PHILIPPINE AIR FORCE

520TH AIR BASE WING

AIR FORCE GENERAL HOSPITAL

Colonel Jesus Villamor Airbase, Pasay City

A Case Study on
Nursing Care Management
of Patient with

INTESTINAL AMOEBIASIS

Presented by:

14 March 2018
SCOPE OF PRESENTATION
INTRODUCTION
 INTRODUCTION

To present a comprehensive case study that

enhances knowledge, improve critical thinking and clinical
nursing skills, and develop expertise and application of
right attitude in nursing care of patient with
Intestinal Amoebiasis.
 INTRODUCTION

1. Establish rapport with the client and significant others to obtain cooperation.
2. Conduct thorough physical assessment of the patient in cephalocaudal
manner to note other problems of the patient to be managed.
3. Discuss the anatomy and physiology of the affected system to have a
background regarding the organ affected by the disease.
 INTRODUCTION

4. Discuss the pathophysiology of the disease

5. Determine the significance or implications of the different laboratory and
diagnostic examinations for the disease.
6. Provide appropriate nursing care plan to prioritize the immediate problem of
the patient.
 INTRODUCTION

7. Provide comprehensive discharge plan of the patient to ensure the

continuation of the management of the disease even after discharge.
INTRODUCTION
 INTRODUCTION

This study is focused on the nursing aspect of care of a two year old, male,

enlisted dependent son, patient who had been diagnosed with Intestinal Amoebiasis. This
study will only be used in the nursing profession. The presenters will only focus their
attention on the medications, diagnostics, care plan, pathophysiology and discharge
planning of Intestinal Amoebiasis as applicable to the said patient. This study is not limited
to patients who have Intestinal Amoebiasis, but also for all the people who are interested
in the disease.
 INTRODUCTION

The data was gathered through interview, physical assessment and

laboratory findings with permission from the patient’s parents.

Sources of information are: patient’s mother, attending physician and medical records.
 INTRODUCTION

The timeline of the study is from the time of admission, 24 January

2018, up to the time of discharge, 27 January 2018.
PROFILE, HX, & PE
 PROFILE, HX, & PE

RP’s father is a SSgt assigned at 950th CEISG while his mother is a plain

housewife. RP’s primary caregivers are his mother and his grandmother. The family’s
monthly income is estimated at P35,000. RP is the youngest in the family of two siblings
and he has an older sister. The family lives together in San Pascual, Batangas. Usually, his
father comes home during weekends and stays in EP barracks at Villamor Air Base, Pasay
City during weekdays. The family owns the house as claimed by the parents. The house is
well- ventilated and well- lighted.
 PROFILE, HX, & PE

Drinking water comes from a water refilling station for the family’s
consumption. Tap water is from a commercial water distributor in Batangas. Mother claims
that RP’s food is prepared at home, but there are times that they buy some street foods
for snack.
 PROFILE, HX, & PE

A few hours prior to consult, patient experienced watery loose stool, foul
smelling, accompanied by vomiting. Loss of appetite, fever and abdominal pain were also
noted. Patient was brought to our institution by his parents, and was admitted.
 PROFILE, HX, & PE

This is RP’s first admission. RP was given birth through normal spontaneous
delivery and was delivered full term. No associated abnormalities were found after birth.
He has no known allergy to food nor drugs. The mother claimed that RP was breastfed
until 12 months of age.

As claimed by mother, RP has completed vaccination doses of BCG, OPV 123,

DPT 123, HBV 123 and Measles. No vaccine of Rota Virus and HIb.

As claimed by mother, RP has previously contracted Urinary Tract Infection when

he was 1 year old.
PROFILE, HX, & PE
 PROFILE, HX, & PE

Language And Cognitive Milestones

• knows names of familiar people and body parts
• follows simple instructions
• repeat words heard in conversation
• points to things or pictures when they are named
• finds things even when hidden under two or three covers
• begins to sort shapes and colors
• builds towers of 4 or more blocks
• follows two-step instructions such as “pick up your own shoes and put them in the
closet”
 PROFILE, HX, & PE

Movement Milestones Hand And Finger Skills

• stands on tiptoe
• kicks a ball
• begins to run
• climbs onto and down from furniture without help
• walks up and down stairs holding on to support
• throws ball overhand
 PROFILE, HX, & PE

