Naga College Foundation Inc.

T Villanueva Avenue, Naga City

S/Y 2022-2023

CASE STUDY
on
Acute Gastritis

Group 15
Monique D. Francisco
Kaye Hasminne P. Froa
Bianca lee F. Gilbas
Arjel R. Laureta
Jona H. Llamas
Mark Jefferson C. Luna
Jessakin A. Naron
Sharmaine Mirandilla
Aimee B. Orlina
Justine Ray SJ. Osabel
 ACKNOWLEDGEMENT

First, we would like to thank those who helped and supported the
completion of the case study. Second, we would like to express our sincere
gratitude towards Ms. Eden C. Ocampo for providing invaluable guidance,
comments, and suggestions that helped in the completion of our study. It was an
honor to work under her guidance. Third, we would like to thank our parents for
their mental and emotional support. Last but not the least, a big thanks to
Almighty God for giving us strength and knowledge. This would not be possible
without Almighty God.
Abstract

It's time to recognize the health problems that gastritis can bring about and
to treat it seriously. Although prevention is usually preferable, there are
occasions when natural intervention without the risk of addiction is more crucial.
Information from a case study about how gastritis in children is steadily rising day
by day due to changing lifestyle and dietary intake was synthesized in order to
improve our knowledge of chronic gastritis, its etiology, and best-evidence
treatment. Functional gastritis instances can occasionally be incorrectly identified
as inflammation of the protective lining due to an infection with the same
bacterium that causes stomach pain.

The best evidence-based treatment for chronic gastritis should be used

and should be managed in accordance with its etiology. When you are diagnosed
with chronic gastritis, you can reduce your symptoms by making some lifestyle
changes, such as practicing relaxation techniques, giving up smoking, abstaining
from alcohol. We should start by helping the living. The parents are a fantastic
place to start. Although we can't give them life in return, we can at least give
them quality and joy by paying them a little homage here and there. If you
accidentally ate the greetings meant for your loved ones, throw them up right
away to prevent experiencing regret chronic gastritis.
 Introduction
Acute gastritis occurs as a result of weakness or injury to the gastric
mucosa, which can allow stomach acids to further damage and inflame the lining.
There are several risk factors for damage of the gastric mucosa, including use of
certain medications, infections, acute stress, and dietary factors. Additional risk
factors for developing acute gastritis include increased intake of alcohol and
caffeine and exposure to cigarette smoke, all of which can irritate the gastric
mucosa. More rarely, the ingestion of harsh chemicals can lead to severe
mucosal damage due to a direct gastric injury. Typically, acute gastritis doesn't
last very long. Once the inflammation has subsided, it typically fades naturally
within a few days or weeks. In some instances, however, acute gastritis can
result in chronic gastritis, also referred to as recurring or protracted stomach
mucosal inflammation. Chronic gastritis over time might raise the possibility of
various problems such as stomach ulcers, upper gastrointestinal bleeding, and
specific kinds of stomach cancer.
The 16-year-old patient, Barrameda, Earl zaues SolTanay, complains of
epigastric pain, which is pain in the upper abdomen and can be a symptom of
conditions including Gastritis and Acid Reflux. We decided on this subject
because it is current and frequently affects young people, and because we
believe that many intestinal diseases can be avoided or reduced by leading a
healthy lifestyle. We chose to provide this case study because we contend that
prevention is more beneficial to treatment.
The most important facts to know about acute gastritis refers to a sudden
onset of inflammation of the stomach lining those results from a disruption to the
gastric mucosa that allows for further damage and inflammation from stomach
acids. that many risk factors that can lead to acute gastritis. and the possible
Treatment of acute gastritis depends on the underlying cause of inflammation
and may include lifestyle changes, acid-reducing medications, or antibiotics.
 Objectives of the Study

General
This study aims to identify the overall health problem and provide effective
nursing care to a client with acute gastritis. This also promotes health and a
medical understanding of the condition.

