Acute

Gastritis
 PRESENTED BY:
GROUP 3 & 4
Group 3 Group 4

Hugo Angie L. Jeshel Tubil

Cataytay Seth Daphne Lampaso Krezialyn
Nano Godffrey M. Jalali Anna
Duluthalias Diltha Ongcoy Honey
Tamin Fershia Ferrater Ann Trisha
Alabang Jenarmae Abadiano Maxine
Salacut Angela
Bation Nika Joy
Dupol Claire
Timtim Richamae Belocura Danica
Ansog Chrish Mucsan Haya
Lopez France Quezon Michaella
Nice Milky Amistad Alrets
Paragoso Christelyn
 INTRODUCTION:
 Acute gastritis refers to a sudden onset of inflammation of the stomach lining, also known
as the gastric mucosa. This lining protects the stomach from the strong stomach acid that
digests food. When something damages or weakens this protective lining, the mucosa
becomes inflamed, causing gastritis.
 In contrast, chronic gastritis refers to long-lasting inflammation of the gastric mucosa.
 If the mucosal damage is severe enough, acute gastritis can progress to erosive gastritis,
which consists of shallow lesions of the stomach lining (i.e., gastric erosions), painful
ulcerations or sores, and small areas of bleeding within the mucosa.
 The most common bacteria can cause gastritis is called Helicobacter pylori, a type of
bacteria can infect the stomach its often cause peptic ulcer.
 EPIDEMIOLOGY:
 In acute gastritis, the prevalence of eosinophilic gastritis is approximately 6.3 per 100,000
individuals worldwide.
 The incidence of the new cases of Helicobacter pylori infection each year ranges from 3000 to
10,000 per 100,000 individuals in developing countries.
 It has been observed that with advancing age, the incidence of Helicobacter pylori infection
increases.
 In united states, 20% of adolescents are infected with Helicobacter pylori when compared to
90% by 5 years of age in developing countries. In addition, Helicobacter pylori infection
associated gastritis is more common in African Americans (54%), Hispanics (52%), and the
elderly compared to Whites (21%).
 In acute gastritis, females are usually more affected than men.
 ETIOLOGY:

Gastritis is an inflammation of the stomach lining.

Weaknesses or injury to the mucus-lined barrier that protects the
stomach wall allows digestive juices to damage and inflame the
stomach lining.
A number of diseases and conditions can increase the risk of gastritis,
including inflammatory conditions, such as Crohn's disease (a type of
inflammatory bowel disease)
RISK FACTORS:
 Bacterial infections such as Helicobacter pylo
 Long term use of nonsteroidal anti-inflammato
drugs (NSAIDs) and corticosteroids.
 Excessive Alcohol consumption
 High stress levels
 Smoking
 Intolerance to spicy/citric food
 Surgery
 Older age
 Other diseases and conditions.
 TWO TYPES OF ACUTE GASTRITIS
Erosive (reactive): Erosive gastritis causes both inflammation and erosion

(wearing away) of the stomach lining. This condition is also known as reactive

gastritis. Causes include alcohol, smoking, NSAIDs, corticosteroids, viral or

bacterial infections and stress from illnesses or injuries.

Non-erosive: Inflammation of the stomach lining without erosion or

compromising the stomach lining.

