children become infected with the
most common agents. Severe cases are seen in the elderly, infant and immunosuppressed
population including transplant patients.

Last July 05, 2007, we encountered a patient with such kind of infection. This
patient has caught our attention and has given the opportunity to study his case. The
objective of this study is to help us understand the disease process of gastroenteritis and
to orient ourselves for appropriate nursing interventions that we could offer to the patient.
This approach enables us to exercise our duties as student nurses which is to render care.
I was given the chance to improve the quality of care I can offer and to pursue our chosen
profession as future nurses.

PATIENT’S PROFILE

Patient’s Name: Budong

Age: 4 years & 7 months

Gender: Male

Address: Carig Sur, Tuguegarao City

Date of Birth: December 3, 2002

Civil Status: Single

Religion: Roman Catholic

Nationality: Filipino

Dialect: Ilocano
Date of Admission: July 5, 2007

Time Admitted: 9:50 AM

Attending Physician: Dra. M. Velarde

Chief Complaint: LBM & vomiting

Admitting Diagnosis: AGE with Dehydration

Final Diagnosis: AGE with Dehydration

 NURSING HISTORY OF ILLNESS

PRESENT HEALTH HISTORY

 Two days prior to admission (July 3, 2007 in the evening), the patient had
vomiting for 3 times associated with abdominal pain and passage of watery
stool due to his intake of ice-cold coke and water according to his mother. A
day prior to admission (July 4, 2007), the patient still attended his classes but
still with vomiting and passage of watery stool. And last July 5, 2007, he was
rushed to St. Paul Hospital due to weakness and severe abdominal pain.

PAST HEALTH HISTORY

 According to the patient’s mother, the patient has his complete immunizations.
He is taking his vitamin supplements but still he is very slim and never liked
vegetables. The patient was first hospitalized due to asthma. His second
hospitalization was due to bronchopneumonia and the latest was due to AGE.

FAMILY HEALTH HISTORY

 According to the patient’s mother, their family have history of Hypertension,

Diabetes mellitus, Bronchial Asthma and Cancer. Hypertension is evident on
the patient’s grandfather and uncle, while Cancer is evident on the patient’s
aunt.
 GORDON’S 11 FUNCTIONAL PATTERN

Health Perception-Health Management Pattern

 Before his hospitalization, the patient perceives health in a way that he is not
suffering from any disease. He takes vitamins for him to improve his health
and to protect him from acquiring any disease.

 During his hospitalization, the patient feels so unhealthy according to his

mother because of his hospitalization. He is obedient in taking his medications
and is participative in all the nurses’ interventions.

Nutritional-Metabolic Pattern

 Before his hospitalization, the patient takes his meal three times a day without
any restrictions. According to his mother, he has food preferences on fatty and
oily foods. Her mother even shared that when they eat adobo, he prefers to eat
the fat rather than the muscle because he gets irritated with foods between his
teeth. He has no difficulty in swallowing and he usually eat junk foods when
its snack time. He drinks 4-5 glasses of water a day and takes Clusivol to
improve his appetite.

 During his hospitalization, his appetite decreased. He was restricted from

eating dairy products. His fluid intake increased for about 5-7 glasses of water
a day.

Elimination Pattern

 Before his hospitalization, the patient used to eliminate once a day every
morning before going to school with a semi-solid consistency and is brownish
in color. He usually urinates 2 times a day with the normal light yellow color
and aromatic odor. He also perspires every time he plays.

 During is hospitalization, the patient’s stool is watery with a yellowish color.

He urinates 2-3 times a day. He also perspires but it’s due to the hot
environment not from any activity since he just stays on bed.

Activity-Exercise Pattern

 Before his hospitalization, especially during the weekend, he used to play

outside with his cousins. They usually play toy cars and the usual games of his
age. He stops playing when he feels tired.
  During his hospitalization, he used his time playing the cell phone of his
father. Most of his time was spent for resting and sleeping.

Sleep-Rest Pattern

 Before his hospitalization, he usually sleeps 8-9 hours. He is fond of watching

the TV series “Super Twins” before going to bed when it was still showing.

