Gastritis is an inflammation of the stomach lining that can be acute or chronic. This nursing diagnosis focuses on the assessment, interventions, and care planning for patients experiencing gastritis. Proper nursing care is crucial for managing symptoms, preventing complications, and promoting healing.
Causes (Related to)
Gastritis can result from various factors that irritate or damage the stomach lining. Common causes include:
- Helicobacter pylori (H. pylori) infection
- Excessive alcohol consumption
- Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- Stress
- Autoimmune disorders
- Bile reflux
- Certain viral or bacterial infections
- Chronic vomiting
- Eating disorders (e.g., bulimia)
- Radiation therapy
Signs and Symptoms (As evidenced by)
Patients with gastritis may present with a range of symptoms. During a physical assessment, a nurse may observe:
Subjective: (Patient reports)
- Abdominal pain or discomfort
- Nausea
- Vomiting
- Loss of appetite
- A feeling of fullness in the upper abdomen
- Indigestion
- Burning sensation in the stomach
Objective: (Nurse assesses)
- Bloating
- Unintentional weight loss
- Pallor (in cases of anemia due to chronic gastritis)
- Hematemesis (vomiting blood)
- Melena (black, tarry stools)
- Abnormal laboratory values (e.g., elevated inflammatory markers, low hemoglobin)
Expected Outcomes
The following are common nursing care planning goals and expected outcomes for gastritis:
- The patient will report reduced abdominal pain and discomfort.
- The patient will demonstrate normal vital signs.
- The patient will maintain adequate nutrition and hydration.
- The patient will show no signs of gastrointestinal bleeding.
- The patient will verbalize understanding of dietary modifications and medication regimens.
- The patient will demonstrate improved quality of life and daily functioning.
Nursing Assessment
Comprehensive nursing assessment is crucial for the effective management of gastritis. The following steps should be taken:
- Obtain a detailed health history.
Gather information about the onset, duration, and nature of symptoms. Ask about dietary habits, alcohol consumption, medication use, and any known allergies. - Perform a physical examination.
Assess the abdomen for tenderness, distension, or masses. Note any signs of dehydration or malnutrition. - Monitor vital signs.
Check for tachycardia, hypotension, or fever, which may indicate complications or severe inflammation. - Assess pain levels.
Use a standardized pain scale to evaluate the severity and characteristics of abdominal pain. - Evaluate nutritional status.
Assess the patient’s appetite, recent weight changes, and ability to tolerate food and fluids. - Review laboratory results.
Check for anemia, elevated inflammatory markers, or abnormal liver function tests. - Prepare for diagnostic procedures.
Assist with endoscopy preparation if ordered by the healthcare provider. - Assess for psychological factors.
Evaluate stress levels and coping mechanisms, as stress can exacerbate gastritis symptoms. - Monitor for signs of complications.
Be alert for symptoms of gastrointestinal bleeding or perforation.
Nursing Interventions
Effective nursing interventions are essential for managing gastritis and promoting patient comfort and healing. Consider the following interventions:
- Administer medications as prescribed.
This may include antacids, proton pump inhibitors, H2 blockers, or antibiotics for H. pylori eradication. - Provide dietary education.
Teach patients about foods to avoid (e.g., spicy, acidic, or fatty foods) and recommend a bland diet during acute phases. - Encourage small, frequent meals.
This can help reduce stomach acid production and minimize discomfort. - Promote adequate hydration.
Encourage fluid intake, especially if the patient is experiencing vomiting or diarrhea. - Implement stress reduction techniques.
Teach relaxation methods such as deep breathing exercises or guided imagery. - Position the patient for comfort.
Elevate the head of the bed to reduce acid reflux. - Monitor for adverse effects of medications.
Be alert for signs of allergic reactions or side effects from prescribed treatments. - Educate about lifestyle modifications.
Discuss the importance of avoiding alcohol, tobacco, and NSAIDs. - Provide emotional support.
Offer reassurance and address any concerns or anxieties the patient may have. - Collaborate with the healthcare team.
Communicate any changes in the patient’s condition to the provider and participate in multidisciplinary care planning.
Nursing Care Plans
The following nursing care plans address common issues associated with gastritis:
Nursing Care Plan 1: Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to inflammation of the gastric mucosa as evidenced by patient reports of burning abdominal pain rated 7/10 and guarding behavior.
Related factors/causes:
- Inflammation of the stomach lining
- Increased gastric acid production
- Mucosal irritation
Nursing Interventions and Rationales:
- Assess pain characteristics regularly using a standardized pain scale.
Rationale: Provides a baseline for evaluating the effectiveness of interventions. - Administer prescribed pain medications and monitor their effectiveness.
Rationale: Helps manage pain and promotes comfort. - Teach and encourage relaxation techniques such as deep breathing.
Rationale: It may help reduce pain perception and promote relaxation. - Provide a calm, quiet environment to minimize stimuli.
Rationale: Reduces stress and promotes rest, which can aid in healing.
Desired Outcomes:
- The patient will report pain level reduced to 3/10 or less within 24 hours.
