CHAPTER I

PRELIMINARY

1. BACKGROUND

Increasingly high progress technology that has been achieved increasingly Similarly high degree
of obtained health corresponding with progress times, arise various kind of a
disease that attacks whole lifewithout know place, time and age.
By because that role nurse very needed in resolve problems encountered patient with give counse
ling for improve knowledge patient, keep cleanliness environmental, nurse too collaborate with d
octor in givetherapy and too give some important information.

2. AIM
Aim general :
Aim in manufacture paper this on general is for help college
student in learn about anemia and care nursing arrhythmia
Aim special :
1. Knowing understanding from Gastroenteritis
2. Menngetahui cause from Gastroenteritis
3. Knowing sign and symptoms from Gastroenteritis
4. Knowing classification from Gastroenteritis
5. Learn care nursing Gastroenteritis

3. FORMULATION OF THE PROBLEM

1) What understanding Gastroenteritis?
2) What only cause Gastroenteritis?
3) What only sign and symptoms on patient Gastroenteritis?
4) How process travel Gastroenteritis?
5) and how Care Nursing on patient Gastroenteritis?

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 CHAPTER II
CONTENTS

A. Understanding
Gastroenteritis is a condition where the frequency of bowel movements more than 4
times in infants and more 3 times in children with consistency of aqueous feces may be green or
may be mixed with mucus and blood / mucus only. (Sudaryat Suraatmaja.2005)
Gastroenteritis is a dilute defecation of more than three times a day with or without
blood and or inner lenders feces. (Suharyono, 1999)
Gastroenteritis is an excessive loss of fluid and electrolyte occurring due to the
frequency of one or more defecation with changes in aqueous or liquid form. (Suriadi, 2001)
Gastroenteritis is a condition in the gaster characterized by vomiting and diarrhea caused
by infection, allergies, intolerance to certain foods or digesting toxins. (Tucker, 1998)
From bebepara understanding above can be concluded that gastroenteritis is a defecate or
abnormal shape feces dilute with more frequency than usual.

B. Etiology
Cause diarrhea divided in several factors namely:
1. Infection
a. Infection internal that
is infection channel digestion is cause which caused major in children infection bacteria (E.
Colli, Salmonella, Shigella, Vibrio etc.) parasites (protozoa: E. histolytica, G. lamblia; worms:
Askaris, trikurus; Fungi: Candida) through the fecal oral: food, beverages, contaminated feces or
direct contact with stool patients
b. Namely parenteral infection infection from part body others outside tool digestion such
as acute otitis media, tonsilofaringitis, infection parasite: worms, protozoa, jamur.keadaan this oc
curs in infantsand children age under 2 years old.
2. Malabsorption
a. mal absorption kalbohidrat, disaccharide (intolerance lactose, maltose
and sucrose). In infants and children the most important and common is intolerance lactose.
b. mal absorption fat

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c. mal absorption protein
3. Food
Food stale, baeracun, allergies to food
4. Psychologic
Fear and anxiety although rarely could cause diarrhea especially in children who have
been great.

C. Symptoms / Signs.
1. First whiny and restless
2. Body temperature usually rises
3. Anorexia
4. Arising diarrhea is fluid stool and may be accompanied by mucus and / or blood
5. Vomiting may occur before or after diarrhea.
6. Around the anus can become blistered due to frequent defecation and feces sour, and
there arose a condition called dehydration with signs:
a. Sunken eyes
b. Turgor ugly skin
c. BB decreased
d. Piss a little
e. Mucous membranes of lips, mouth and dry skin
f. Fever

D. Pathophysiology
Acute gastroenteritis is characterized by vomiting and diarrhea resulting in fluid and
electrolyte loss. The main causes of acute gastroenteritis are viruses (virus roba, enterica virus
enteric, norwalk virus and parasites (blardia lambia) these pathogens cause disease by infecting
cells). These organisms produce enterotoxins or critotoxins that damage cells or adhere to the
intestinal wall in acute gastroenteritis. The small intestine is the most affected organ.
Acute gastroenteritis is transmitted through rectal routes, orally from person to
person. Some daily care facilities that increase the risk of gastroenterity can also be a medium of
transmission. Active transport due to excitatory bacterial toxin against electrolyte ka in the small
intestine. The intestinal cells become irritated and increase the secretion of fluid and electrolytes,

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incoming microorganisms will damage the intestinal mucosal cells, thereby lowering the
intestinal surface area.
Change intestinal capacity and happening interference absorption fluids and electrolytes.
Inflammation could reduce the ability
of intestinal absorption fluid and electrolyte p this happen to malabsorption syndromes that incre
ase motility intestinal bowel. Increasing motility and rapid intestinal emptying in a interference fr
om absorption and secretion and elektroli excessive fluid. Fluid potassium anddicarbonat move f
rom cavity extra mobile to in feces so cause dehydration, lack
of electrolyte could happen acidosis metebolik. (Suriadi, 2004: 83)
Irritation intestines by something pathogens influence layer mucosa intestines so happen
product secretist including mucus. Irritation microbes also affect layer muscle so happen enhance
ment motiltascause plenty of water
and electrolytes wasted, because time available for absorption substances The decrease in
the colon.