Specific
After 15 minutes of case presentation the Group 15 of BSN 2D will be able
to:
● To present a comprehensive assessment through nursing health history
and present illness.
● To demonstrate a thorough physical assessment and review of the system
for the comparison of the patient's condition with normal anatomy and
physiology.
● To formulate a nursing care plan to promote the patient's recovery.
●
PATIENT’S PROFILE

Nursing Health History:

3 days PTA, patient had a sudden episode of chest pain associated with
numbness of left upper extremity associated with poor appetite. no consult was
done. no meds were given. few hours PTA, still with persistence of symptoms
hence consulted and subsequently admitted.
Physical Assessment:
GENERAL SURVEY: Awake and alert
VITAL SIGNS: BP:130/70 CR: 91 RR: 20 Temp: 36.6
HEENT: Dry lips, sunken eye balls
CHEST/LUNGS: Clear breath sound, no retractions, no crackles, symmetric
expansion
CSV: Adynamic precordium, normal rate, regular rhythm, no murmurs
ABDOMEN: Globular, soft, non-tender abdomen, no palpable mass or visible
deformities
GU (IE): No gross deformities, no mass, no discharge, no erythema
SKIN/EXTREMITIES: No discolorations, no lesions, no swelling, no edema, full
equal pulses crt <2 seconds
NEURO EXAM: No neurological deficit

Theoretical framework
This study used the Social Ecological Theory. As it was explained by
Kuykendall, the theory was developed by a group of experts, namely, Kenneth
McLeroy, Daniel Bibeau, Allan Steckler, and Karen Glanz in 1988. The theory
draws its attention to the contributory factors of health problems by addressing
disease or illness. It addressed the contributory factors of disease or illness from
the psychosocial environmental elements. Moreover, the theory emphasizes to
single out contributory factors with different scales or levels, aiming at suggesting
appropriate measures for the intervention.
Initially, the theory underlines individual behavioral factors which
encompass variables such as diet, substance use, age, past experiences, and
knowledge or attitudes toward physical exercise. Second, socio-cultural factors
such as gender, beliefs, traditions and type of foods, preferences and choices of
meals, socioeconomic status, norms, and values within their way of life. Finally,
institutional and community factors such as faith-based institutions influencing
dietary choices, the nature of protection, access to fresh fruits and vegetables,
recreational areas, and housing nature were included.
The theory presents individuals at a center point and it explains that health
in general and disease in particular were influenced by individual behaviors,
community, socio-cultural, and institutional factors. Therefore, this study
employed the theory as a theoretical framework aimed to determine the social,
cultural, and individual behavioral factors affecting gastritis in the study area. In
addition, the study used the theory not only identifying the contributory factors,
but also forwards the best possible measures that reduce or diminish the
problems.
ANATOMY AND PHYSIOLOGY

The GI system’s major functions include ingestion and digestion of food and
elimination of waste products. When these processes are interrupted, the patient
can experience problems ranging from loss of appetite to acid-base imbalances.

The GI system consists of two major divisions: the GI tract and the accessory
organs.

GI TRACT

The GI tract is a hollow tube that begins at the mouth and ends at the anus.
About (7.5 m) long, it consists of smooth muscle alternating with blood vessels
and nerve tissue. Specialized circular and longitudinal fibers contract, causing
peristalsis, which helps propel food through the GI tract. The GI tract includes the
pharynx, esophagus, stomach, small intestine, and large intestine.
Mouth

Digestive processes begin in the mouth with chewing, salivating, and swallowing.

The tongue provides the sense of taste. Saliva is produced by three pairs of
glands: the parotid, submandibular, and sublingual.

Pharynx

The pharynx, or throat, allows the passage of food from the mouth to the
esophagus. The pharynx assists in the swallowing process and secretes mucus
that aids in digestion. The epiglottis — a thin, leaf-shaped structure made of
fibrocartilage — lies directly behind the root of the tongue. When food is
swallowed, the epiglottis closes over the larynx, and the soft palate lifts to block
the nasal cavity. These actions keep food and fluid from being aspirated into the
airway.