 MORTALITY AND MORBIDITY
Morbidity/mortality is dependent on the etiology of the
gastritis. Generally, most cases of gastritis are treatable
once the etiology is determined.
ANATOMY AND PHYSIOLOGY
 The STOMACH is a J-shaped organ that digests food. The stomach is an enlarged
segment of the digestive tract in the left superior part of the abdomen. It produces enzymes
(substances that create chemical reactions) and acids (digestive juices). This mix of enzymes
and digestive juices breaks down food so it can pass to the small intestine.
FUNCTIONS OF THE STOMACH
The stomach’s purpose is to digest food and sent it to the small intestine. It has three
functions:
1. Temporarily store food
2. Contract and relax to mix and break down food
3. Produce enzymes and other specialized cells to digest food
 The stomach is part of the gastrointestinal tract (GI). It is a long tube
that starts at the mouth. It runs to the anus, where stool leaves the body. The
GI tract is a key part of the digestive system.
HOW DOES THE STOMACH WORK WITH THE REST OF THE GI
TRACT?
Each part of your GI tract breaks down food and liquid and carries it
though your body. During the digestive process your body absorbs nutrients
and water. Then, you expel the waste products of digestion through the large
intestine.
 Food moves through your GI tract in a few steps such as:
 MOUTH - As you chew and swallow, your tongue pushes food into your throat. A small piece of tissue
 ESOPHAGUS - Food travels down a hallow tube called the esophagus. At the bottom, your esophageal
sphincter relaxes to let food pass to your stomach. (A sphincter is a ring – shaped muscle that tightens
and loosens.
 STOMACH - Your stomach creates digestive juices and breaks down food. It holds food until it is
ready to empty into your small intestine.
 SMALL IINTESTINE - Food mixes with the digestive juices, from your intestine, liver and pancreas,
your intestinal walls absorb nutrients and water from food and send waste products to the large
intestine.
 LARGE INTESTINE - Your large intestine turn waste product into stool. It pushes the stool into your
rectum.
 RECTUM - The rectum in the lower portion of your large intestine, it stores stool until you have a
bowel movement.
 The opening from the esophagus into the stomach is
called the cardiac opening because it is near the heart. The
region of the stomach around the cardiac opening is the cardiac
region. The most superior part of the stomach is called the
fundus (the bottom of a roundbottomed leather bottle). The
largest part of the stomach is the body, which turns to the right,
forming a greater curvature on the left, and a lesser curvature
on the right. The opening from the stomach into the small
intestine is the pyloric opening, which is surrounded by a
relatively thick ring of smooth muscle called the pyloric
sphincter. The region of the stomach near the pyloric opening
is the pyloric region.
 THE PARTS OF THE STOMACH’S ANATOMY
Human stomach can be divided into 5 anatomical regions:
 CARDIA - Is the top part of the stomach. It contains the cardiac sphincter, which prevents
food from traveling back to your esophagus.
 FUNDUS - A rounded section next to the cardia. It’s below your diaphragm (the dome-shaped
muscle that helps you breathe).
 BODY (CORPUS) - Is the largest section of your stomach. In the body, your stomach contracts
and begins to mix food.
 ANTRUM - Lies below the body. T holds food until the stomach is ready to sent it to your
small intestine.
 PYLORUS - Is the bottom part of the stomach. It includes the pyloric sphincter. This ring of
tissue controls when and how your stomach contents move to the small intestine.
 STRUCTURES OF THE STOMACH
Several layers of muscle and other tissues make up your stomach
 MUCOSA - Is the stomach’s inner lining. When the stomach is empty, the
mucosa has small ridges (rugae). When your stomach is full, the mucosa
expands, and the ridges flatten.
 SUBMUCOSA - Contains connective tissue, blood vessels lymph vessels (part of
the lymphatic system) and nerve cells. It covers and protects the mucosa.
 MUSCULARIS EXTERNA - Is the primary muscle of the stomach. It has three
layers that contract and relax to break down food.
 SEROSA - Is a layer of membrane that covers the stomach.
 The muscular layer of the stomach is different from other regions of the
digestive tract in that it consists of three layers: an outer longitudinal layer, a
middle circular layer, and an inner oblique layer. These muscular layers produce a
churning action in the stomach, important in the digestive process. The
submucosa and mucosa of the stomach are thrown into large folds called Rugae
when the stomach is empty. These folds allow the mucosa and submucosa to
stretch, and the folds disappear as the stomach is filled.
 The stomach is lined with simple columnar epithelium. The mucosal surface
forms numerous, tube-like gastric pits, which are the openings for the gastric glands. The
epithelial cells of the stomach can be divided into five groups. The first group consists of
surface mucous cells on the inner surface of the stomach and lining the gastric pits.
Those cells produce mucus, which coats and protects the stomach lining. The remaining
four cell types are in the gastric glands. They are:
1. mucous neck cells, which produce mucus;
2. parietal cells, which produce hydrochloric acid and intrinsic factor;
3. endocrine cells, which produce regulatory hormones and;
4. chief cells, which produce pepsinogen, a precursor of the protein-digesting enzyme
pepsin
 Secretions of the Stomach

