UNIVERSITY OF LA SALETTE INC.

College of Nursing, Public Health and Midwifery

Santiago City, Isabela, Philippines

ACUTE GASTRITIS WITH MODERATE

DEHYDRATION
A Case Study
Presented to the College of Nursing, Public Health and Midwifery

Case presented by:

Jenny P. Amurao
Bridget Girlie M. An
Doracia L. Anekang
Justine Heart Anama
Precious Star B. Antolin
Neslyn Q. Antonino
Dieanne Nicole A. Apan
Maxi Louie B. Arconcil
Ianne Dale B. Baldonado

BSN – 3A

Case presented to:

Antonio Panganiban, RN
Clinical Instructor
I. CASE DESCRIPTION

A. ACUTE GASTRITIS

Acute gastritis is an inflammation of the stomach lining that develops suddenly and
typically causes a range of digestive symptoms. It can result from various factors, including
excessive alcohol consumption, certain medications, bacterial infections (like H. pylori), stress,
or ingestion of irritants such as spicy foods. Common symptoms include abdominal pain, nausea,
vomiting, indigestion, and a feeling of fullness. Treatment often involves addressing the
underlying cause, lifestyle modifications (such as dietary changes and stress reduction), and
medications to alleviate symptoms or eradicate infections if present.

II. PATIENT’S PROFILE

A. Demographic Data

● Name: Patient W

● Age: 5-years-old

● Address: P6 Rosario, Santiago City, Isabela

● Sex: M

● Religion: Roman Catholic

● Height: 105cm

● Weight: 16.5 kg

● Date of Admission: September 27, 2023

● Time of Admission: 8:20 AM

● Chief Complaint: Vomiting 10 times.

● Admitting Diagnosis: t/c Acute Gastritis with moderate dehydration

● Final Diagnosis: Acute Gastritis

● Admitting Physician: Dr. Kingslee L. Corpuz, MD

● Vital Signs upon Admission:

BP: 90/60
 PR: 128
RR: 32
TEMP: 37.7

III. PATIENT’S HISTORY

A. History of Patient’s Present Illness
2 days PTC the patient experience vomiting.
10 am- 10x vomiting, approx. 5 cups
(-)LBM (-)DOB

2 pm- The patient consulted in CHG and given Cefuroxime and Dolan Forte.
The patient is admitted at DVMCI for persistent vomiting.
B. Past Health History
The SO stated that the patient was diagnosed with Pneumonia when he's 2 years old.
(-) asthma
C. Familial History
The SO stated that the sibling of patient had pneumonia and that both side of the family is
(+)HTN.

D. Gordon’s Structura

1. HEALTH PERCEPTION/ MANAGEMENT

BEFORE DURING
The SO stated that. The child is generally The patient, is aware that he is in the
in good health and has a positive attitude. hospital. His parents and healthcare
providers have explained that the doctors
Parents ensure medical check-ups and
and nurses are helping him feel better.
seek for medical assistance. Does not
mention any use of herbal medicine.
 2. NUTRITIONAL-METABOLIC

BEFORE DURING
As stated by significance others, the The SO stated that the patient eat rice,
patient is fond of eating junk foods and burger, and donut. And drinks a few water.
fast foods specifically burgers and fries as
- DAT
well as soft drinks. The SO mentioned
that the patient do not want to eat
vegetables. Although the mother include
milk and fish on his meal sometimes. Eats
on time with snacks on between. Drinks
about 3-5 of glasses a day.
Drug and food allergies are not present to
the patient.

3. ELIMINATION

BEFORE DURING
SO stated that patient’s usual bowel Urine output during hospitalization was
elimination would be once a day and with about 300mL within 6 hours. And does not
no discomfort. Urinary elimination mention any difficulties in defecation.
would be about six times a day, with dark
yellow urine and no discomfort.
Prior to admission the patient had severe
vomiting (10 times).

4. ACTIVITY AND EXERCISE

BEFORE DURING
The patient is engaging in regular Due to weakness he only engage in room
physical activities such as running, activities like watching to pass time.
playing sports, and riding a bike.
Attending kindergarten where physical
play, games, and outdoor activities were
part of the daily routine.