Esophagus

The esophagus is a muscular, hollow tube about (25.5 cm) long that moves food
from the pharynx to the stomach. When food is swallowed, the upper esophageal
sphincter relaxes, and the food moves into the esophagus. Peristalsis then
propels the food toward the stomach. The gastroesophageal sphincter at the
lower end of the esophagus normally remains closed to prevent reflux of gastric
contents. The sphincter opens during swallowing, belching, and vomiting.
Stomach

The stomach, a reservoir for food, is a dilated, saclike structure that lies
obliquely in the left upper quadrant below the esophagus and diaphragm, to the
right of the spleen, and partly under the liver. The stomach contains two
important sphincters:

The cardiac sphincter, which protects the entrance to the stomach, and the
pyloric sphincter, which guards the exit.

The stomach has three major functions. It:

• stores food
• mixes food with gastric juices (hydrochloric acid, pepsin, gastrin, and
intrinsic factor)
• passes chyme — a watery mixture of partly digested food and digestive
juices — into the small intestine for further digestion and absorption.

An average meal can remain in the stomach for 3 to 4 hours. Accordion-like folds
in the stomach lining called rugae allow the stomach to expand when large
amounts of food and fluid are ingested.

Small intestine

The small intestine is about (6 m) long and is named for its diameter, not
its length. It has three sections: the duodenum, the jejunum, and the ileum. As
food passes into the small intestine, the end products of digestion are absorbed
through its thin mucous membrane lining into the bloodstream.

Carbohydrates, fats, and proteins are broken down in the small intestine.
Enzymes from the pancreas, bile from the liver, and hormones from glands of the
small intestine all aid digestion. These secretions mix with the food as it moves
through the intestines by peristalsis.
Large intestine

The large intestine, or colon, is about (1.5 m) long and is responsible for:

• absorbing excess water and electrolytes

• storing food residue
• eliminating waste products in the form of feces.

The large intestine includes the cecum; the ascending, transverse, descending,
and sigmoid colons; the rectum; and the anus — in that order. The appendix, a
fingerlike projection, is attached to the cecum. Bacteria in the colon produce gas
or flatus.

Anatomy of stomach lining

Four major types of secretory epithelial cells cover the surface of the stomach
and extend down into gastric pits and glands:

 Mucous cells: secrete an alkaline mucus that protects the epithelium

against shear stress and acid
 Parietal cells: secrete hydrochloric acid
 Chief cells: secrete pepsin, a proteolytic enzyme
 G cells: secrete the hormone gastrin
 Pathophysiology of Acute Gastritis
Predisposing Factors: Precipitating
Factors:
• Stress • High Hydrochloric Acid
• Helicobacter Pylori
• Dietary Factor • Bile Reflux
(Consumption of beverages/soft drinks)
• Ingestion of strong acid

Stress increases Intracranial Pressure (ICP)

Stimulates Vagus nerve (CN-X)

Parietal cells produce an abundant amount of HCl, H. Pylori, and ingestion of

strong acid

Mucus Depletion

HCl, pepsin, H. Pylori, and other irritating agents come in contact with gastric
mucosa

Inflammation of gastric mucosa

Signs and symptoms:

Nausea, Vomiting, Anorexia, Abdominal pain
If treated:
If not treated:
Patient recovers within 24 hrs. GI bleeding
although the appetite maybe Shock
diminished for an additional of 2-3 days.
Death
 Gastritis is characterized by a disruption of the mucosal barrier that
normally protects the stomach tissue from digestive juices (e.g., hydrochloric acid
(HCI) and pepsin). The impaired mucosal barrier allows corrosive HCL, pepsin,
and other irritating agents (e.g., NSAIDs and H. pylori) to come in contact with
the gastric mucosa, resulting in inflammation. In acute gastritis, this inflammation
is usually transient and self-limiting in nature. Inflammation causes the gastric
mucosa to become edematous and hyperemic (congested with fluid and blood)
and to undergo superficial erosion (see Fig. 46-1). Superficial ulceration may
occur as a result of erosive disease and may lead to hemorrhage. In chronic
gastritis, persistent or repeated insults lead to chronic inflammatory changes, and
eventually atrophy (or thinning) of the gastric tissue (Grossman & Porth, 2014).

