GASTRITIS:

ANATOMY OF THE STOMACH

GASTRITIS:

Gastritis is an inflammation, irritation or erosion of the lining of the stomach. inflammation of whole
stomach is called pangastritis and an inflammation of a part of stomach is called antral gastritis.

ACUTE GASTRITIS
Acute gastritis is a sudden inflammation of the lining of the stomach.

Acute gastritis can be divided into:

1. Acute superficial gastritis.

2. Acute erosive gastritis.

3. Acute gastric ulceration.

Chronic gastritis can divided into:

1. Type 1 chronic gastritis (autoimmune gastritis)

2. Type2 chronic gastritis (bacteria induced gastritis)

3. Type3 chronic gastritis (chemical induced gastritis)

ETIOLOGY:
Book etiology Patient etiology
1. Bacterial infection. Present
2. Non-steroid anti inflammatory disease Absent
3. Autoimmune. Absent
4. Bile reflux disorder Absent
5. Alcohol Absent
6. Cocaine Present
7. Radiation and chemo therapy Absent
8. Helicobacter pylori Present

PATHOPHYSIOLOGY

Due to etiological factor

This barrier is penetrated.

Hydrochloric acid comes into contact with the mucosa.

 Injury to small vessels.

Edema, hemorrhage, and possible ulcer formation.

CLINICAL MANIFESTATION:

Book symptom Patient symptom

1. Nausea or recurrent upset stomach. Present
2. Vomiting. Present
3. Indigestion. Present
4. Hiccups. Absent
5. Loss of appetite Present
6. Burning or gnawing feeling in the stomach between meals or at night. Present
7. Burning ache or pain (indigestion) in your upper abdomen Present
8. Felling of fullness in your upper abdomen Present
9. Felling of fullness in your abdomen after eating. Present
10. Hematemesis Absent
11. Abdominal tenderness Absent

DIAGNOSTIC EVALUATION
Name of the investigation Patient investigation
1. Assessment of symptoms, medical history, risk factors. Medical History - there is no medical history.
2. Physical examination Done
3. Blood test Increased WBC as evidence by previous reports
4. Stool test Occult blood
5. Upper gastro intestinal x-ray Absent
6. Upper gastro intestinal endoscopy. Absent
7. Histological examination by biopsy of a sample. Absent

MEDICAL MANAGEMENT
Book management Patient management
1. Antiemetic drugs as prescribed by doctor. :Inj. Emset LV SOS.(To reduce the
2. Antiacids like ranitidine H2 receptor Eimetidine, ranitidine, vomiting)
famotidine are effective to reduce the pain.
3. Inj. Antibiotic as prescribed by doctor.
4. Administer analgesics as prescribed by doctor.

NURSING MANAGEMENT:

 Imbalance fluid and electrolytes related to vomiting as evidence by patient verbalization.

 Abdominal pain related to inflammation in the mucous membrane of the stomach as evidence
by patient facial expression.

 Impaired nutritional status related to decrease appetite as evidence by patient refusal of food.

 Altered body thermoregulation related to infection as evidence by checked vital signs.

 Anxiety related to disease condition and treatment plan as evidence by patient verbalization

 Activity intolerance related to generalized weakness as evidence by observation.

 Knowledge deficit related to disease condition and treatment plan as evidence by patient
verbalization.
ASSESSMEN DIAGNOSIS GOAL PLANNING IMPLEMENTA RATIONAL EVALUATIO
T TION N
Subjective Fluid and To reduce To assess the General condition To know the Patient feel
data: electrolyte vomiting and condition of was assessed by condition of better and
Patient says imbalance maintain patient. vomiting episode patient. maintain
that I am related to fluid and 3. hydration and
having vomiting as electrolyte. reduce vomiting
vomiting from evidence by To check the To checked vital To obtained base 1.
last night. observation vital signs signs Temp. 98.2, line data.
Objective and vomiting pulse-78, resp
data: Diagnosis
episode 3. Goal Planning 20b/minImplementation Rational Evaluation
On my To give plenty To maintain
observation of oral fluids. To give plenty of hydration.
after eating the oral fluids.
food patient To give IV
have vomit. fluids to the I.V fluids as To maintain
Vomiting patient as prescribed by electrolyte
episodes 3 prescribed by doctor are imbalance.
doctor. provided to the
patient
To give small To maintain
frequent oral Small and electrolyte and
liquids frequent oral hydration.
liquids are
To provide provided To prevent form
kidney tray Kidney tray was the bed linen
provided to the
To give anti patient To reduce
emetics drugs vomiting.
as prescribed To give inj Emset
by doctor. as prescribed by
doctor.
Assessment
Subjective Abdominal To reduce To assess the General condition To know the Patient feel
data: Patient pain related to pain. condition of patient. was assessed of the condition of better and
says that I am disease patient by facial patient. reduced
having condition as To check the vital expression. pain.
abdominal evidence by signs. Vital signs. Are To obtained base Pain score is
pain from last patient Temp - 98, Pulse - line data. 1.
night. verbalization 48, Resp - 20 b
and pain score To assess the pain /min.
5/10. by using the pain To find out the
score. Pain is assessed by pain intensity.
using the pain score
To give analgesics scale - 5.
as prescribed by To reduce pain.
Objective doctor. Inj. Tramadol is
data: Patient given as prescribed
looks restless by doctor.
due to pain. To give diversional To divert the
Pain score therapy to the Diversional therapy mind of the
5/10 patient. is given to the patient.
patient (music).