5. COGNITIVE-PERCEPTUAL

BEFORE DURING
Both visual acuity and hearing are in Although the patient is weak, he was able to
good condition. Responds to stimuli understand and hear comprehensively.
verbally and physically as states by the
SO.
Developmentally appropriate cognitive
skills for a 5-year-old. Curious,
inquisitive, and eager to learn.
Speech and language skills are age
appropriate.

6. SLEEP-REST

BEFORE DURING
The patient would have eight hours of The significant others do not stated any
sleep. He sleeps right away when he goes difficulties of the sleeping pattern of patient.
to bed and always have a good sleep. And
takes a nap in the afternoon.

7. SELF-PERCEPTION/ SELF CONCEPT

BEFORE DURING
The SO stated that the patient developing As stated by the SO, despite being in the
a sense of self and identity. Exhibits self- hospital, the patient’s self-perception and
confidence and independence. self-concept remain stable and are actively
nurtured by their caregivers and healthcare
Parents provide positive reinforcement
providers. He is encouraged to express his
and support.
thoughts and feelings.

8. ROLE RELATIONSHIP

BEFORE DURING
The patient is currently a kindergarten Patient is being taken care of by his mother
student (Kinder 2). The patient has two during hospitalization. And he is well
siblings and loving parents. supported by his family members.

9. SEXUALITY AND REPRODUCTIVE

 ⮚ Patient is male.

⮚ Patient is 5 years old.

⮚ SO stated that the patient is not yet circumcised.

10. COPING-STRESS TOLERANCE

BEFORE DURING
Engages in active play and physical Watching his favorite cartoons helps him
activities appropriate for age. divert his attention from hospital
environment.
Attends preschool or kindergarten,
promoting social interaction.
Maintains age-appropriate energy levels.
As Stated by the SO.

11. VALUE-BELIEF

BEFORE DURING
The patients is actively attending their No restrictions to any treatment because of
church together with his family. They are religion. Prays a lot.
Roman Catholic as stated by the SO.

l Pattern

IV. PHYSICAL ASSESSMENT

DATE: November 29, 2022
TIME: 2:00 p.m.
I. General Appearance:
Received patient lying on her bed with an ongoing IVF of PNSS 1L x 8 hours
regulated at infusion pump. Patient in on the side of the window with a brown
blanket on touching her abdomen. The Patient is alert, coherent and with a chief
complaint of pain on her abdomen.

II. Receiving Vital Signs:

BP: 100/80
 PR: 92
RR: 19
TEMP: 37.5
III.
AREAS METHOD FINDINGS INTERPRETATIONS

HEAD Inspection Round and NORMAL

Symmetrical

SCALP Inspection
(-) Lesions and
Palpation NORMAL
Lumps

(-) Dandruff

(-) Areas of
bogginess

HAIR Inspection Dark hair and no

dandruff
Palpation
(-) Lice
NORMAL
(-) Lumps and
Lesions

FACE Inspection Symmetrical NORMAL

EYES Inspection Symmetrical pupils ABNORMAL

(+) sunken eyeballs

EARS AND HEARING Inspection Symmetric in size NORMAL

and shape

(-) Tenderness
Palpation NORMAL
(-) Lesions and
Lumps
 Patient can hear NORMAL
properly both left
and right ears.

NOSE Inspection External nose is NORMAL

symmetrical

(-) Swelling
NORMAL
(-) malformations

(-) discolouration

NECK Inspection Able to freely move

his neck.
NORMAL
(-) Lumps and
Lesions

(-) scars

LYMPH NODES Palpation (-) Palpable NORMAL

(-) Swelling

THYROID GLAND Inspection (-) Visible NORMAL

Palpation

SKIN Inspection (+) Pale ABNORMAL

(+) dry skin

Palpation

NAILS Inspection Clean and short nails NORMAL

(+) smooth

Palpation 2 secs. capillary refill NORMAL

CHEST Inspection (-) Lesions NORMAL

Palpation Temperature warm NORMAL

to touch
 (-) pain

(+) dull

Percussion

(-) Wheezing and

crackle sounds
Auscultation

ABDOMEN Inspection (+) Tenderness DUE TO THE

INFLAMMATION OF
Auscultation Hyperactive bowel
THE GASTRIC LINING
sounds
Percussion AND ABNORMAL
CONTRACTIONS OF
Palpation THE INTESTINAL
MUSCLES.