 During his hospitalization, the patient sleeps early but has sleep disturbances
when the nurses take his vital signs, administer medicines and also due to the
environment.

Cognitive-Perception Pattern

 Before his hospitalization, the patient is normal in terms of his cognitive

abilities. He has no problems with his senses. His mother even shared to us
that he is already capable of writing his name and is capable of reading the
alphabet and numbers.

 During his hospitalization, he relates to us actively. He responded to our

questions enthusiastically. He also related to us some of his school activities.

Self-Perception/ Self-Concept Pattern

 According to the patient’s mother, he’s a good son though sometimes he tends
to disobey his parents. She said this is normal for his age. He is the eldest but
according to her mother he acts as if he is the youngest.

Role-Relationship Pattern

 The patient has a close relationship with his family, but he is closer to his
father. He has a 2 year old sister, but according to his mother, he does not play
the role of an elder brother. His mother even added that his sister ie more
obedient than he is. But during his confinement, he is more obedient because
he wanted to get well immediately.

Sexual-Reproductive Pattern

 Prior to his age, the patient is not yet oriented with any sexual matters.
According to hid mother, he has not yet undergone circumcision.
Coping Stress- Tolerance Pattern

 According to his mother, when he has problems he always approach his

parents. She even added that when he gets scolded, he just stays in his room.
When he is bullied or when his cousins get his toys, he does not quarrel with
them but instead he reports it to his parents. During his hospitalization, he
feels unsafe with people when his mother is not with him. He cries without the
sight of his mother.

Value-Belief Pattern

 He is a Roman Catholic. They attend mass regularly. He afraid to do

something bad because he believes that God will punish him. According to his
mother, before they consult the doctors or the hospital, they first consult the
quack doctors.
 PHYSICAL ASSESSMENT

Date assessed: July 06, 2007

General assessment: neat, conscious and coherent
Initial vital signs: T=37.9, RR=20, BP=80/60, PR=95

Area Assessed Technique Normal Findings Actual Findings Evaluation

Skin
Color Inspection Light brown, Tanned skin Normal
tanned skin (vary
according to race)
Lips, nail beds, Lighter colored Lighter colored
soles and palms Inspection palms, soles, lips palms, soles, lips Normal
and nail beds and nail beds
Moisture Inspection/ Skin normally dry Skin normally dry Normal
Palpation
Temperature Palpation Normally warm 37.9 o C d/t
hyperthermia
Smooth, soft and Smooth, soft and
Texture Palpation flexible palms and flexible palms and Normal
soles (thicker) soles (thicker)

Turgor Palpation Skin snaps back Skin snaps back Normal

immediately immediately
Skin
appendages
a. Nails Inspection Transparent, Transparent, Normal
smooth and convex smooth and convex
Nail beds Inspection Pinkish Pinkish Normal
Nail base Inspection Firm Firm Normal
White color of nail White color of nail
bed under pressure bed under pressure
Capillary refill Inspection/ should return to returned to pink Normal
Palpation pink within 2-3 within 2-3 seconds
seconds
b. Hair
Distribution Inspection Evenly distributed Evenly distributed Normal
Color Inspection Black Black Normal
Texture Inspection/ Smooth Smooth Normal
Palpation
Eyes
Eyes Inspection Parallel to each Parallel to each d/t
other other but sunken dehydration
Visual Acuity Inspection PERRLA- Pupils PERRLA- Pupils Normal
(penlight) equally round react equally round react
 to light and to light and
accommodation accommodation
Eyebrows Inspection Symmetrical in Symmetrical in Normal
size, extension, hair size, extension, hair
texture and texture and
movement movement
Eyelashes Inspection Distributed evenly Distributed evenly Normal
and curved outward and curved outward
Eyelids Inspection Same color as the Same color as the Normal
skin skin

Blinks involuntarily Blinks involuntarily

and bilaterally up to and bilaterally up to Normal
20 times per minute 16 times per minute