DIAGNOSTIC TEST

(Physical Assessment and Diagnostic test evaluation for Acute Gastritis)

To diagnose Acute Gastritis doctor will ask about medical History, symptoms,
and many medicines you take. Your Doctor will also perform a physical exam,
laboratory exam, and may order upper gastrointestinal (GI) endoscopy with
Biopsies or other tests.
Here are the tests and their rationale that should be done to diagnosed Acute
Gastritis:
DIAGNOSTIC TEST RESULT OF BARAMEDA
HEMATOLOGY
TEST RESULT UNIT REFERENCE
RANGE
COMPLETE
BLOOD COUNT
WHITE BLOOD 10.40 10e3/uL 3.70/11.3
CELLS
RED BLOOD 5.22 10e6/uL 4.10-5.85
CELL
HEMOGLOBIN 148.00 g/L 115-160
HEMATOCRIT 0.459 L/L 0.280-0.500
MCV 87.9 fL 77.0-94.9
MCH 28.3 pg 27.0-33.2
MCHC 32.2 G/dL 31.0-34.8
PLATELET 338 10e3/uL 140-450
COUNT

DIFFERENTIAL
COUNT
NEUTROPHILL 75.8 H % 35.0-65.0
S
LYMPHOCYTES 15.2 L % 20.0-55.0
MONOCYTES 8.1 % 2.00-10.00
EOSINOPHILS 0.5 % 0.00-4.00
BASOPHILS 0.3 % 0.00-1.50
ESR 10 mm/hr 0-15

CHEMISTRY
TEST RESUL FLA S.I UNITS RESULT CONVENTI
NAME T G ONAL
UNITS
RANGE UNIT RAN UNI
GE T
Calcium 1.87 L 2.10-2.55 mmol/ 7.48 8.4- mg/
L 10.2 dL
 137.49 136-145 mmol/ 137.49 136- mm
L 145 ol/L
3.79 35-5.1 mmol/ 3.79 35- mm
L 5.1 ol/L
1.30 1.10-1.40 mmol/
L
Amylase 125.40 H 25-125 U/L 125.40 25- U/L
125
lipase 17.40 8-78 U/L 17.40 8-78 U/L

DIAGNOSTIC TEST RESULT OF BARRAMEDA

Physical examination
General Survey: irritable, not in respiratory distress
Vital sign: BP: 130/70 CR: 91 RR: 24 Temperature: 36.6
HEENT: dry lips, sunken eye balls
Chest/lungs: Symmetrical Chest Expansion, Clear Breath Sounds, No Retraction
and no cracles
CSV: Adynamic precordium, normal rate, regular rhythm, no murmurs
Abdomen: Globular,soft, no tender abdomen, no palpable Mass or visible
deformity
GU (IE); DRE: no gross deformities, no mass, no discharge, no Erythema
skin's extremities: no discoloration, no lesions, no swelling, n edema, full equal
pulses CRT <2secs.
Neurological Exam: no neurological deficit

Laboratory and major diagnostic result

WBC 10.40
HGB 148
HMT: 0.459PT: 338
RADIOLOGY: normal chest findings
CHEMISTRY: Amylase high-125.40
ESR: normal
SARS-COV2: Negative.