TOENAILS Inspection Clean and short NORMAL

Palpation 2 sec. Capillary refill NORMAL

V. ANATOMY AND PHYSIOLOGY
Stomach:
The stomach is a muscular organ located in the upper abdomen, responsible for food storage,
digestion, and mixing with digestive juices.
Gastric Mucosa:
The stomach's inner lining is called the gastric mucosa, consisting of various layers, including
the mucous layer, epithelial cells, and glands.
Small intestine:
A long tube-like organ that connects the stomach and
the large intestine. It is about 20 feet long and folds
many times to fit inside the abdomen. The small
intestine has three parts: the duodenum, jejunum, and
ileum. It helps to further digest food coming from the
stomach.

VI. DIAGNOSTIC STUDY

De Vera Medical Center Inc

City Road Calao East Santiago City Isabela
3311

LABORATORY REPORT
 September 27,2023
Results Normal Results Normal
Values Values

Physical Color LIGHTLY Yellow Microscopic Pus Cells 0-1/ HPF 0-2/ HPF
YELLOW

Transparency SLIGHTLY Clear Red Blood 0-2/ HPF 0-1/ HPF

HAZY Cell

Reaction 6.0 4.8-7.8 Epithelial RARE Few

Cell
Signs of UTI

Specific NEGATIVE 1.015-1.025 Bacteria RARE None

gravity
Signs of UTI

Glucose NEGATIVE Negative Mucus FEW Few

Thread

Protein NEGATIVE Negative Amorphous RARE Few

Signs of UTI

Blood NEGATIVE Negative Uric Acid NONE None

Bilirubin NEGATIVE Negative Hyaline Cast None

Urobilinogen NEGATIVE Negative Fine Gran. None

Cast

Ketone Negative Coarse Gran. None

Cast

Nitrite NEGATIVE Negative WBC Cast None

Leukocyte NEGATIVE Negative RBC Cast None

Esterase

Ascorbic Negative Other

Acid

URINALYSIS REPORT
September 27,2023

Results Normal Results Normal

 values values

Color AMBER Yellow RBC 0-1/HPF >3/HPF

Transparency SLIGHTLY TURBID Clear Pus cells 3-5/HPF 0-5/HPF

Indicate the
presence of
infection

Ph/Reaction 6.0 4.5-8 Epithelial Cells RARE Few

Signs of UTI

Specific Gravity 1.025 1.015-1.025 Amorphous RARE Few

materials
Signs of UTI

Mucus Threads MODERATE Few

Signs of UTI

Protein TRACE Negative Bacteria FEW None

Signs of UTI

Glucose NEGATIVE Negative Others

Bilirubin

Ketone

Nitrite

LABORATORY REPORT
September 28,2023

Results Normal value Results Normal

value

Hemoglobin 11.1 (L) 14.000-18.000 PT Patient 10.000-

g/dl 15.000
seconds

Hematocrit 34.9 (L) 42.000-51.000% PT Control 11.700-

18.800

WBC 21.1 (H) 5.000-10.000 PT Activity 70.000-

 X10^9 cells/L 120.000%

Segmenters 45.6 (L) 50.000-80.000% INR <1.2

Lymphocytes 24.7 (L) 25.000-50.000% PTT 27.000-

42.000
seconds

Eosinophils 0.1 0.000-5.000% Blood Type

Monocytes 13.4 (H) 2.000-10.000% MCV 74.7 (L) 80.000-

97.000
um^3

Basophils 16.2 (H) 0.000-2.000% MCH 23.6 (L) 26.000-

32.000 pg

Platelet count 514 150.000-450.00 MCHC 31.8 31.000-

mm^3 36.000 g/dL

ESR 0.000-10.000 RDW-CV 14.3 10.000-

mm/hr 16.000%

Reticulocyte 0.500-1.500% Toxic

Granules

Bleeding time 1.000-3.000 mins MPV

Clotting time 3.000-6.000 mins Others:

VII. PATHOPHYSIOLOGY

PREDISPOSING FACTOR PRECIPITATING FACTOR

 AGE  CONSUMPTION OF
 UNHEALTHY CARBONATED DRINKS
LIFESTYLE AND SALTY FOODS
 INCREASED ACID PRODUCTION IN THE STOMACH

DELAYED ABNORMAL
GASTRIC CONTRACTIONS
EMPTYING OF THE
INTESTINAL
MUSCLES

VOMITING TENDER
ABDOMEN,
HYPERACTIVE
ABDOMINAL
BOWEL SOUNDS
CRAMPS/PAIN
(BORBOGOMI
SOUND)
MODERATE
DEHYDRATION

BODY WEAKNESS,
SUNKEN EYEBALLS, DRY
MUCOUS MEMBRANES

Date Time Multidisciplinary Progress Doctor’s Order Rationale

Notes
09/27/2 8:20 Receiving notes >PNSS 300ml to run
3 PM for 1 hr then D5LR
Please admit patient at 1L x 80ml/hr x 6
room of choice then decrease to
60ml/hr ( use
Secure consent for
infusion pump)
admission and
management Dx:

HDI: Few hours PTA (10 CBC

AM), patient experienced
10 times vomiting that CXR
results to body weakness.
Na, K, Ca
VS q4
RAT
I & O q shift
UA 10 parameter
NPO for now
Abdominal X-ray AP
and Crosstable
Lateral

Rx:
Acute
Gastritis >Omeprazole 20mg
with IV now then q24
moderat
>Paracetamol
e
150mg Iv now then
dehydra
q4 PRN for fever
tion
>Refer

Date Time Multidisciplinary Doctor’s Order Rationale

 Progress notes

9/28/23 11:18 May start DAT

PM Start Dx:

>Flotera 1 tab PO OD

>e-zinc syrup 5ml PO

OD

>Hydroaid (ORS) as
much as tolerated,
give slowly 5-10ml via
dropper every 5-10
mins

Viber Order

Dr. A, De Vera

Date Time Progress Notes Doctor’s Order Rationale

9/28/23 Decrease fever Decrease IVF to 30ml/ hr,

d/c infusion pump
(-)vomiting
Increase oral fluid intake
 (-)LBM Refer

(-)dehydration

Weight: 16.5g

Date Time Progress Notes Doctors Order Rationale

9/29/2023 (-) vomit Heplach

(-) fever Increase Fluid Intake

Omeprazole to consume d/c

Possible may go home

tomorrow

9/29/2023
Do not reinsert for the mean
2: 27 PM time

Viber Order

Dr. A, De Vera
 Date Time Progress Notes Doctor’s Order Rationale

9/ 30/ 2023 7: 03 May go home

AM
Take home meds to follow
Bill pt.

Viber Order
Dr. A, De Vera

9/30/2023 May go home

(-) fever -Flotera 1 tab for 7 days
(-) vomitting -E-zinc syrup 5ml PO on X 2
bottles
Follow up check up Tuesday
10 AM

IX. NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

Subjective:  Fluid volume  After 1-2  Educate S/O  After 1-2 hours
deficit r/t hours of on the of nursing
Objective:
inadequate nursing importance of intervention,
 750 input fluid intake as intervention maintaining a the patient‘s
 1170 output manifested , the proper intake and
 Dry lips by dry lips, patient‘s hydration and output was
 Poor skin turgor poor skin intake and nutrition stabilize as
 Dry mucous turgor and output will status evidence by
membrane dry mucous stabilize as regularly. absence of dry
membrane. evidence by  Educate the lips, poor skin
absence of patient or the turgor and dry
 dry lips, family on mucous
poor skin possible membrane
turgor and cause of
dry mucous dehydration.
membrane  Regulate IVF
 Monitor I & O
 Administer
intravenous
hydration if
needed.
 Encourage
the S/O to
increase oral
fluid intake of
the patient.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

SUBJECTIVE: Acute pain r/t After 1 hour of ● Assess for After 1 hour of nursing
inflammation of gastric nursing contributing intervention, the
lining intervention, the factors that patient’s pain that he
● Pain scale: 6/10 patient’s pain that causes pain. feel was lessened.
he feel will be
● Encourage
lessened as
verbal report
evidenced by
during and
verbalization of
OBJECTIVE: after nursing
relief.
interventions.
 Abdominal
cramps ● Assess for
 Abdominal pain contributing
 Guarded factors that
movement causes pain.
 Facial grimace ● Encourage
patient verbal
report of pain.

● Provide
relaxation
 technique like
slow deep
breathing
exercise and
imagery.

● Assist the
patient in a
comfortable
position.