The stomach functions primarily as a storage and mixing chamber for ingested food. As food enters
the stomach, it is mixed with stomach secretions to become a semifluid mixture called chyme.
Stomach secretions from the gastric glands include mucus, hydrochloric acid, pepsinogen,
intrinsic factor, and gastrin. A thick layer of mucus lubricates and protects the epithelial cells of
the stomach wall from the damaging effect of the acidic chyme and pepsin. Irritation of the stomach
mucosa stimulates the secretion of a greater volume of mucus. Hydrochloric acid produces pH of
about 2.0 in the stomach. Pepsinogen is converted by hydrochloric acid to the active enzyme
pepsin. Pepsin breaks covalent bonds of proteins to form smaller peptide chains. The low pH also
kills microorganisms. Intrinsic factor binds with vitamin B12 and makes it more readily absorbed
in the small intestine. Gastrin is a hormone that helps regulate stomach secretions.
 Regulation of Stomach Secretions

Approximately 2L of gastric secretions (gastric juice) is produced each day. Both

nervous and hormonal mechanisms regulate gastric secretions. The neural mechanisms
involve central nervous system (CNS) reflexes integrated within the medulla oblongata.
Higher brain centers can influence these reflexes. Local reflexes are integrated within the
enteric plexus in the wall of the digestive tract and do not involve the CNS. Hormones
produced by the stomach and intestine help regulate stomach secretions. Regulation
of stomach secretions can be divided into three phases: the cephalic, gastric, and
intestinal phases. The cephalic phase of stomach secretion is anticipatory and prepares
the stomach to receive food.
 In the cephalic phase, sensations of taste, the smell of food, stimulation of
tactile receptors during the process of chewing and swallowing, and pleasant
thoughts of food stimulate centers within the medulla oblongata that influence
gastric secretions. Action potentials are sent from the medulla oblongata that
influence gastric secretions. Action potentials are sent from the medulla oblongata
along parasympathetic axons within the vagus nerves to the stomach. Within the
stomach wall, the preganglionic neurons stimulate secretory activity in the cells of
the stomach mucosa, causing the release of mucus, hydrochloric acid, pepsinogen,
intrinsic factor, and gastrin. The gastrin enters the circulation and is carried back to
the stomach, where it stimulates additional secretory activity. The gastric phase is
the period of greatest gastric secretion.
The gastric phase is responsible for the
greatest volume of gastric secretions, and is
responsible for the greatest volume of the
vagus nerve) and local reflexes, resulting in
secretion of hydrochloric acid and pepsinogen
by the gastric glands. Peptides, produced by
the action of pepsin proteins, stimulate the
secretion of gastrin, which in turn stimulates
additional hydrochloric acid secretion. The
intestinal phase of gastric secretion primarily
inhibits gastric secretions.
 It is controlled by the entrance of acidic chyme into the duodenum. The
presence of chyme in the duodenum initiates both neural and hormonal
mechanisms. When the pH of the chyme entering the duodenum drops to 2.0 or
below, the inhibitory influence of the intestinal phase is greatest. The hormone
secretin, which inhibits gastric secretions, is released from the duodenum. Fatty
acids and certain other lipids in the duodenum initiate the release of two
hormones: cholecystokinin and gastric inhibitory peptide, which also inhibit
gastric secretions. Acidic chyme (pH<2.0) in the duodenum also inhibits CNS
stimulation and initiates local reflexes that inhibit gastric secretion.
 Movement in the Stomach
Two types of stomach movement occur: mixing waves and peristaltic waves. Both types of
movements result from smooth muscle contractions in the stomach wall. The contractions occur about every
20 seconds and proceed from the body of the stomach toward the pyloric sphincter. Relatively weak
contractions result in mixing waves, which thoroughly mix ingested food with stomach secretions to form
chyme. The more fluid part of the chyme is pushed to toward the pyloric sphincter, whereas the more solid
center moves back toward the body of the stomach. Stronger contractions result in peristaltic waves, which
force the chyme toward and through the pyloric sphincter. The pyloric sphincter usually remains closed
because of mild tonic contraction. Each peristaltic contraction is sufficiently strong to cause partial
