INTRODUCTION Diarrhea is the condition of having three or more loose or liquid bowel movements per day.

It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and electrolyte imbalances. In 2009 diarrhea was estimated to have caused 1.1 million deaths in people aged 5 and over and 1.5 million deaths in children under the age of 5. Diarrheal diseases are one of the leading causes of childhood morbidity and mortality in developing countrie s. An estimated 1,000 million episodes occur each year in children under 5 years of age. Diarrhea causes an estimated 5 million deaths in children under 5 years of age per year. About 80% of these deaths occur in children in the first 2 years of life. Approximately one third of deaths among children under five are caused by diarrhea.1 In the Philippines, diarrheal disease is the second leading cause of morbidity and 6th leading cause of mortality for all ages. It is the third leading cause of infant deaths.2 Surveys done in La Union, Bohol, and Bukidnon in 1985 showed that every Filipino child suffered an average of 2.8 episodes annually.3 Most diarrheal illnesses are acute, usually lasting no more than 3-5 days and are secondary to infectious causes (bacterial, viral, and parasitic). Infectious agents that cause diarrheal disease are usually spread by the fecal-oral route, specifically by a) ingestion of contaminated food or water and b) contact with contaminated hands.

PERSONAL DATA Robert a 6 years old boy who was born on January 23, 2005. He Lives at Baliwasan Grande Zamboanga City together with his family. Youngest among 3 siblings of Mr. and Mrs. Soler. On May 6, 2011 Robert was rushes to Zamboanga City Medical Center due to consistent increase in frequency of bowel movements and was suspected of having diarrhea. PERTINENT FAMILY HISTORY Soler Family is a nuclear type of family that composed of a father, mother and 3children of their own. Roberts mother is a house wife while his father is working on YL fishing corp. as a harvester earning php 7,650.00 monthly. His eldest brother is 11 years old studying in Baliwasan elementary school as a 6th grader student and his other brother is 8years old studying in the same school as 2nd grader student. They live in a shanty house that was only made of light materials and closely build with other houses. They dont have a permanent supply of water because they dont have access from the water district, they just get water from the Brother of Mr. Soler which has a access on water district. According to the family their earnings is less enough to sustain the necessities of their family because of the increasing cost of goods and supplies that is a need for their daily living. They are also experiencing poor sanitation because of their close neighbours that doesnt practise proper disposal of garbage. The place where they are staying doesnt also have proper drainage which causes stagnant of water making good reservoir for mosquitos.

11 FUNCTIONAL PATTERN FOR YOUNG ASSESSMENT 1. Health-perception health management pattern Parents report of: a. Mothers pregnancy/labor/delivery history (of this infant, of others)? The mother had normal pregnancy and deliveries b. Childs health status since birth? The child has a healthy condition from birth. Only experiencing discomforts this few days. c. Adherence to routine health checks for the infant/child? Immunizations? The child has completed all of the important immunizations such as, BCG, DPT, OPV, Measles vaccine and Hepa Vaccine d. Infections/illnesses in the infant/child? Childs absences from school/day care? Now suffering from fecal discomfort and recently was been absent from school for 4days. e. If applicable: Infants/childs medical problems, treatment, and prognosis? Suspected for diarrhea. f. If applicable: Actions taken by parents when signs and/or symptoms were perceived? Given plenty of water to drink and was encourage to eat bananas. g. If appropriate: Has it been easy to follow doctors or nurses suggestions? No, due to financial problem. h. Preventive health practices (e.g., diaper change, clean clothes, hand washing)? Yes i. Do parents smoke? Around children? No j. Accidents? Types? Frequency? No k. Infants crib toys (safety)? Child's toys? Carrying safety? Car safety? l. Parents safety practices (e.g., household products and medicines). Going to the nearest health centers for consultations. Parents (self): a. Parents/familys general health status? Illnesses? Injuries? 2. Nutritional-metabolic pattern Parents report of the infants/childs: a. Breast/bottle feeding? Intake (estimated)? Schedule? Sucking strength? b. Appetite? Feeding discomfort? Gas? Burping? Lack of appetite due to discomfort. c. 24-hour intake of nutrients? Supplements? No. d. Eating behavior? Food preferences? Conflicts over food? Eats 3 times a day. Most of the time they have fish in their meal. e. Birth weight? Current weight? f. Skin problems: For example, rashes, lesions, others? Minor rashes Parents (self): 3. Elimination pattern Parents report of the infants/childs: a. Bowel elimination of the child recently? (Describe) Frequency? Character discomfort? Passes stool for about 3 times a day which are loose and watery in consistency. b. Diaper changes? Potty training bowel, bladder? (Describe routine) use Bathroom c. Urinary elimination pattern? (Describe) more or less 8 times a day d. Excess perspiration? Odor? No Parents (self): a. Elimination pattern? Problems? No 4. Activity-exercise pattern. Parents report of: a. Bathing routine? (When, how, where, and what type of soap?) 1x a day using safe guard. b. Dressing routine? (Clothing worn, changes inside/outside home) 2x a day c. Typical days activity for the infant/child (e.g., hours spent in crib, being carried, playing; type of toys used)? d. Infants/childs general activity level? Tolerance? Active. Plays well with other children.