The table shows every diagnostic test that Barrameda underwent. Blood
test result show a high range of neutrophils, which indicates neutropenia, it is a
condition where your body produces too many neutrophils which may develop
leukocytosis or a high total white blood cell count. Neutrophilia may be
associated with Helicobacter pylori (H. pylori) infection, which is one of the
most common causes of gastritis. The result also shows low lymphocytes,
indicates lymphocytopenia, a condition when there are too few white blood cells
called lymphocytes in which means the patient has not enough white blood cells
to fight infection specifically the H.pylori
In chemistry, the patient has high amounts of amylase in the blood, which is often
a symptoms of acute or chronic pancreatitis. High levels of serum amylase have
also been linked to gastritis; it is thought that the inflammation generated by
gastritis might lead to increased permeability of the stomach lining, allowing
amylase to escape into circulation. Chemistry also discovers that low calcium
levels indicate hypocalcemia, and Dehydration, this is because it can lead to
electrolyte imbalances, which can affect the levels of calcium in your blood. Low
calcium levels in the blood can also be caused by a problem with the parathyroid
glands, as well as from diet and certain drugs. The doctor also considers the
physical examination, where the results are dry lips and sunken eyeballs, another
sign of dehydration. The general survey also stated that the infant is irritable but
not in respiratory distress. His vital signs are normal, except for his blood
pressure, which is higher than usual, another symptom of gastritis because the
majority of these cases have high blood pressure. All of the results point to the
diagnosis of acute gastroenteritis with moderate dehydration.
 MEDICAL MANAGEMENT
Medications prescribed by the Physician;
 Omeprazole
 Ranitidine
 Aluminum-Magnesium Hydroxide
 Paracetamol
 Multivitamins
Drug name Mechanism of Action Indications Nursing Considerations

Generic name: It inhibits secretion of
Omeprazole Brand gastric acid by
name: Prilosec irreversibly blocking the
Pharmacological class: enzyme system of
Proton-pump inhibitors hydrogen/potassium
(PPIs) adenosine
Dosage, route, and triphosphatase, the
frequency: 40 mg IV OD “proton pump” of the
gastric parietal cell.
Drug name Mechanism of Action
Treat certain ● Assess the patient's overall
conditions where status and condition before
there is too much administering the medication.
acid in the ● Assess dizziness that might
stomach. affect gait, balance, and other
functional activities.
● Report balance problems and
functional limitations to the
physician, and caution the patient
and family/caregivers to guard
against falls and trauma.
Indications Nursing Considerations

Generic name: Nonsystemic antacid antacids used  Note number and

Aluminum-Magnesium with moderate together to relieve consistency of stools.
Hydroxide neutralizing action. heartburn, acid Constipation is common
Pharmacological Decreases rate of indigestion, and and dose related. Intestinal
obstruction from fecal
class: Antacid gastric emptying and upset stomach.
concretions has been
Dosage, route, and has demulcent, They may be used reported.
frequency: 1 tab, Hab. adsorbent, and mild to treat these  Lab tests: Monitor periodic
TID astringent properties. symptoms in serum calcium and
Reduces acid patients with peptic phosphorus levels with
concentration and ulcer, gastritis, prolonged high-dose
pepsin activity by esophagitis, hiatal therapy or impaired renal
function.
raising pH of gastric hernia, or too much
 Patient & Family Education
and intraesophageal acid in the stomach
 Increase phosphorus in diet
secretions. (gastric when taking large doses of
hyperacidity) these antacids for
prolonged periods;
hypophosphatemia can
 develop within 2 wk. of
continuous use of these
antacids. The older adult in
a poor nutritional state is at
high risk.
NURSING MANAGEMENT
Drug name Mechanism of Action Indications Nursing Considerations

Generic name: Multivitamins used to provide vitamins that  Administer vitamins with
Multivitamins provide vitamins and fill are not taken in food to promote
Pharmacological in nutritional gaps to through the diet. absorption
class: vitamins prevent vitamin Multivitamins are also  Advise patient that
adequate nutrition must
Dosage, route, and deficiency due to poor used to treat vitamin
be maintained to
frequency: 500 diet. deficiencies (lack of prevent further
mg/tab O.D 8:0 am vitamins) poor deficiencies; to comply
nutrition, digestive with treatment regimen.
disorders, and many
other conditions.