Do not cover the Do not cover the

pupil and the pupil and the sclera, Normal
sclera, lids lids normally close
normally close symmetrically
symmetrically
Conjunctiva Inspection Transparent with Transparent with Normal
light pink color light pink color
Sclera Inspection Color is white Color is white Normal
Cornea Inspection Transparent, shiny Transparent, shiny Normal
Pupils Inspection Black, constrict Black, constrict Normal
briskly briskly
Iris Inspection Clearly visible Clearly visible Normal
Ears
Ear canal Inspection Free of lesions, Free of lesions, Normal
opening discharge of discharge of
inflammation inflammation

Canal walls pink Canal walls pink Normal

Hearing Acuity Inspection Client normally Client normally
hears words when hears words when Normal
whispered whispered
Nose
Shape, size and Inspection Smooth, symmetric Smooth, symmetric
skin color with same color as with same color as Normal
the face the face
Nasal septum Inspection Close to midline, Close to midline,
thicker anteriorly thicker anteriorly Normal
than posteriorly than posteriorly

Nares Inspection Oval, symmetric Oval, symmetric

and without and without Normal
 discharge discharge

Mouth and
Pharynx
Lips Inspection Pink, moist Pink, moist Normal
symmetric symmetric

Buccal mucosa Inspection Glistening pink soft Glistening pink soft Normal
moist moist
Gums Inspection Slightly pink color, Slightly pink color,
moist and tightly fit moist and tightly fit Normal
against each tooth against each tooth
Tongue Inspection Moist, slightly Moist, slightly
rough on dorsal rough on dorsal Normal
surface medium or surface medium or
dull red dull red
Teeth Inspection Firmly set, shiny Firmly set, shiny Normal
No tooth decay
Hard and soft Inspection Hard palate- dome- Hard palate- dome-
palate shaped shaped Normal
Soft Palate- light Soft Palate- light
pink pink
Neck
Symmetry of Neck is slightly Neck is slightly
neck muscles, Inspection hyper extended, hyper extended, Normal
alignment of without masses or without masses or
trachea asymmetry asymmetry
Neck Rom Inspection Neck moves freely, Neck moves freely, Normal
without discomfort without discomfort
Thyroid gland Palpation Rises freely with Rises freely with Normal
swallowing swallowing
Trachea Inspection Midline Midline Normal
Thorax and Auscultation Clear breath sounds Clear breath sounds Normal
Lungs
Abdomen Inspection Skin same color Skin same color Normal
with the rest of the with the rest of the
body body

Bowel sounds Auscultation Clicks or gurling Clicks or gurling

sounds occur sounds occur Normal
irregularly and irregularly and
range from 5-35 per range from 5-35 per
minute minute
Neurology
system
 Level of Inspection Fully conscious, Fully conscious,
consciousness respond to respond to Normal
questions quickly, questions quickly
perceptive of perceptive of events
events

Behavior and Inspection Makes eye contact Makes eye contact

appearance with examiner, with examiner,
hyperactive hyperactive Normal
expresses feelings expresses feelings
with response to the with response to the
situation situation
 LABORATORY RESULTS

HEMATOLOGY RESULTS

Normal Value Results Analysis

WBC 5-10 x 10 g/L 7.8 Normal
Hgb M 13-16 g/dl 11 Decreased
F 12-16 g/dl
Hct M 39%-54% 33% Decreased
F 37%-48%
Differential Count
Lymphocytes 20%-40% 31% Normal
Segmenters 60%-70% 69% Normal

FECALYSIS
Method used: Direct Smear

Results Analysis
Physical properties:
Color Light brown Normal
Consistency Watery d/t profuse secretion of
water and electrolytes
Remarks:
No oral intestinal parasite seen

URINALYSIS

Results Analysis
Color Yellow Normal
Transparency Slightly turbid d/t increased urine
concentration
Reaction 6.0 Normal
Specific gravity -1.020 Decreased: d/t
dehydration
Sugar Negative Normal
Protein Trace Normal
MICROSCOPIC EXAM