relaxation of the pyloric sphincter and to pump a few milliliters of chyme through the pyloric opening and
into the duodenum. If the stomach empties too fast, the efficiency of digestion and absorption in the small
intestine is reduced. If the rate of emptying is too slow, however, the highly acidic contents of the stomach
may damage the stomach wall. Stomach emptying is regulated to prevent these two extremes.
PATIENT’S PROFILE AND HISTORY
Patient’s Name: Randy Pasil
Address: Tiogan, Leon Postigo Z.N
Gender: Male
Birthday: January 03, 1979
Age: 42 years old
Birthplace: Tiogan, Leon Postigo Z.N
Nationality: Filipino
Civil Status: Married
Religion: Roman Catholic
Educational Attainment: Highschool Level
Occupation: Farmer and a Construction worker
Allergies: No Allergies
 CASE SCENARIO:
Patient X is a Male resident of Tiogan, Leon Postigo, Zamboanga del Norte Who is 42
years old. He is happily married to his wife for about 17 years now. They were blessed with 4
children. He lives in a concrete house together with his family. The patient works as a construction
worker and a farmer as well. He belongs to the Roman Catholic denomination but does not usually
goes to church every Sunday with her family. 10 years ago, patient was infected with Urinary Tract
Infection. 3 days before the admission, as patient wake up and get ready for work he suddenly feel
tired, weak and dizzy. Along with this feelings, patient also experience abdominal pain and body
weakness. Her wife was alarmed by and so she took care of her husband and make him take alaxan
fr thinking that the sudden happening was just due to his husband tiredness from work. They think
that the pain along with other symptoms will just disappear so they did not bother to take him to
the hospital.
 3 days after, the pain is still present and so the wife decided to admit her
husband in Sindangan District Hospital with admitting diagnosis of acute gastritis.
V/S taken T- 36.5 P- 84 bpm BP- 110/75 mmHg RR- 19 taken on September 16,
2022. Patient was tested for URINALYSIS (performed on Sept 01, 2022) COLOR
is dark yellow, APPEARANCE slight natty, REACTION 0.6, SUGAR negative,
ALBUMIN (+), SP Gravity 1-010. MICROSCOPE FINDINGS (performed on
Sept 17, 2022) Pus Cells 3-7 RBC – 0-1 HEMATOLOGY (performed on Sept 17,
2022) WCC- 11-12 HEMOGLOBIN – 13.8 HEMATOCRIT- 41.0 Neutrophils
79.5 LYMPHOCYTES- 16.9 MONOCYTES- 3.6
• Reasons for Seeking Health care:
Patient complains with fever, epigastric pain, weakness and fatigue
• History of Present Health Concern
Patient is a Male resident of Tiogan, Leon Postigo, Zamboanga del Norte Who
is 42 years old. The patient works as a construction worker and a farmer as well. As
the patient wake up and get ready for work he suddenly feel tired, weak and dizzy.
Pain started three days before admission .He complains radiating pain in his
stomach. His wife was alarmed by and so she took care of her husband and make
him take alakan fr thinking that the sudden happening was just due to his husband
tiredness from work. Thinking that the pain along with other symptoms will just
disappear the patient was not taken to the hospital . For three consecutive days, the
pain is still present so the wife decided to admit her husband.
 Patient rates the pain on a scale of 7 out of 10. If he experience fever and body
weakness he takes OTC drug such as paracetamol and alaxan and he also uses verbal
medicine such as “lipana and himoghat”. Alcohol irritates his stomach and makes the
pain worse. Due to physical stress on work, patient stated that the pain is also triggered.
Along with this feelings, patient also experience abdominal pain and body weakness.
The patient stated that he becomes weak in prolonged activities. He can only perform
limited action due to his condition.
• Personal Health History:
Patient is a 42-year old resident of Tiogan, Leon Postigo Zamboanga del Norte
and is a farmer and a construction worker as well. He started his vices such as smoking
2 packs per day when he was 20 years up until now and drinking alcohol about 5 shots
of alcoholic beverages trice a week. Patient does not have any allergies with food.
GORDON’S 11 FUNCTIONAL
HEALTH PATTERNS
Functional Health Pattern Before hospitalization During Hospitalization
Pt viewed health as a state in which he can perform his work daily Patient stated that he feels that he’s not healthy anymore due t
and with the absence of illness and disease, he considered himself his condition. He is not able to adjust immediately with the
as healthy human being. If he experience fever and body weakness changing environment from his usual life. He’s eager to listen to