Mechanism of Action Indications Nursing Considerations

Drug name

Generic name: Paracetamol produces For the relief of Do not take for >5days for pain in
Paracetamol analgesia by raising the mild to moderate children and check that the
Pharmacological threshold of the pain pain and the patient is not taking any other
class: analgesic and center in the brain and reduction of fever medication containing
antipyretic drugs by obstructing impulses where an paracetamol.
Dosage, route, and at the pain mediating intravenous route
frequency: 500mg/tab chemoreceptors. of administration is
considered
clinically necessary.
 NURSING CARE PLAN
Assessment Nursing Goals & Nursing Rationale Nursing Outcomes
Diagnosi Objective Intervention
s s
Subjective: Acute pain At the end Independent: At the end of the 4
- Patient related to of the 4 1. Establish rapport 1. To facilitate hours shift of
verbalized irritation/in hours shift cooperation as well rendering nursing
“nasa 5 po flammatio of 2. Note for the as to gain pt’s trust care patient has
ang kulog n of rendering location, scale, 2. To determine the been relieved from
ning tulak gastric nursing intensity and nursing care to be abdominal pain
kang mucosa care onset of pain given to the patient - Pain scale from
namamati as patient will 3. Maintain a calm 3. To minimize 5/10 became
ko” evidenced be relieve and quite stimulus that could 2/10
Objective: by from pain environment. aggravate the
- Facial recurrent condition of the
grimace abdominal 4. Provide a dim patient
- Restlessne pain and light but 4. To add comfort to
ss providing good the patient
Vital signs ventilation
Temp: 36.6⁰C
CR: 91 5. Take and record 5. To note changes
RR: 20 vital signs that can affect the
BP: 130/70 patient’s condition
6. Provide health 6. To promote
teachings such optimum wellness
as:
 Emphasize the
importance of
proper hygiene
Dependent: - To aid in the easy
- To regulate IV as recovery
ordered - To relieve
- Give hot epigastric pain
compress for the - To serve as a
relief of pain guide in doing self-
- To give due medication that
medications promotes
prescribed by the independence
doctor;
 Omeprazole
 Aluminum-
Magnesium
Hydroxide
 Paracetamol
 Multivitamins

Assessmen Nursing Goals & Nursing Rationale Nursing Outcomes

t Diagnosi Objectives Intervention
s
Subjective: Deficient At the end of 8 1. Assess vital 1. Getting the vital Short term goal met:
The mother Fluid hours the patient signs and note signs will allow After 8 hours of nursing
verbalized Volume demonstrates: for physical us to compare intervention, the patient
“Dikit dikit related to - Increase fluid signs of the result from along with the nurse:
mag inom fluid loss; volume dehydration the last 1. Verbalized
vomiting. intake 2. Discuss the recorded VS awareness of
tubig tapos
- Demonstrate significance of 2. Dehydration causative factors
mahiligon increased fluid occurs as a and behaviors
behaviors to
saa monitor and intake result of the contributing to
softdrinks, correct deficit 3. Discuss the body lacking the deficient fluid
kaaga-aga as indicated role of fluids volume
nag hydration in 3. Fluids regulate 2. Verbalized
sosoftdrinks the body body understanding of the
system temperature, importance of
tulos”
keep joints increasing fluid
Objective: lubricated, intake
(+) sunken deliver nutrients 3. Demonstrate
eyes to cells, and willingness for
(+) dry lips 4. Discuss the keep organs lifestyle changes
Irritable complications functioning such as drinking
-skin turgor of dehydration properly. water and milk over
goes back 4. Severe and carbonated
normally prolonged beverages to avoid
dehydration progression of
results in kidney dehydration
stones, kidney 4. Exhibited signs of
5. Check and failure and hydration (e.g.,
regulate IV at heatstroke, elastic skin turgor of
desired rate, including other <2 seconds)
and record life-threatening
6. Encourage to illnesses Long Term Goal Met:
increase fluid 5. It guarantees After 1-2 days of
intake. the right amount nursing interventions,
of fluid needed the patient along with
the nurse:
6. Hydration is 1. Took at least 1,500
necessary to to 2,500 mL of clear
maintain blood liquids within 24
pressure, hours following
control blood nursing
electrolytes, interventions
maintain body 2. Maintained good
temperature, skin turgor
and eliminate
waste through
the kidneys and
alimentary canal
 Assessment Nursing Goals & Objectives Nursing Rationale Nursing
Diagnosis Intervention Outcomes
Subjective: Imbalanced Short Term: Independent: Short Term:
The mother Nutrition After 1 hour of 1. Assessed 1. Identify At the end of
verbalized “dai Less than nursing intervention, nutritional deficiencies, the 8 hours shift
nagkakakan body the patient will be history. suspect the of rendering
tultol ta ang requirements able to: possibility of nursing care,
pirming related to A. Verbalized the intervention patient
kinakakan Inadequate importance of 2. Advise the to 2. Little food can increased
chichirya” nutritional nutrition to their eat small reduce appetite
intake due to body amount but vulnerabilities Long Term:
Objective: nausea and B. Drink more fluids frequent and increase At the end of
- Patient decreased and eat more input and also the 1-month
appears appetite nutritious foods. prevent gastric shift of
weak and 3. Emphasize distention rendering
drowsy Long Term: the 3. Increased nursing care,
- Patient has After 2 days of importance appetite and the patient:
reduced nursing intervention, of oral oral input - Gain weight
activity the patient will hygiene from 40kg
- Height: maintain an to 45kg
153cm adequate nutritional 4. Avoid foods 4. Lowering - Improved
- Weight: status as evidenced that stimulate distention and Body Mass
40kg by: gas gastric irritation Index (BMI)
- BMI: 17.1 a. Increased production from 17.1
- underweight Body Weight (e.g., apple, became
b. BMI wheat, fatty 19.2
becomes foods, - Resumed
normal cabbage, the activity
dairy in daily
products) - To fill in living
Dependent: nutritional gaps
- Give to eliminate
multivitamins as vitamin
prescribed by deficiency due
the Doctor. to poor diet
Interdependent:
- Follow - To help gain
recommende weight and
d diet lower the acid
suggested by in the stomach
nutritionist
(e.g., high
fiber foods,
low fats food,
foods with
low acidity,
and
noncarbonat
ed drinks)
 EVALUATION, RESULTS & DISCUSSION