Result Analysis
Round epithelial cells Occasional Normal
Mucus thread Many Normal
RBC 0-1 Normal
Pus cells 1-2 Normal
Amorp urates/phosphates Few Normal
 ANATOMY AND PHYSIOLOGY

THE DIGESTIVE SYSTEM

 Every morsel of food we eat has to be broken down into nutrients that can be
absorbed by the body, which is why it takes hours to fully digest food. In humans, protein
must be broken down into amino acids, starches into simple sugars, and fats into fatty
acids and glycerol. The water in our food and drink is also absorbed into the bloodstream
to provide the body with the fluid it needs.

The digestive system is made up of the alimentary canal and the other abdominal
organs that play a part in digestion, such as the liver and pancreas. The alimentary canal
(also called the digestive tract) is the long tube of organs — including the esophagus, the
stomach, and the intestines — that runs from the mouth to the anus. An adult's digestive
tract is about 30 feet long.

Digestion begins in the mouth, well before food reaches the stomach. When we
see, smell, taste, or even imagine a tasty snack, our salivary glands, which are located
under the tongue and near the lower jaw, begin producing saliva. This flow of saliva is set
in motion by a brain reflex that's triggered when we sense food or even think about
eating. In response to this sensory stimulation, the brain sends impulses through the
nerves that control the salivary glands, telling them to prepare for a meal.

As the teeth tear and chop the food, saliva moistens it for easy swallowing. A
digestive enzyme called amylase, which is found in saliva, starts to break down some of
the carbohydrates (starches and sugars) in the food even before it leaves the mouth.

Swallowing, which is accomplished by muscle movements in the tongue and

mouth, moves the food into the throat, or pharynx. The pharynx (pronounced: fair-inks),
a passageway for food and air, is about 5 inches long. A flexible flap of tissue called the
epiglottis reflexively closes over the windpipe when we swallow to prevent choking.

From the throat, food travels down a muscular tube in the chest called the
esophagus. Waves of muscle contractions called peristalsis force food down through the
esophagus to the stomach. A person normally isn't aware of the movements of the
esophagus, stomach, and intestine that take place as food passes through the digestive
tract.

At the end of the esophagus, a muscular ring called a sphincter allows food to
enter the stomach and then squeezes shut to keep food or fluid from flowing back up into
the esophagus. The stomach muscles churn and mix the food with acids and enzymes,
breaking it into much smaller, more digestible pieces. An acidic environment is needed
for the digestion that takes place in the stomach. Glands in the stomach lining produce
about 3 quarts of these digestive juices each day.

Most substances in the food we eat need further digestion and must travel into the
intestine before being absorbed. When it's empty, an adult's stomach has a volume of one
fifth of a cup, but it can expand to hold more than 8 cups of food after a large meal.
 By the time food is ready to leave the stomach, it has been processed into a thick
liquid called chyme. A walnut-sized muscular tube at the outlet of the stomach called the
pylorus keeps chyme in the stomach until it reaches the right consistency to pass into the
small intestine. Chyme is then squirted down into the small intestine, where digestion of
food continues so the body can absorb the nutrients into the bloodstream.

The small intestine is made up of three parts:

1. the duodenum, the C-shaped first part

2. the jejunum, the coiled midsection
3. the ileum, the final section that leads into the large intestine

The inner wall of the small intestine is covered with millions of microscopic, finger-
like projections called villi. The villi are the vehicles through which nutrients can be
absorbed into the body.

The liver (located under the ribcage in the right upper part of the abdomen), the
gallbladder (hidden just below the liver), and the pancreas (beneath the stomach) are
not part of the alimentary canal, but these organs are still important for healthy digestion.

The pancreas produces enzymes that help digest proteins, fats, and carbohydrates. It
also makes a substance that neutralizes stomach acid. The liver produces bile, which
helps the body absorb fat. Bile is stored in the gallbladder until it is needed. These
enzymes and bile travel through special channels (called ducts) directly into the small
intestine, where they help to break down food.

