Nursing care in ER for patient with food poisoning
Stephen, age 45 was admitted in ER for food poisoning. Food poisoning cases are due to the consumption of contaminated food. The patient consumed some confectionaries and undercooked meat. After the period of 2-3 hours he vomited with abdominal pain and cramps. In next half-an-hour he had diarrhea with fever. When he was admitted in ER he was feeling very weak, pale, with strong headache, tired and dehydrated. He was given flagyl and nasograstric (NG) tube was inserted. When I was assigned as a student nurse in the ER for taking care of this patient there was no other nurse present at that time.
Initial Nursing Assessment:
Alert/Oriented x 3.
Complaining of right rib pain 10/10 scale
P=64 weak and irregular,
In lungs – coarse crackles to the Right upper lobes and decrease breath sound to the bases, oxygen saturation 90% on room air
Reduced flow of urine
Inconsistency in bowels
Complaining of difficulty sleeping due to pain
Bowel sounds present x4.
Abdominal cramps and pain
Last BM was 5 days ago.
Poor skin turgor turgid indicates dehydration
Oral thrush noted on inside of cheeks and under his tongue
I did not give him solid food because he was still feeling nauseous. It is important to check his signs and symptoms closely in order to evaluate his further treatment. Because he was dehydrated I gave him plenty of liquid and regular slips of clear liquid. I avoided giving him drinks with excess sugar as excessive consumption of sugar can only worsen the situation.
Antiemitic drugs For Nausea and Vomiting I gave him
Antidiahrrheal drugs For diahrrea
Loperamide (one brand name: Imodium)
Bismuth subsalicylate (brand names: Kaopectate, Pepto-Bismol).
He was already taking Flagyl
I monitored all the complications after every 20-30 minutes. As patient was excessively dehydrated I inserted peripheral LV. Catheters with large bore to administer liquid with 0.9% Nacl. In addition potassium chloride was also administered as his potassium levels were also declining. The fluid was kept warm to maintian his bodily temperature. He needed at least 75ml/kg of fluid per hour in order to increase urine output and balance the depletion of water in body.
I monitored his body temperature, pulse, BP, urine flow and skin turgor. In addition his blood sample was obtained to know the red blood cell count, white blood cell count, blood glucose and electrolytes. I also sent his stool sample for examination to check for any other infections. E.coli 0157.H7 was suspected, hence he was given large volume of fluids to release toxins from urine.
I continued treatment for E.Coli food poisoning as there was a possibility for hemorrhagic colitis.
I kept his hands washing before consumption of food. He bed and clothings were also kept clean.
Patient was made to wash hands
After using washroom
After sneezing, blowing nose or coughing
Prior to dining, lunch or eating anything
Prior to handling food
After touching/handling raw meat
After picking or handling trash
After changing a diaper
After handling paper, currency or money
After being with a pet and playing with them or holding them including, dogs, cats, reptiles, turtles, fish etc
Avoid touching mouth, eyes or ear when are not washed
As Stated by physician, the patient needs a complete nursing care. An appropriately made care plan for the patient suffering from food poisoning needs to have complete assessment, diagnosis, drugs administration, intervention and evaluation.
Dehydration can be minimized by increasing water intake and dietary fiber.
His constipation is evaluated by regularly observing the frequency of bowel movements, checking for daily salt-formed stools, abdominal distention, rectal fullness, pressure, straining and pain at the time of defecation.
The causes of constipation are mostly associated with lack of water in body due to excessive diarrhea.
Pain is relieved by use of medication prescribed by the physician. Other side effects like nausea and vomiting are eliminated by use of anemeitic drugs.
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Food poisoning (2001)