EVALUATION, RESULTS & DISCUSSION

As discussed throughout the presentation of our case study, our patient has
Acute Gastritis which refer to a sudden onset of inflammation of the stomach
lining those results from a disruption to the gastric mucosa that allows for further
damage and inflammation from stomach acids.

Prognosis

If treated If not treated

● The aim of the hospitalization is to ● If left treated and not admitted to

lower the gastric acid in the hospital for medical management
stomach and to relieve pain. other complications may develop
● If treated the patient may be able such as:
to continue management at home. ● Bleeding from an erosion or ulcer.
Verbalize the importance of ● Gastric outlet obstruction due to
increasing fluid intake, and edema limiting an adequate
demonstrate his view towards transfer of food from the stomach
promoting health and willingness to to the small intestine.
make lifestyle changes such as ● Renal insufficiency as a result of
drinking water and milk instead of dehydration.
carbonated beverages to avoid
dehydration progression. And
expected that the patient would be
able to successfully gain weight
from 40kg to 45kg and improve his
Body Mass Index (BMI) from 17.1-
19.2.

Discharge Plan

Medication

● Discuss all take home medications to the patient and to significant other.
● Encourage the patient to take Omeprazole 20mg oral OD, Multivitamins
500 mg/tab OD 8:00 am as recommended by the Physician, and
Paracetamol 500mg/tab if pain persists.
 ● Instruct the patient regarding the vital information of the medications,
including drugs indication and side effects.

Economy/Exercise

● Encouraged the patient to engage in light exercises or exercise like brisk

walking, or slow running. However, patient is instructed to observe rest
periods and consume oral fluids to replace water lost through perspiration.

Treatment/Therapy

● Explain the treatment and medication purposes to the patient.

● Instructed to increase fluid intake to 3 liters per day.
● Reducing stress through relaxation techniques like meditation.

Health Teaching/Hygiene

● Instructed the patient to maintain an adequate rest period.

● Instructed the patient to avoid alcohol, caffeine and hot spicy foods.
● Encourage the patient to have good hygiene habits, especially washing of
hands.