The liver also plays a major role in the handling and processing of nutrients. These
nutrients are carried to the liver in the blood from the small intestine.

From the small intestine, food that has not been digested (and some water) travels to
the large intestine through a valve that prevents food from returning to the small intestine.
By the time food reaches the large intestine, the work of absorbing nutrients is nearly
finished. The large intestine's main function is to remove water from the undigested
matter and form solid waste that can be excreted. The large intestine is made up of three
parts:

1. The cecum is a pouch at the beginning of the large intestine that joins the small
intestine to the large intestine. This transition area allows food to travel from the
small intestine to the large intestine. The appendix, a small, hollow, finger-like
pouch, hangs off the cecum. Doctors believe the appendix is left over from a
previous time in human evolution. It no longer appears to be useful to the
digestive process.
2. The colon extends from the cecum up the right side of the abdomen, across the
upper abdomen, and then down the left side of the abdomen, finally connecting to
the rectum. The colon has three parts: the ascending colon and transverse colon,
 which absorb water and salts, and the descending colon, which holds the resulting
waste. Bacteria in the colon help to digest the remaining food products.
3. The rectum is where feces are stored until they leave the digestive system
through the anus as a bowel movement.
 PATHOPHYSIOLOGY

(GASTROENTERITIS)

Predisposing Factors Precipitating Factors

¤ Age ¤ Lifestyle

¤ Environment ¤ Poor Hygiene

¤ Diet

Etiology: infants/young children: Haemophilus influenzae

Person to person (hands) Contaminated food/water Animal pets

Ingestion of Pathogens

Invasion of the GIT

 Enterotoxin production Affects the vomit Destruction of epithelial reduced absorption Systemic Invasion
receptors cells of fluid &
electrolytes

Interacts with mucosal lining Vomiting center Superficial ulceration of Inflammation of

in the brain is mucosa layer of tissue
stimulated beneath epithelium
abdominal spasm to limit of mucosa
Alters permeability mucosal injury
Vomiting
Vomiting
Cellular metabolism
d/t underlying injury
Profusesecretion
Profuse secretionof
offluids
water Abdominal Blood, mucus to GI
and electrolytes cramps in stool

Hyperthermia and edema

Abdominal
abdominalpain
pain

Abdominal cramps
Diarrhea Excretion of Access to
General weakness Interstitial fluids Systemic circulation

Fluid and electrolytes loss

Infection in other
part of the body
 Dehydration

Deterioration and collapse DEATH Septicemia Meningitis

NURSING CARE PLANS

ASSESSMENT NURSING PLANNING NURSING RATIONALE EVALUATION

DIAGNOSIS INTERVENTIONS
Subjective data: Hyperthermia At the end of  Provide proper  Proper ventilation
“Mainit po ang r/t exposure to thirty minutes, the ventilation. may reduce the
pakiramdam ko” as hot environment patient will temperature of the
verbalize by the maintain a core patient.
patient temperature
within normal.  Monitor heart rate  Dysrhythmias are
Objective data: and rhythm. common due to
 T= 37.9 o C electrolyte
 Skin is imbalance,
warm to dehydration, and
touch direct effects of
 RR= 20 hyperthermia on
blood and cardiac
tissue.

 Promote surface  Heat loss by

cooling by means convention.
of cool
environment
and/or fans.
  Promote client  Ensuring patient’s
safety. safety prevents
other problems.
 Encourage  Self-care awareness
patient’s help in the
participation in prevention and
ways to protect control of
oneself from hyperthermia.
excessive
exposure to hot
environment.

 Instruct client/SO  Adequate fluid

to increase fluid intake prevents
intake. dehydration.

 Review sings and  These may indicate

symptoms of prompt
hyperthermia. interventions.

Objective data: Risk for At the end of 30  Note risk factors  Identifying the
 Decreased infection r/t IV minutes, the for the occurrence possible causative
immunity therapy client will of infection. factors helps
verbalize prevent/control the
understanding of occurrence of
individual infection.
causative and risk
factors.
 Observe for  Visible sings of
localized sings for infection enable the
infection at management of
insertion sites. more severe
infections.
 Assess skin  The skin is our
conditions around primary defense
insertion sites of against infectious
pins, wires, and diseases.
tongs, noting
inflammation and
drainage.