Health Perception he takes OTC drug such as paracetamol and alaxan and he also health teaching in order to recover him easily. He comply all his
uses verbal medicine such as “lipana and himoghat”. Pt is fully medication and orders from healthcare.
immunized.

Pt eats 3x a day, he has no allergies in foods and drugs. He drinks He eat the food served in the
7-8 glasses of water everyday. He also dinks coffee in the morning. hospital. He drinks 3-5 glasses a day. His nails are long and dir
Nutritional Metabolic Pattern At the young age when he’s 15 he practice drinking alcohol and also his hair has scalp he doesn’t taken a bath for days becaus
smoke. of his condition in order to remove the dirt .

Pt usually voids 3-4 times a day, he defecates once a day. He Patient usually voids 3-4 times a day with a little amount of urin
doesn’t experience any problem in voiding and defecating. and at night he voids 3 times. He always wake up due to his UT
Elimination And he defecates once he is Constipated with blood

He states that he’s the breadwinner of the family, he do the heavy The patient stated that he becomes weak in prolonged activitie
work he also walks that serve as his exercise He can only perform limited action due to his condition. The
Activity and Exercise Pattern doctor says he Should avoid to get tired.

Patient is oriented to people, time And place responses verbally Patient having a difficulty of hearing sometimes he doesn’t
and Physically. His educational attainment is high school level, responses actively and he didn’t talk anymore when he feel
Cognitive Perceptual he’s able to read And write. bothered. But when The Pt. is having abdominal pain the Pt. ca
responded immediately.
 Self Perception The patient is able to express his Feelings about his condition, he’s The pt’s state he believed that admission will be
Contented seeing his family their Support, love and care. The things helpful to adjust Him in need and will alleviate the
That made him stressed were problems That caused by pressured to Occurrence of his condition
work

Role Relationship The patient plays the role of a father to his child and a husband to his wife Patient is well supported by his family. He receives a
Pattern They maintain a good communication There are no conflicts among them positive reinforcement and provided him comfort and
And share his idea when it comes to decision making. reassurance.

Coping stress The patient copes up with stress by Jamming with friends. When they The patient take a rest when tired. He’s able to accept
Have a problem in family they resolved It by means of talking to each situation by cooperating with the medical advices.
other

Sexual reproductive Patient got married at the age of 25 yrs. old. Currently, he has 4 children 3 The wife of the pt. claimed that they are sexually
Pattern males And 1 girl the patient is continuously Sexually active inactive due to the condition of his husband.

Values Belief Pattern Patient I religious they go to church every Sunday. Their religion is Roman Patient relationship with God remained unchanged that
Catholic even I they are in hospital didn’t forgot to pray.
REVIEW OF SYSTEM (ROS)
 AREA FINDINGS
Head The patient reports of having headache. No lumps and bumps of
patient’s head were present.
Eyes The patient reports of blurred vision. Not yet gone for an eye
examination.
Ears The patient reports ringing on the left side and has hearing problem.

Nose The patient reports of nosebleeding during his childhood. And no

other pain reported.
Mouth and Throat The patient has dry mouth and reports of loss of appetite.

Neck The patient denies pain on the neck.

Respiratory System The patient reports normal breathing. Uses two pillows at night, and
no complaints of cough.
Cardiovascular System The patient denies chest pain or pressure, and reports normal vital
signs.
 Breast and Axilla No pain and lumps were reported by the patient.
Gastrointestinal System The patient complaints of vomiting, loss of appetite, abdominal pain and
rectal bleeding.
Genitourinary System The patient reports pain during urination and the urine was dark yellow
in color. Complaints of getting up during night time and urinate for 3
times.
Reproductive System Patient denies penile pain, discharge or lesions or testicular lumps.