● Medications as
ordered like
paracetamol.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

Assessment Nutritional Imbalance After 1 hour of After 1 hour of nursing

less than body nursing  Advice the interventions, the S/O
Subjective S/O to feed
requirement r/t interventions, the was able to verbalize
"Nasusuka ko mga unnutritious food S/O will be able to the child with the importance of
kinakain ko" as intake verbalize the nutritious eating healthy foods.
verbalized by the importance of foods(fruits,
patient eating healthy vegetables
foods. etc.)
 Advice the
Objective: S/O to avoid
salty foods
 BMI= 14.96 and soft
 W=16.5 kg drinks.
 H= 105 cm  Educate the
S/O about low
cost nutritious
 food.
 Advice the
S/O to
prepare
attractive
food.
 Discourage
the patient
from
consuming
spicy foods,
caffeine and
alcohol.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

Subjective: Actual infection r/t After 6 hours of  Monitor vital . After 6 hours of
presence of nursing signs nursing intervention,
Objective:
pathogens in the intervention, the especially the patient boost his
 Temperature: blood stream as patient will boost temperature. immune system as
37.6 manifested by his immune system  Advice the evidenced by
 WBC: 21.1 elevated labs. as evidenced by S/O to feed increased appetite and
 Weak in increased appetite the patient increased mobility.
appearance and increased with nutritios
 Basophils: 16.2 mobility. foods.
(H)  Demonstrate
 Monocytes: to the patient
13.4 (H) proper or
 Hemoglobin: basic
11.1 (L) handwashing.
 Hematocrit:  Educate the
34.9 (L) patient about
 Segmenters: the
45.6 (L) importance of
 Lymphocytes: vitamin
24.7 (L) supplements.
 Monitor v/s
especially the
 temperature.
 Medication as
ordered (E-
zinc)

X. DRUG STUDY
INJECTIBLE MEDICATION

DRUG CLASSIFICATIO DOSAGE ACTION INDICATION ADVERSE CONTRAINDIC NURSING

CONSIDERATIONS
N REACTION
ATIONS

Generic Therapeutic 20mg -Inhibits -symptomatic Asthenia, Contraindicate - Monitor

name: Class: Antacids IV q24 proton GERD Dizziness, d in patient’s patient for
pump without headache, hypertensive vital signs.
Omeprazol
activity by esophageal Abdominal to drug or its - monitor
e
Pharmacologic binding to lesions. pain, components. patients for
Class: hydrogen- constipation signs and
potassium , diarrhea, symptoms of
Brand Proton Pump
adenosine -erosive flatulence, -risk for fundic low
name: Inhibitor
triphosphat esophagitis nausea, gland polyps magnesium
Prilosec ase located vomiting, increases with level, such as
-duodenal
at secretory acid long term use, abnormal HR
ulcer.
surface of regurgitatio especially or rhythm,
gastric n. beyond 1 year. palpitations,
parietal muscle
-dyspepsia
cells to spasms,
(indigestion).
suppress tremors, or
gastric acid seizures.
secretion

PRN MEDICATION
 DRUG CLASSIFICATIO DOSAG ACTION INDICATION ADVERSE CONTRAINDIC NURSING
N E REACTION CONSIDERATIONS
ATIONS

Generic Analgesic, 150 mg -Thought to -mild pain or Agitation, contraindicate - Avoid taking
name: IV now produce fever anxiety, d in patients OTC drugs.
Antipyretic
then q4 analgesia fatigue, hypersensitive - report
Paracetam
PRN for by headache, to drugs. paleness,
ol
fever inhibiting insomnia, weakness,
- use
prostagland pyrexia, and heartbeat
cautiously
in and nausea, skips.
Brand in patients
other vomiting,
name: with long-
substances abdominal
term
Tylenol, that pain
alcohol
Panadol sensitize
use
pain
because
receptors.
therapeuti
drug may
c doses
relieve
cause
fever
hepatotox
through
icity in
central
these
action in
patients.
the
hypothala
mi c heat-
regulating
center.

PNSS(Norm Isotonic 300 ml Replaces - Hyponatr Local Contraindicate - Document

al Saline) Solution to run sodium and emia tenderness, d in patients baseline
for 1 chloride - Shock abscess, with data. Before
hour and - Mainten tissue conditions in infusion,
maintain ance necrosis at which sodium assess the
levels. fluids injection and chloride patient's vital
- Dehydra site. administration signs, edema
tion is detrimental. status, lung
Sodium sounds, and
Chloride heart sounds.
injections are Continue
 contraindicate monitoring
d in patients during and
with after the
increased, infusion.
normal or any - Monitor
slightly electrolyte
decreased levels
serum
electrolyte
levels.