Consultation

● Instruct the patient and significant other to seek consultation if signs and
symptoms of the disease recur.
● And discussed the need for referral if it is necessary.

Diet

● Instructed the patient to eat small frequent feedings.

● Encourage the patient to eat high fiber foods, such as whole grains, fruits,
vegetables, and beans.

LESSONS
Our assessment for three successive days showed that the patient’s
status has slightly been stable. We had established rapport and harmonious
communication during the whole course of the study. Moreover, we had
understood the Anatomy, Physiology and Pathophysiology of the disease
condition of the patient which is Acute Gastritis. We had identified Patient’s
Clinical Manifestations as basis for the Actual and Ideal Nursing Care Plans and
had intervened identified problems through patient-based nursing care.
As a nursing student, the knowledge that we had gained during the three days
assessing and caring of the patient had enhanced our understanding about the
patient’s condition. This exposure had helped us improve and developed our
interpersonal relationship with people whom we worked with.

DEFINITION OF TERMS
Acute gastritis: refers to a sudden onset of inflammation of the stomach lining,

also known as the gastric mucosa. In contrast, chronic gastritis refers to long-

lasting inflammation of the gastric mucosa.

Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin

belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is

also being studied in cancer prevention.

Bacterium: A type of very small organism that lives in air, earth, water, plants,

and animals, often one that causes disease.

Bile reflux: A backflow of bile into the stomach from the bile tract

Cytoprotective Drugs: Its predominant feature is a protection of the mucosa

from endogenous and exogenous noxious agents. These cytoprotective

properties result from a locally formed layer covering ulcers and erosions which

inhibits the diffusion of H-ions and pepsin to the damaged mucosa.

Chronic gastritis: refers to a persistent, but low grade, inflammation and

damage to the stomach lining. The gastric mucosa becomes thinner as the

normal cells are destroyed. The inflammatory cells include lymphocytes, which

indicate an immune response.

Epigastric pain: is pain in the upper abdomen. It can be a sign of disease.

Common causes include: Acid reflux (stomach acid flowing up into the
esophagus) Gastritis (irritation of the stomach lining) Most often this is from

aspirin or NSAID medicines such as ibuprofen, bacteria called H.

Functional dyspepsia: is a kind of chronic indigestion — a stomach ache, a

feeling of fullness or bloating during and after meals.

Gnawing: a sensation of dull, constant pain or suffering.

Gas or gastric problem: is one of the most common problems which usually

occurs after the age of 40. There can be various reasons contributing to gastric

problems like indigestion or an empty stomach. Gastric problem or gastritis is an

inflammation, irritation, or erosion of the lining of the stomach. It starts from being

acute and can turn gradually into a chronic condition.

Gastrointestinal system: The organs that take in food and liquids and break

them down into substances that the body can use for energy, growth, and tissue

repair. Waste products the body cannot use leave the body through bowel

movements.

Helicobacter pylori (H. pylori): It is a bacteria that lives in the mucous lining of

the stomach. If not treated on time, this infection can lead to ulcers, and in some

people, stomach cancer.

Hypocalcemia: is a treatable condition that happens when the levels of calcium

in your blood are too low. Many different health conditions can cause

hypocalcemia, and it's often caused by abnormal levels of parathyroid hormone

(PTH) or vitamin D in your body.

Neutrophilia: is defined as a higher neutrophil count in the blood than the

normal reference range of absolute neutrophil count. Neutrophilia can be seen in

infections, inflammation, and/or neoplastic processes

Omeprazole: sold under the brand names Prilosec and Losec, among others, is

a medication used in the treatment of gastroesophageal reflux disease, peptic

ulcer disease, and Zollinger–Ellison syndrome. It is also used to prevent upper

gastrointestinal bleeding in people who are at high risk.

Paracetamol: is a medication used to treat fever and mild to moderate pain.

Common brand names include Tylenol and Panadol. At a standard dose,

paracetamol only slightly decreases body temperature; it is inferior to ibuprofen in

that respect, and the benefits of its use for fever are unclear.
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