Musculoskeletal system Patient reports muscle weakness.

Endocrine System Patient reports that he have been usually tired, feels hungry and thirsty
more often than usual.

Hematologic System Patient denies any blood abnormalities and never had blood
transfusion.
Psychological Status Patient reports being depressed.
PHYSICAL ASSESSMENT
INTEGUMENTARY
Skin: The client’s skin is uniform in color, unblemished and no presence of any foul odor. He has a good skin turgid
and skin’s temperature is above normal limit 39.5 C
Hair: The hair of the client is thick and messy. There is presence of dandruff.
Nails: The client has a light brown nails. It is long and dirty.

HEAD
Head: The head of the client is rounded; normocephalic and symmetrical
Face: The face of the client appeared smooth but oily and has uniform consistency and with no pressure of nodules or
masses.
EYES AND VISION
Eyebrows: Hair is evenly distributed. The client’s eyebrows are symmetrical
Eyelashes: Eyelashes appeared to be equally distributed and curled slightly outward.
Eyelids: There were no presence of discharges, no discoloration and lids close symmetrically.
Eyes: The sclera appeared white. The pupils of the eyes are black and equal in size.
Ears and Hearing Ears: The auricles are symmetrical and has the same color with his facial skin. The auricles are
aligned with the outer canthus of eye.
NOSE AND SINUS:
Nose: The nose appeared symmetric, straight and uniform in color. There was no presence of discharge or
flaring.
Mouth: The lips of the client are dark and symmetric.
Teeth and Gums: Teeth are yellowish and gums are dark.
Neck: The neck muscles are equal in size. The client showed coordinated, smooth head movement with
no discomfort.

Thorax, Lungs, and Abdomen

Lungs and Chest: The chest wall is intact with no tenderness and masses.
Heart: There is no presence of heaves or lifts.
Abdomen: The abdomen of the client has an unblemished skin and is uniform in color.
Extremities: The extremities are symmetrical in size and length.
Bones: There were no presence of bone deformities, tenderness and swelling.
LABORATORY AND DIAGNOSTIC
TESTS
DATE AND LABORATORY/ RESULT NORMAL INTERPRETATION NURSING
TIME DIAGNOSTIC TEST FINDINGS RESPONSIBILITI
ES

Hemoglobin (gm/L) 13.8 Male- 13.5-18 Normal

9/16/2022
Female- 12.0-16.0

Hematocrit (L/L) 41.0 Male-41-52 Normal

Female- 36-42

White cell count 11.2 5.0-10.0 x 10g/L Slightly Elevated Instruct patient to
increase intake of
vitamin c and increase
fluid intake.
Administer antibiotic
as ordered
 Instruct patient to
Neutrophils 79.5% 60-70% High indicates bacterial increase intake of
infection vitamin c and increase
fluid intake.
Administer antibiotic as
ordered

Lymphocytes 16.9 20-30% Low level of lymphocytes Instruct patient to take

indicates high risk of infection administered Antibiotics to
treat underlying bacterial
infections

Monocyte 3.6 2-5% Normal

LABORATORY AND DIGNOSTIC
TEST
URINALYSIS
9-17-22 Color Dark Yellow Pale Yellow to Urine is Instruct the patient to
deep amber concentrated and increase fluid intake
a sign of low
urine volume

Appearance Slightly hazy Clear to slightly Normal

hazy

Reaction 6.0 4.6-8 Normal

Sugar Negative Negative Normal
Albumin + Negative Abnormal Instruct the patient to
avoid foods high in
sodium or salt and to eat
the right amounts and
types of protein
Lose weight (if
overweight) in a healthy
way
 Instruct the patient to
Sp. Gravity 1.010 1.015- Slightly low drink plain water and
1.025 avoid sodas and soft
drinks
Pus cells 3-7 4.5-8.0 Normal

RBC 0-1 hpf 0-4 hpf Normal

Epithelial cells few none Abnormal Instruct the patient to

increase fluid intake
Administer antibiotics
as ordered

Instruct the patient to

Bacteria few negative Abnormal increase fluid intake
Administer antibiotics
as ordered
NURSING CARE PLAN
NURSING DIAGNOSIS: Acute pain related to inflammation of gastric mucosa as evidenced by recurrent abdominal pain.