To give proper rest To reduce pain.

to the client. Proper rest
provided to the
client.

Assessment Diagnosis Goal Planning Implementation Rational Evaluation

Subjective Impaired Improved To assess the General condition To know the Patient feel
data: nutritional appetite and condition of of client was condition of better and
Patient says status less nutritional client. assessed by client. improve the
that I am than body status of observation. nutritional
having loss of requirement as client. status.
appetite. evidence by To check vital To checked vital To obtained base
patient signs. signs temp 98.1, line data.
verbalization Resp -22 , Pulse -
78 b/ min .
To give small Small frequent To improve the
frequent diet to diet is provided to nutritional status
Objective the client. the client. of the client.
data: To reduce
Patient To give food Food was weakness.
refusal of according to provided
food. likes of patient. according to the
likes of patient.
To give To improve
nutritious food Nutritional food health status.
to the client. was provided to
the client.
Assessment Diagnose Goal Planning Implementation Rational Evaluation
Subjective Knowledge To provide Ask the patient to To know the exact Asked various Patients
data deficit related complete tell his feelings. reason. questions from level of
Patient to present knowledge the patient to knowledge
complaints condition as of the collect some was
that she has evidence by disease data. improved.
no idea what request for condition Clear the doubts and To increase some
Doctors are information. and area of concern of knowledge of the All the doubts
talking on treatment. the patient. patient regarding and queries were
rounds and the disease solved one by
why the condition. one.
samples are Provided the
taken appropriate and
frequently. up to data status
of the patient
Objective disease
Data: Patient condition.
looks tensed Explain the
and confused importance of the
asking for present treatment
briefing and investigation.
requiring the
present
disease
condition.

DETAILS OF SUMMARY CARE:

26 / 10/2023

General condition

General condition of the patient was assessed. Patient was conscious, oriented to time place and
person. Vital sign checked and there was increased pulse rate, B.P. history was taken blood glucose
was 134 mg/dl. Physical examination performed.

Vital signs:

Temperature: 98.6-degree Fahrenheit

Pulse: 104 b/min.

Respiration: 20 b/min.

B.P: 150/80 mm/hg

27 / 10/2023

General condition of the patient was fair. Patient was conscious, oriented to time place and person.
Vital sign checked and there was increased pulse rate, B.P.

Vital signs:

Temperature: 97.3degree Fahrenheit

Pulse: 98 b/min.

Respiration: 20 b/min.

B.P: 130/80 mm/hg

28 / 10/2023

General condition of the patient was good. Patient was conscious, oriented to time, place and
person. vital signs are checked and found stable.

Vital signs

Temperature: 98.1 Fahrenheit

Pulse: 88 b/min

Respiration: 18 b/min

B.P: 110/80 mm/Hg

29 / 10/2023

General condition of the patient was good. Patient was conscious, oriented to time place and
person. Vital sign checked and found stable.

Vital signs:

Temperature: 98.6degree Fahrenheit

Pulse: 80 b/min

Respiration: 18 b/min.
B.P: 110/70 mm/Hg.

DIET MANAGEMENT:

 Initially foods and fluids are withheld until nausea and vomiting subside.

 Once the client tolerates food, the diet includes gelatin, toast, simple bland foods.

 The client should avoid spicy foods, caffeine and large, heavy meals

 In the continued absence of nausea, vomiting, bloating can slowly return to a normal diet.

SUMMARY OF NURSING CARE:

Patient came with the complain of severe restlessness due to abdominal pain and provided
supportive management, via medicines patient got better and now patient is taking discharge.

PROGNOSIS
Book prognosis Patient prognosis
According to the book the prognosis of the gastritis According to the patient condition the prognosis of
depends on the level of severity of the disease the client is not good. but cooperate well.
condition. As stated by the doctors and the laboratory
investigation on comparison with the book the
patient she is a known case of gastritis.
Level of severity are high for the patient.

HEALTH EDUCATION:

 Educate patient to take plenty of fluids.

 Restricted alcohol intake.

 Add fruits and vegetables to patient diet.

 Do not take spicy and heavy meal

 Avoid taking junk foods.

 Advise patient and family not to discontinue medications without doctors’ permission

 Advise for follow up.

 BIBLIOGRAPHY:

1. B T Basavanthappa; A textbook of Medical Surgical Nursing; published by JAYPEE Brothers

Medical Publishers (P) LTD: edition.

2. Lippincott Manual of Nursing practice, 10 edition, Walter publishers, page no. 820

3. BRUNNER and SUDDARTH'S Textbook of Medical Surgical Nursing; Published by Wolters

Kluwer Health; edition 12"; volume 1; page no.850-875.