e. Perception of infants/childs strength (strong or fragile)? Strong. f. Childs self-care ability (bathing, feeding, toileting, dressing, grooming)? All but with guidance. 5. Sleep-rest pattern Parents report of: a. Sleep pattern of the infant/child: Estimated hours? 10hrs b. Infants/childs restlessness? Nightmares? Nocturia? No c. Infants sleep position? Body movements? Nighttime routine? Sleeps at 8pm with less movements when asleep Parents (self): a. Sleep pattern? 6 hrs. 6. Cognitive-perceptual pattern Parents report of: a. General responsiveness of the infant/child? Response well b. Infants response to talking? Noise? Objects? Touch? Communicates well and gives responds to stimulis. c. Infants following of objects with eyes? Response to crib toys? yes d. Ability to learn (changes noted)? What is being taught to the infant/child? Yes e. Noises/vocalizations? Speech pattern? Words? Sentences? Can talk f. Use of stimulation: For example, talking, games, what else? Alphabet reading. g. Vision, hearing, touch, kinesthesia of the infant/child? good h. Childs ability to tell name, time, address, telephone number? Can able to verbalise name, time, address. i. Infants/childs ability to identify needs (hunger, thirst, pain, discomfort)? yes Parents (self): a. Problems with vision, hearing, touch, other senses? no b. Difficulties making decisions? Judgments? Yes 7. Self-perception self-concept pattern Parents report of: a. Infants/childs mood, state (irritability)? Easily to be irritated. b. Childs sense of worth, identity, competency? Very competitive with other children Childs report of: a. Mood state? Cheerful b. Many/few friends? Liked by others? Many friends c. Self-perception (good most of time? Hard to be good?) Good d. Ever lonely? No Parents (self): a. General sense of worth, identity, competency? Law abiding citizen b. Self-perception as parents? Responsible parents 8. Role-relationship pattern. Commited Parents report of: a. Family/household structure? Strong b. Family problems/stresses? Financial Problems c. Interactions among family members and infant (or child)? Yes d. Infants/childs response to separation? e. Child: Dependency? Yes f. Child: Play pattern? Active Parents (self): a. Role engagements? Satisfaction? Yes 9. Sexually-reproductive pattern Parents report of childs: a. Feeling of maleness/femaleness? Stick to gender b. Questions regarding sexuality? How parent responds? Yes. Answering what seems to be right.

Parents (self): a. If applicable: Reproductive history? active b. Sexual satisfaction/problems? Satisfied. 10. Coping stress-tolerance pattern. Spending time with family Parents report of: a. What produces stress in child? Level of stress tolerance. Environment condition. Parents (self): a. Life stressors? Family stress? No b. Patterns for handling problems? Stress? Anger? Support systems? Talking with the member of the family. 11. Value-belief pattern Parents report of: a. Childs moral development, choice behavior, commitments? Good and obedient, and a respectful child Parents (self): a. Things important in life (values, spirituality)? Desires for the future? Family and faith.

