Nursing Assessment for Cholera

Cholera

Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission is primarily through consuming contaminated drinking water or food. The severity of the diarrhea and vomiting can lead to rapid dehydration and electrolyte imbalance. Primary treatment is with oral rehydration solution and if these are not tolerated, intravenous fluids. Antibiotics are beneficial in those with severe disease. Worldwide it affects 3–5 million people and causes 100,000–130,000 deaths a year as of 2010. Cholera was one of the earliest infections to be studied by epidemiological methods.

Signs and symptoms

A person with severe dehydration due to cholera. Note the sunken eyes and decreased skin turgor which produces wrinkled hands

The primary symptoms of cholera are profuse painless diarrhea and vomiting of clear fluid. These symptoms usually start suddenly, one to five days after ingestion of the bacteria. The diarrhea is frequently described as "rice water" in nature and may have a fishy odor. An untreated person with cholera may produce 10–20 liters of diarrhea a day with fatal results. For every symptomatic person there are 3 to 100 people who get the infection but remain asymptomatic.

If the severe diarrhea and vomiting are not aggressively treated it can, within hours, result in life-threatening dehydration and electrolyte imbalances. The typical symptoms of dehydration include low blood pressure, poor skin turgor (wrinkled hands), sunken eyes, and a rapid pulse.
(wikipedia)

Nursing Assessment for Cholera

Assess the status of dehydration (skin color, temperature, acral, skin turgor, mucous membranes, eyes, crown, body temperature, pulse, respiration, behavior, weight loss).

Observe for manifestations of acute diarrhea
- A sudden attack of diarrhea
- Fever
- Anorexia, nausea, vomiting
- Weight loss
- Pain and abdominal cramps, abdominal distension
- Increased bowel sounds / hyper-peristaltic
- Malaise
- Bowel movements more than 3 times a day, liquid stool consistency, with / or without mucus and blood
Assess the psychosocial status of families