 Stress proper  Hand washing

hand washing technique is a first-
techniques by all line defense against
caregivers and nosocomial
SO’s of the infections.
patient.

 Instruct client/SO  Care for the skin

in techniques to integrity prevents
protect the the occurrence of
integrity of the infection.
skin.
Subjective data: Fluid volume At the end of  Assessed vital  Provides baseline
“Nagsuka siya at deficit the shift, the signs and data and
nagtae”, as related to patient will be degree of information; this is
verbalized by her increase able to: hydration and also important in
mother metabolic - Achieve level of the evaluating
demand and adequate consciousness clients condition an
Objective data: insensible hydration as success of
 Dry fluid loss evidenced by intervention
mucous through good skin
membranes vomiting and turgor, moist
and lips increased mucous  Encouraged  Adequate fluids
 Sunken body membranes and adequate fluid will replace fluid
eyeballs temperature lips, no intake as lost through
alteration in tolerated by the insensible water
mentation patient. loss due to hyper
Instructed SO metabolic state and
to provide vomiting
fluids in the
bedside

 Regulated IVF  Regulation of fluid

according to is critical in
specified flow maintaining
rates basing on adequate circulating
the physician’s fluids to recover for
order the amount of water
loss through fever
and vomiting
 Monitored  Urine output serves
frequency of as an important
urination and parameter in
amount of assessing client’s
excreted urine ability to conserve
fluids
 DRUG STUDY

METRONIDAZOLE

Generic name: Metronidazole

Brand name: Flagyl

Classification: Trichomonacide, amebicide

Action:
Effective against anaerobic bacteria and protozoa. Specifically inhibits
growth by binding to DNA, resulting in loss of helical structure, strand breakage,
inhibition of nucleic acid synthesis and cell death.

Side Effects:
GI: nausea, dry mouth, metallic taste, vomiting,
abdominal discomfort, andominal pain
CNS: headache, dizziness

Nursing Responsibilities:
 Monitor stool number and character.
 With IV therapy, assess for sodium retention.

METOCLOPRAMIDE

Generic name: Metoclopramide

Brand name: Reglan

Classification: gastrointestinal stimulant

Action:
Dopamine antagonist that acts by increasing sensitivity to acetylcholine;
results in increased motility of the upper GI tract and relaxation of the pyloric sphincter
and duodenal bulb.

Side Effects:
GI: nausea, bowel disturbances
CNS: restlessness, drowsiness, fatigue, headache, dizziness

Nursing Responsibilities:
 Inject slowly IV to prevent transient feelings of anxiety and restlessness.
 Assess abdomen for bowel sounds and distention.
 AMPICILLIN

Generic name: Ampicillin

Brand name: Unasyn

Classification: Antiboitic, penicillin

Action:
Synthetic, broad-spectrum antibiotic suitable for gram-negative bacteria.

Side Effects:
GI: diarrhea, abdominal distention
CNS: fatigue, headache
GU: dysuria, urinary retention
At the site of infection: pain and thrombo-phlebities

Nursing Responsibilities:
 Note history of sensitivity/reactions to these or related drugs.
 Monitor CBC, liver, and renal function
 Monitor urinary output and serum potassium levels

RANITIDINE

Generic name: Ranitidine

Brand name: Zantac

Classification: histamine H2 receptor blocking drug

Action:
Competitively inhibits gastric acid secretion by blocking the effect of histamine
on histamine H2 receptors.

Side Effects:
GI: constipation, diarrhea, abdominal pain
CNS: dizziness, headache, insomnia, anxiety

Nursing Responsibilities:
 Assess patient GI condition before starting therapy and regularly thereafter to
monitor the doing effectiveness.
 Be alert for adverse reaction and drug interaction.
 Assess patient’s and family knowledge of the drug therapy.