Case Study C: Crohn Disease
Regis College


Case Study A: Gastroenteritis
For this case study a 14 month old baby is suffering from vomiting and diarrhea. This baby also has a cry that is said to be from abdominal pain. Staphylococcus aureus was found in the milk that was improperly stored so suspicion of gastroenteritis will be explored. Gastroenteritis is inflammation occurring in the stomach and intestines and is often caused by infections or allergic reactions (Hubert and VanMeter, 2018, p. 449). Nausea, abdominal cramping, fever, and malaise are all common symptoms of this inflammatory reaction. It is important to be aware of these symptoms due to the severity of gastroenteritis on infants (Rivera-Dominguez, 2019)
1. Staph. aureus in the milk custard could be the catalyst to the baby’s vomiting and diarrhea. Staph. aureus is a toxin that develops with improper storage of food causing contamination. Ingesting this toxin creates nausea with vomiting usually within the first 6 hours (Rivera-Dominguez, 2019). Fever and diarrhea come after 8 hours of ingestion. The inflammation response in the gastric system initiates vomiting and the diarrhea comes later due to inflamed intestines creating…”increase motility, impaired reabsorption, and in some cases, increased secretions,” (Hubert and VanMeter, 2019, p. 449).
4. Dehydration in infants can manifest differently dependent on the severity of the dehydration. Due to the severity of gastroenteritis on newborns we will look at the sever form of dehydration. This can appear in infants as irritable, altered mental status, thread pulses, hypotension, tachypnea, sunken fontanels, and low urine output (Vega, 2019).
6. For infants with severe dehydration treatment involves firstly starting IV fluids. This is not adequate alone, however, due to other electrolytes being altered in the face of dehydration. Blood work for electrolytes, assessing blood sugar levels, and checking a urine sample are all needed to properly treat these babies (Vega, 2019). The World Health Organization also recommends rehydrating infants in a slower manner than that of an adult due to their overall sensitive systems and smaller size, (Houston et al., 2019). Typically sodium, potassium, and glucose will need repletion in these infants (Chukwu and Molloy, 2020).
References
Chukwu, J., & Molloy, E. J. (2020). Fluid and Electrolyte Balance in Infants and Children. Pediatric Surgery, 245–261. doi: 10.1007/978-3-662-43588-5_16
Houston, K. A., Gibb, J., Olupot-Olupot, P., Obonyo, N., Mpoya, A., Nakuya, M., … Maitland, K. (2019). Gastroenteritis aggressive versus slow treatment for rehydration (GASTRO): a phase II rehydration trial for severe dehydration: WHO plan C versus slow rehydration. BMC Medicine, 17(1). doi: 10.1186/s12916-019-1356-z
Hubert, R. J., & VanMeter, K. (2018). Goulds pathophysiology for the health professions. St. Louis, MO: Elsevier.
Rivera-Dominguez, G. (2019, September 6). Pediatric Gastroenteritis. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499939/
Vega, R. M. (2019, February 3). Pediatric Dehydration. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK436022/

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