E. Manifestation Clinical k
Initial symptoms are the child becomes whiny and restless, the body temperature may
increase, decreased appetite and then arise diarrhea liquid faeces, may contain blood or mucus,
the color of the stool turned into green because mixed bile, the anus and surrounding areas
become blisters due to feces become acid , the amount of lactic acid that occurs from the
breakdown of lactose that can not be absorbed by the intestine. Symptoms of vomiting can occur
before or after dehydration of diarrhea.
If the patient has a lot of water loss and electrolytes there are symptoms of dehydration.
Weight decreases in the baby, big and crooked head, muscle tone and turgor decreases, mucous
membranes of mouth and lips become dry.
Clinical symptoms are appropriate dehydration levels are as follows:
a. Mild dehydration (loss of 2, 5% of body weight)
Awareness of composmentis, pulse less than 120 times per minute, ordinary breathing, large
crowns slightly sunken, slightly sunken eyes, turgor and ordinary tonus, dry mouth.
b. Moderate dehydration (loss of 6, 9% BB)

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Awareness of anxiety, pulse 120-140 times per minute, breathing rather quickly, crowned large
crown, eyes appear sunken, turgor and tonus somewhat less, dry mouth
c. Severe dehydration (loss> 10% BB)
Apathy awareness to coma, pulse more than 140 times per minute, kusmaul respiration, crowned
large crown, turgor and tone less once, dry mouth and cyanosis
Disturbance of acid and base balance and electrolyte :
a. The large amounts of fluid out through BAB cause loss of bicarbonate, resulting in
decreased PH, increased PCO2, metabolic acidosis characterized by kusmaul respiration.
b. Occurred hypo / hyperthermia (<130 or> 150 mEq / L), hypokalemia (<3 mEq).
c. Hypoglycemia interference nutrition
d. Shock hypovolemia.

F. Classification
Classification Signs and symptoms
There is no dehydration No signs and symptoms of dehydration:
- General situation is good, conscious
- Vital signs (blood pressure, temperature, pulse,
breathing) within normal limits
Dehydration is not heavy Two or more of the following signs:
- Restless, fussy
- Sunken eyes
- Tears less
- Thirst (drink a lot)
- Mouth and lips slightly dry
- Pinch of abdominal skin back slowly
- Hands and feet warm
Severe dehydration Two or more of the following signs:
- The general condition is limp
- Awareness decreases - unconscious
- Sunken eyes
- No tears

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 - Not able to drink / drink weak
- Dry mouth and lips
- Pinch of abdominal skin returns very slowly (≥ 2
seconds)
- Cold hands and feet

G. Complications
a) Dehydration
b) Hypovolemic shock
c) Seizures
d) Bacterimia
e) Mal nutrition
f) Hypoglycemia
g) Secondary intolerance due to damage to the intestinal mucosa.

H. Prevention
In the prevention of disease Gastroenteritis can be seen in the five levels of
prevention (five levels of prevention) as follows:
1) Improved nutritional status of individuals / individuals or communities to form better
immune system and can fight Agent diseases that will enter the body, such as consuming food
that contains better nutrients and required by the body.
2) Exclusive breastfeeding to newborns, because breast milk contains many calories, protein
and vitamins are much needed by the body, this prevention aims to establish the immune system
so protected from various infectious diseases such as Gastroenteritis.
3) Early Diagnosis and Treatment Soon (Early Diagnosis and Prompt Treatment)
4) Combating Disabilities (Disability Limitation)
Disease Gastroenteritis this if not treated properly and regularly will be able to cause
death. Limitation of disability (Disability Limitation) in preventing gastroenteritis disease can
be done with various efforts including:
- Prevent further disease process by continuing treatment to achieve a good recovery
process.

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- Perform special care regularly to achieve faster health recovery.
- Wash hands before eating
5) Rehabilitation (Rehabilitation)
Rehabilitation (Rehabilitation) in preventing disease Gastroenteritis can be done with physical
/ medical rehabilitation if there is a physical health problem due to illness Gastroenteritis