Gastritis – Pathophysiology, Podcast, and Nursing Care Plan

Gastrointestinal system

Gastritis

Gastritis occurs when the lining of the stomach gets swollen or inflamed. This can occur suddenly, this is called  acute gastritis or if the gastritis occurs slowly, it is called chronic gastritis.  Chronic gastritis can last from weeks to years.

Once the stomach lining is inflamed, the lining of the stomach weakens and allows gastric acid to cause damage.

Causes

There can be many causes of gastritis:

  • Helicobacter pylori (H. pylori) – The bacteria enters through contaminated food or water. Once ingested the bacteria can lead to infection and cause gastric ulcers.
  • Alcohol
  • Stress
  • Use of NSAIDS
  • Use of Aspirin
  • Chronic vomiting
  • Bile reflux
  • Autoimmune infections
  • Cocaine abuse
  • Viral infections
  • Ingestion of caustic substances (i.e. poisons).

Gastritis

Signs and Symptoms

Some patients may not show signs of gastritis but when they do, they may exhibit:

  • Nausea
  • Vomiting – food contents or blood
  • Indigestion – burning pain in upper abdomen, becomes worse with meals.
  • Abdominal bloating
  • Loss of appetite
  • Black tarry stools

Complications

If gastritis is not treated, the following complications may result:

  • Gastric ulcers
  • Gastric bleeding
  • Stomach cancer (rare)

Diagnosis

The following may be utilized to diagnose gastritis:

  • Upper endoscopy
  • Test Blood, breath, or stool for H. Pylori
  • Barium swallow or upper GI series – these are x-rays to visualize esophagus all the way down to the small intestine to see if any ulcers are present.

Treatments and Nursing Considerations

The following treatments may be used to treat gastritis:

  • Antibiotics – to kill the H. pylori bacteria if found in the digestive tract.
  • Proton pump inhibitors – to reduce stomach acid.
  • Histamine H2 antagonists – to reduce the amount of gastric acid that is released into the digestive tract.
  • Antacids – to neutralize gastric acid.

 

Nurses need to educate the patient for the following:

  • Avoid alcohol
  • Avoid chocolate and caffeine
  • Avoid aspirin
  • Avoid NSAIDS
  • Avoid smoking

Nursing Care Plan

Nursing Diagnosis

1. Risk for Infection related to possible tissue damage from necrosis from increased gastric acid breaking down the mucosal lining.

Desired outcomes:

By discharge, the patient will remain free signs and symptoms of infection.

InterventionsRationals
InterventionsRationals
Assess vital signs including temperature every 4 hours and as needed. Report any abnormal findings to the healthcare provider.Fever is often one of the first signs of infection.
Assess mental status and level of consciousnesses every 4-6 hours.Mental status changes, confusion, or any deterioration from baseline can signify infection.
Report and note any abnormal laboratory values (i.e. elevated WBC count) to the healthcare provider.Certain abnormal laboratory results could be an indicator of infection.

 

2. Risk for bleeding related to possible perforation due to ulcerative process.

Desired outcomes:

By discharge, the patient will remain free of signs of symptoms of bleeding or perforation.

InterventionsRationals
InterventionsRationals
Assess for blood in emesis and melana. Assess NGT aspirate, stools, and emesis for occult blood.Due to the ulcerative process, bleeding can occur.
Monitor laboratory results. Especially coags and CBC.Abnormal values may indicate bleeding and healthcare provider should be notified immediately.
Monitor oxygen saturations, report saturations of 92% or less.These patients with an 02 saturations of 92% or less, may require additional oxygen.

 

 

 

Disclaimer:

Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

 

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Anna C. RN-BC, BSN, PHN, CMSRN Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process. She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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