Acute Diarrhea


Admit Orders: Acute Diarrhea

1. Admit to:

2. Diagnosis: Acute Diarrhea

3. Condition:

4. Vital Signs: q6h; call physician if BP >160/90, <80/60; P >120; R>25; T >38.5°C.

5. Activity: Up ad lib

6. Nursing: Daily weights, inputs and outputs.

7. Diet: NPO except ice chips for 24h, then low residual elemental diet; no milk products.

8. IV Fluids: 1-2 L NS over 1-2 hours; then D5 ½ NS with 40 mEq KCL/L at 125 cc/h.
 

9. Special Medications:

Febrile or gross blood in stool or neutrophils on microscopic exam or prior travel:

-Ciprofloxacin (Cipro) 500 mg PO bid OR

-Levofloxacin (Levaquin) 500 mg PO qdOR

  -Trimethoprim/SMX (Bactrim DS) (160/800 mg) one DS tab PO bid.

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Symptomatic Medications: - Morphine sulfate 5-10 mg IV push prn pain.
 - Zolpidem (Ambien) 5-10 mg qhs PO prn insomnia.
 - Zofran 4mg IV q4-6h prn
 -Acetaminophen (Tylenol) 650 mg 2 tab PO/PR q4-6h prn temp >38°C or pain.
 -Docusate sodium (Colace) 100 mg PO qhs.
 -Famotidine (Pepcid) 20 mg IV/PO q12h.
 -Heparin 5000 U SQ q12h or pneumatic compression stockings
 

11. Extras: Upright abdomen. GI consult.

12. Labs: CMP CBC with differential, UA, blood culture x 2.
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3.Stool studies: Wright's stain for fecal leukocytes, culture for enteric pathogens, ova and parasites x 3, clostridium difficile toxin.