Hey guys, let’s talk about some vomiting and diarrhea and putting this into a nursing care plan. First we have to collect all our data. That’s all the assessment pieces, so what your patient is saying and what we are observing. So subjective data is from the patient, so our patient is having some abdominal pain, right, nausea, they are maybe having a decreased appetite, right? No one wants to eat when all that’s going on. Our objective data includes the things we’re observing on the patient. Let’s say we’re noting that the patient has been vomiting a lot and they are having over two loose or watery stools in 24 hours, or even more than that. So, let’s take that data and let’s analyze it. So what’s the problem here? Well, our patient, if they’re having excessive vomiting and diarrhea, they probably have an electrolyte imbalance going on, right? We don’t have an imbalance and we don’t have good fluids, and we’re dehydrated, and this is all just because of the vomiting and the diarrhea. 

So, what needs to be improved? Well, we need to improve the vomiting and diarrhea to help fix this imbalance that’s happening and help fix the dehydration. 

What’s the priority? Well, for our patients, the priority is just going to be to hydrate and to reduce the excessive elimination, right, with all the vomiting and diarrhea happening. 

So, now we have to ask our “how” questions. How questions are going to help us to plan, implement and evaluate. How do we know this was a problem? This is where you are always going to link your data that you have collected and just link your assessment pieces. For our patient, we knew it was a problem because of all the vomiting and diarrhea. Maybe we could visualize the dehydration because we had low urinary output. They don’t have good filled veins to get lab work on. We’re seeing this patient is dehydrated. We’re seeing all the vomiting and diarrhea, we’re linking our data, and that’s how we knew it was a problem. How are we going to address it? So for this patient, we can do some IV hydration, some medications, and some anti-nausea medications to help. How am I going to know if it gets better? Well, we’re going to have an improved hydration status, which Is going to be awesome. If we can improve that, maybe we will have the vomiting stop and that would also be an added benefit, right, or diarrhea, stopping, slowing down, whatever it is, that’s how we’re going to know it’s going to be better. 

So translating gets us our high level concepts. This patient has fluid and electrolyte imbalance problems that we need to look at as a priority. We have elimination that we can deal with and some nutrition. 

Let’s put this into a care plan. So first, when you are doing your care plan, you’re going to have your problems and your priorities. This is your subjective and objective data, so just those assessment pieces, this is your intervention. What you are going to do to help fix the assessment that you have, and then the rationale is the why. Why are you doing this intervention? And what do we expect to see happen? First we’re going to start with our fluid and electrolyte balance. So, our patient is showing us on some lab work that maybe the electrolytes don’t look good, because they are super dehydrated and they are having low urinary output. Our intervention. We are going to replace those fluids. So, probably for this patient, if they are excessively vomiting, we’re going to do IV, but of course, we could also do PO if they can keep it down. Our rationale, well, it’s going to fix the hydration status and improve lab work because we’ll have that improved vascular volume. Our outcome, we expect to see improved labs and adequate urinary output. 

So for elimination, our data collection shows that the patient’s having some vomiting and having diarrhea. So, our interventions are going to be Zofran and stool samples. The Zofran to help, right, and the diarrhea to get a stool sample. Our why, is because Zofran is an anti-nausea medication, right, so it’s going to hopefully reduce the nausea and reduce the vomit and then a stool sample, because this can assess for any blood in the stool or the infection type of leave a parasitic infection, or what exactly is causing all of this. Our expected outcome is that this will decrease the vomiting and then we’ll have a diagnosis perhaps from this school sample for better treatment to improve the elimination. Let’s look at nutrition. So nutrition for this patient, our data we’ve collected is we have some diarrhea and we have an upset stomach happening, so we need to improve their nutrition to hopefully fix this. 

Let’s look at our interventions. We can give some bland diet education to help them. Hopefully they can tolerate foods and different things to help their stomach. So this is going to be our why. It’s going to help the stomach to get the nutrition for the body, to get the nutrition from whatever can be tolerated. And as always, with our education and giving this education for nutrition, the patient will verbalize and demonstrate education and hopefully keep the foods in their body that they need, and not continue to be dehydrated and malnourished because they are vomiting and have diarrhea so much.

All right, our key points. So, when you are collecting your information, that’s your data, that’s your subjective and objective assessment pieces. So, you get that and then we’re going to analyze it, and that’s going to help to diagnose and prioritize. We are going to ask how that’s going to help to plan, implement and evaluate. We’re going to translate that. So, our concise terms or concepts, and then we’re going to transcribe that. Use whatever form you prefer, just get your care plan down on paper. 

Alright, that was it for our vomiting and diarrhea care plan. Check out all the care plans that we have available for you on NURSING.com as well as the videos and extra resources. We love you guys. Now, go out and be your best selves today and as always, happy nursing!