- The patient will demonstrate the use of non-pharmacological pain management techniques.
- The patient will exhibit improved comfort and reduced guarding behavior.
Nursing Care Plan 2: Imbalanced Nutrition: Less than Body Requirements
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to nausea and decreased appetite as evidenced by weight loss of 5 kg in one month and reports of early satiety.
Related factors/causes:
- Nausea and vomiting
- Decreased appetite due to abdominal discomfort
- Dietary restrictions
Nursing Interventions and Rationales:
- Assess nutritional status, including weight, dietary intake, and laboratory values.
Rationale: Provides baseline data for planning interventions. - Collaborate with a dietitian to develop an appropriate meal plan.
Rationale: Ensures nutritional needs are met while avoiding gastric irritants. - Encourage small, frequent meals throughout the day.
Rationale: Reduces gastric distension and acid production. - Administer antiemetics as prescribed before meals.
Rationale: Helps control nausea and improves food intake.
Desired Outcomes:
- The patient will demonstrate weight gain or stabilization within one week.
- The patient will report improved appetite and tolerance of meals.
- The patient will maintain adequate nutritional intake as evidenced by food diary records.
Nursing Care Plan 3: Deficient Fluid Volume
Nursing Diagnosis Statement:
Risk for Deficient Fluid Volume related to nausea, vomiting, and decreased oral intake.
Related factors/causes:
- Frequent vomiting
- Reduced fluid intake due to nausea
- Potential for increased gastrointestinal losses
Nursing Interventions and Rationales:
- Monitor fluid intake and output closely.
Rationale: Helps detect early signs of dehydration. - Encourage frequent sips of clear fluids between meals.
Rationale: Promotes hydration without overwhelming the stomach. - Assess for signs of dehydration (e.g., dry mucous membranes, decreased skin turgor).
Rationale: Allows for early intervention if dehydration occurs. - Administer IV fluids as prescribed if oral intake is insufficient.
Rationale: Maintains hydration status when oral intake is inadequate.
Desired Outcomes:
- The patient will maintain adequate hydration as evidenced by moist mucous membranes and normal skin turgor.
- The patient will demonstrate urine output of at least 30 mL/hr.
- The patient will verbalize understanding of the importance of fluid intake.
Nursing Care Plan 4: Anxiety
Nursing Diagnosis Statement:
Anxiety related to chronic illness and lifestyle changes as evidenced by expressed worry about the condition and restlessness.
Related factors/causes:
- Uncertainty about prognosis
- Need for dietary and lifestyle modifications
- Potential impact on daily activities
Nursing Interventions and Rationales:
- Provide clear, concise information about gastritis and its management.
Rationale: Increases patient’s understanding and sense of control. - Teach stress-reduction techniques such as mindfulness or guided imagery.
Rationale: Helps manage anxiety and may reduce gastric symptoms. - Encourage verbalization of concerns and fears.
Rationale: Allows for addressing specific anxieties and providing targeted support. - Refer to support groups or counseling services if needed.
Rationale: Provides additional resources for coping with chronic illness.
Desired Outcomes:
- The patient will report decreased anxiety levels within 48 hours.
- The patient will demonstrate the use of at least one stress-reduction technique.
- The patient will verbalize a realistic understanding of their condition and management plan.
Nursing Care Plan 5: Ineffective Health Management
Nursing Diagnosis Statement:
Ineffective Health Management related to knowledge deficit regarding gastritis management as evidenced by continued use of gastric irritants and non-adherence to the treatment plan.
Related factors/causes:
- Lack of understanding about gastritis triggers
- Inadequate knowledge of medication regimen
- Difficulty implementing lifestyle changes
Nursing Interventions and Rationales:
- Assess the patient’s current knowledge of gastritis and its management.
Rationale: Identifies gaps in understanding to guide education. - Provide education on gastritis triggers, dietary modifications, and the importance of medication adherence.
Rationale: Empowers patient to make informed decisions about self-care. - Demonstrate and have the patients demonstrate proper medication administration techniques.
Rationale: Ensures correct use of prescribed treatments. - Develop a written action plan with the patient for managing symptoms and adhering to treatment.
Rationale: Provides a concrete guide for self-management at home.
Desired Outcomes:
- The patient will verbalize understanding of gastritis management within 24 hours.
- The patient will demonstrate the correct medication administration technique before discharge.
- The patient will identify at least three lifestyle modifications to reduce gastritis symptoms.
References
- Chey, W. D., Leontiadis, G. I., Howden, C. W., & Moss, S. F. (2017). ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American Journal of Gastroenterology, 112(2), 212-239.
- Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care. F.A. Davis Company.
- Gulanick, M., & Myers, J. L. (2017). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences.
- Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. Wolters Kluwer Health.
- Malfertheiner, P., Megraud, F., O’Morain, C. A., Gisbert, J. P., Kuipers, E. J., Axon, A. T., … & European Helicobacter and Microbiota Study Group and Consensus panel. (2017). Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut, 66(1), 6-30.
- Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2020). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. Wolters Kluwer.