Emotional And Social Development

• copies others specially adults and older children
• gets excited when with other children
• shows more and more independence
• shows defiant behavior (doing what they have been told to do)
• plays mainly besides other children, but begins to include other children, such as in
chase games
PROFILE, HX, & PE
CLINICAL DISCUSSION
CLINICAL DISCUSSION
 CLINICAL DISCUSSION

RP, a two (2) years old EDS was admitted at Air Force General Hospital through
the ER Department on 24 January 2018 at 1805H. He was brought by his parents due to
fever and vomiting. Loss of appetite was also noted. Initial vital signs were taken as
follows: CR- 134 bpm, RR- 27 cpm, Temp- 38.1 C, O2 Sat- 98% and weight- 13 kgs. Tepid
sponge bath was rendered and Paracetamol 130mg TIV was given. Routine laboratory
work- ups of CBC with QPC, Urinalysis and Fecalysis were done. RP was placed on NPO
temporarily while venoclysis started. He was medicated with the following: Metronidazole
500mg TIV now the 220mg TIV every 8 hours, Erceflora bottlet: 1 bottlet 2 times a day,
Zinc Sulfate syrup: 2ml once a day, Paracetamol 25omg/5ml: 6ml every 4 hours RTC and
Paracetamol 130mg TIV for fever greater than or equal to 39C.
 CLINICAL DISCUSSION

1st Hospital Day (25 January 2018)

Fever, loose watery stools (6 episodes) and vomiting (3 episodes) associated with
abdominal pain were documented. Repeat CBC with PC was ordered. RP was placed on
liquid diet then afterwards on soft diet.
 CLINICAL DISCUSSION

2nd Hospital Day (26 January 2018)

Still with 4 episodes of BM, soft in consistency, in the morning. Fever and
vomiting had stopped. RP was also observed to be playful has an increase in appetite.
Swelling was noted on the IV site, hence, IV was removed. Referred to attending physician.
Ordered to discontinue venoclysis and shifted Metronidazole IV to oral Metranidazole
25mg/ml: 5ml every 8 hours for 7 days.
 CLINICAL DISCUSSION

3rd Hospital Day (27 January 2018)

No loose watery stool noted. May go home was ordered. Home medications and
follow up check up instructed.
 CLINICAL DISCUSSION

Elevated levels
of Leukocyte
indicates
infection.
 CLINICAL DISCUSSION

Elevated levels
of Leukocyte
indicates
infection.
CLINICAL DISCUSSION
 CLINICAL DISCUSSION

Clinical
Manifestations
Amoebiasis
 CLINICAL DISCUSSION

Problem List

• Loose Bowel Movement/ Fluid Volume Deficit

• Hyperthermia
• Abdominal Pain
• Vomiting
 CLINICAL DISCUSSION

Long Term Objective

At the end of hospitalization, fluid balance is restored and the lack of

understanding of the disease process is addressed thru proper nursing
interventions.
CLINICAL DISCUSSION
 CONCLUSION AND RECOMMENDATIONS

Intestinal amoebiasis is a protozoan disease that can be detrimental to

one’s health but is a highly preventable illness. Personal hygiene practices
including handwashing and proper food handling are always enough to prevent
acquiring the disease. Maintaining environmental cleanliness is also important.
 CONCLUSION AND RECOMMENDATIONS

Education is very important in limiting and preventing occurrence of the

disease. It is crucial for healthcare workers to educate the patient and their
family about the illness and its prevention. Health worker should gear their
knowledge dissemination to the most vulnerable populace, the children. Healthy
and nutritious diet should be emphasized to children and their caregivers to give
boost to their immune system.
 CONCLUSION AND RECOMMENDATIONS

It should also be emphasized to parents and caregivers that once early signs of
Intestinal Amoebiasis occur, it is imperative to have prompt medical consult and to follow
the prescribed treatment regimen.
Understanding in-depth the causes, signs and symptoms,
pathophysiology and treatment of Intestinal Amoebiasis helps the health team to
individualize the plan of care for a specific patient. Nurses can develop a very effective
nursing care plan if they know how the disease happens and how to treat it and further
prevent it from occurring in the future.
 CONCLUSION AND RECOMMENDATIONS

Lastly, it is recommended that more case studies about Intestinal

Amoebiasis be conducted to be able to collect relevant data to help in
formulating effective and efficient treatment that will benefit the patient infected
with the disease.
THANK YOU AND
GOOD DAY!
Committed to Health Care Excellence