Related Literature With diarrhea, stools usually are looser whether or not the frequency of bowel movements is increased. This looseness of stool--which can vary all the way from slightly soft to watery--is caused by increased water in the stool. During normal digestion, food is kept liquid by the secretion of large amounts of water by the stomach, upper small intestine, pancreas, and gallbladder. Food that is not digested reaches the lower small intestine and colon in liquid form. The lower small intestine and particularly the colon absorb the water, turning the undigested food into a more-or-less solid stool with form. Increased amounts of water in stool can occur if the stomach and/or small intestine secretes too much fluid, the distal small intestine and colon do not absorb enough water, or the undigested, liquid food passes too quickly through the small intestine and colon for enough water to be removed. Of course, more than one of these abnormal processes may occur at the same time. For example, some viruses, bacteria and parasites cause increased secretion of fluid, either by invading and inflaming the lining of the small intestine (inflammation stimulates the lining to secrete fluid) or by producing toxins (chemicals) that also stimulate the lining to secrete fluid but without causing inflammation. Inflammation of the small intestine and/or colon from bacteria or from ileitis/colitis can increase the rapidity with which food passes through the intestines, reducing the time that is available for absorbing water. Conditions of the colon such as collagenous colitis can block the ability of the colon to absorb water.

Content What is Diarrhea? Diarrhea is the passage of loose and watery stools (more than 3 bowel movements per day) often associated with gassiness, bloating, and abdominal pain. It may also be accompanied by nausea, vomiting, and fever. Diarrhea results to loss of body fluids and salts leading to dehydration of varying severity. What are the common causes Diarrhea There are several causes of Diarrhea, the common causes of Diarrhea includes Viral gastroenteritis (viral infection of the stomach and the small intestine) caused by several different viruses and is believed to be spread by person-to-person contact, sometimes caused by ingesting food that is contaminated by sick food-handlers; Food poisoning a brief illness that is caused by toxins produced by bacteria sometimes taken from spoiled foods. Bacterial enterocolitis, Disease-causing bacteria usually invade the small intestines and colon and cause enterocolitis (inflammation of the small intestine and colon) These bacteria usually are acquired by drinking contaminated water or eating contaminated foods such as vegetables, poultry, and dairy products. What are the complications of diarrhea? When the diarrhea is left untreated, this ends up into dehydration. This is one of the most fatal conditions. Dehydration is referred to excessive loss of the bodily fluid. In the form of diarrhea, body loses fluids and minerals which are essential to the body. These are termed as electrolytes. The situation gets worsen, when diarrhea accompanied with vomiting. The condition is fatal and person may die. This becomes more dangerous and common in children and infants. Dry mouth and excessive thirst are major symptoms. Further a person develops fall in the pulse rate and the blood pressure also decreases. Moderate to severe hypotension with fainting causes the death. Shock, kidney failure, diminished urine output, confusion, acidosis, coma and severe weakness are other fatal symptoms.

How can dehydration be prevented and treated? Oral rehydration solutions are liquids that contain a carbohydrate (glucose or rice syrup) and electrolyte (sodium, potassium, chloride, and citrate or bicarbonate). ORS solution contains glucose and electrolytes. The glucose in the solution is important because it forces the small intestine to quickly absorb the fluid and the electrolytes. The purpose of the electrolytes in the solution is the prevention and treatment of electrolyte deficiencies. ORS are available in health Centers for free. ORS can also be prepared by own self just by mixing teaspoon of salt and 6 teaspoon of sugar in a 1ltr of water. How can diarrhea be prevented? To prevent from having diarrhea we must drink water only from safe sources. If unsure, boil water for 3 minutes or do water chlorination. Eat only foods that are well cooked and properly prepared. Avoid eating street vended food. Keep the food away from insects and rats by covering them using food cover. Wash fruits and vegetables with clean water before eating or cooking. Use toilet when defecating. Most of all Wash your hands before eating and after using the toilet.

How is diarrhea treated? There are several kinds of medicine that treats diarrhea. The common medication are the Absorbents which are compounds that absorb water. Absorbents that are taken orally bind water in the small intestine and colon and make diarrheal stools less watery. There is also Anti-motility medications that are drugs that relax the muscles of the small intestine and/or the colon. Relaxation results in slower flow of intestinal contents. Slower flow allows more time for water to be absorbed from the intestine and colon and reduces the water content of stool. Cramps, due to spasm of the intestinal muscles, also are relieved by the muscular relaxation.