Generic Therapeutic 20mg -Inhibits -symptomatic Asthenia, - - Monitor patient

name: Class: Antacids IV q24 proton GERD Dizziness, Contraindicate for vital signs and
pump without headache, d in patients symptoms of
Omeprazol
activity by esophageal Abdominal hypertensive acute interstitial
e
Pharmacologic binding to lesions. pain, to drug or its nephritis
Class: hydrogen- constipation components.
potassium , diarrhea,
Brand Proton Pump -risk for fundic
adenosine -erosive flatulence, - monitor patients
name: Inhibitor gland polyps
triphosphat esophagitis nausea, for signs and
increases with
Prilosec ase located vomiting, symptoms of low
-duodenal long term use,
at secretory acid magnesium level,
ulcer. especially
surface of regurgitatio such as abnormal
beyond 1 year.
gastric n. HR or rhythm,
parietal palpitations,
-dyspepsia
cells to muscle spasms,
(indigestion).
suppress tremors, or
gastric acid seizures.
secretion

ORAL MEDICATION

DRUG CLASSIFICATIO DOSAG ACTION INDICATION ADVERSE CONTRAINDIC NURSING

N E REACTION CONSIDERATIONS
ATIONS

Generic Probiotic Food 1 tab Capable of Enhances Increase in Contraindicate Advice the patient
Name: Supplement PO OD preventing intestinal stomach gas d if the patient not to take this
Lactobacill Digestive intestinal ecology. or bloating is allergic to supplement with
us reuteri Health damage Improves any ingredient antibiotics; if
Protectis caused by digestion. in the product. antibiotics cannot
certain Helps If the patient be avoided, take
bacterial enhance has badly this supplement 2
Brand infections. natural damaged hours before meal
Name: resistance to intestines or 2 hours after
Flotera intestinal (e.g., meal.
infections. perforated, or
obstructed
intestines).

E- zinc Dietary 5 ml PO Known to This Nausea, Contraindicate - Do not

Mineral OD support the nutritional vomiting d in patients exceed the
immune supplement and hypersensitive recommen
system by is used for stomach to iodine. ded
contributin the following pain dosage.
g to the conditions: - Pay
developme As an adjunct attention
nt and in the to the
activation management route of
of immune of acute administra
cells. It diarrhea; To tion.
helps with help boost Elemental
the body's immune zinc can be
defense function; To given
against help support orally,
infections optimum topically,
and the physical or
healing of growth and intravenou
wounds. development sly, so
. select the
appropriat
e route for
the
patient's
condition.
- Discontinu
e drug if
hypersensi
 tivity
reactions
occur.
- Continuou
sly assess
the
patient's
condition,
especially
if zinc is
being used
to address
a specific
deficiency
or medical
condition.

XI. DISCHARGE PLANNING

Medication
Provide detailed guidance on the value of the of the following medication and nutrition program
as prescribed by the physician:
Flotera 1 tab to complete for 7 days.
 Probiotic Food Supplement Digestive Health
E- zinc syrup 5 ml
 Dietary mineral

1. Reinforce the importance of taking medication regimen for continuity of care and
prevention of the reoccurrence of the disease.
2. Be safe with medicines.
3. Take your medicines exactly as prescribed.
4. Call your doctor or nurse advice line if you think you are having a problem with your
medicine.
Follow-up Appointments:
Out- patient follow up.
  Follow- up check up after discharge Tuesday 10 AM as Dr. A, De Vera order.
Environment
Advise patient to maintain a clean and safe environment.

Treatment
Advise patient to comply medications as prescribed by the physician.

Health teachings
1. Advise patient to increase fluid intake to avoid dehydration
2. Advise to wash and cooked food’s properly before eating.

Observations
Advise patient to report any signs and symptoms of GI disturbances like nausea and vomiting.

Diet
1. Advise patient to avoid spicy foods because it may cause GI irritation
2. Advise patient to eat his meals on time.
3. Advice patient to avoid drinking cola or any beverages when stomach is empty.
4. Encourage patient to eat nutritious foods like vegetables, and fruits.

Spiritual
Encourage the client to seek physical, emotional, and mental strength from God. Advice patient
to maintain a good relationship with God, ask for guidance in everyday life and to strengthen his
spiritual life to have faith in God.