ASSESSMENT PLANNING NURSING INTERVENTION RATIONALE EVALUATION

Subjective: Independent: At the end of 5
hours shift of
Patient verbalized of At the end of 5 -Establish rapport -To facilitate cooperation as well as gain
rendering nursing
moderate pain with scale of 7/10. hours of shift of patient’s trust
-Note for the location, scale, intensity and care, the patient
rendering nursing
0-3= less pain onset of pain. -To determine the nursing care to be given relieved from pain.
care, patient will be
to the patient.
4-7=moderate pain able to relieve from -Maintain a calm and quite environment.
pain. -To minimize stimulus that could
8-10=severe pain -Take and record vital signs
aggravate the condition of the patient.
Objective: -Provide health teaching such as: a. Increase
-To note changes that can affect the
oral fluid intake
 Facial grimace patient’s condition.
 Restlessness b. Emphasized the importance of proper
-To promote optimum wellnes
V/S hygiene
T= 38C
P= 88bpm Dependent:
-To assure that the body receives accurate
R= 24cpm -To regulate IVF as ordered
amount of fluids and electrolytes
BP=110/70mmHg -To give due medications.
-To aid in the easy recovery.
-Instructed on home medications.
-To serve as a guide in doing self-
medication that promotes independence.
NURSING DIAGNOSIS: Constipation related to decreased dietary intake
ASSESSMENT PLANNING NURSING INTERVENTION RATIONALE EVALUATION
Subjective: Independent: After 8 hours of
nursing interventions, the
“Wala nako After 8 hours of nursing -Determine stool, color. consistency, -Assist in identifying causative or
patient was able to
kalibang sa mga interventions the patient frequency and amount. contributing factors and appropriate
established or return to
nilabay nga adlaw as will establish or return to interventions.
normal patterns of bowel
verbalized by the normal patterns of bowel
functioning.
patient. functioning. -Auscultate bowel sounds
-Bowel sounds are generally decreased in
constipation
Objective: -Encourage fluid intake of
2500-3000ml/day with cardiac tolerance
 Abdominal pain, -Assists in improving stool consistency
urgency, and
cramping -Decease gastric distress and abdominal
-Recommend avoiding gasforming foods
 Altered bowel distention
-Discuss use of stool softeners mild
sounds -Facilitates defecation when constipation is
stimulants bulk-forming
present. Laxatives or enemas as indicated.
V/S -Encouraged to eat high-fiber rich foods Monitor effectiveness
T= 37.1C - To enhance easy defecation
P= 88bpm Collaborative: -Fiber resists enzymatic digestion and
R= 18cpm absorbs liquids in its passage along the
-Consult with dietitian to provide well-
intestinal tract and thereby produces bulk,
BP=110/70mmHg balanced diet high in fiber and bulk
which acts as a stimulant to defecation.
NURSING DIAGNOSIS: Alteration in comfort relates to physical or emotional distress secondary to gastritis as evidenced by pain,
fatigue, and mental exhaustion
ASSESSMENT PLANNING NURSING INTERVENTION RATIONALE EVALUATION

Independent:
Objective: After 5 hours of nursing -Come up with variety of -These approaches After 5 hours of nursing
interventions the patient mindfulness techniques assist in diverting interventions the patient
-Feel tired, weak and dizzy
will verbalized a pain that may help to alleviate attention away from the verbalized a pain level of
level of less than of 3 on the discomfort of the current pain, worry, and less than of 3 on a pain scale
V/S a pain scale and show patient, such as the ones pressure toward more and showed how to employ
T= 37.1C how to employ coping enumerated below: enjoyable sensations. coping method in stressful
method in stressful situation.
P= 88bpm Imagery/visualization with
situation.
guidance
R= 18cpm
Exercising breathing
BP=110/70mmHg
techniques
Meditation
Therapeutic music

- Informing the patient

- Maintain a cheerful
on what to expect my
disposition when
alleviate worry and
socializing with the patient.
enhance comfort.
DRUG STUDY
 Drug Name & Indication Route and Mechanism of Action Side-Effects and Adverse
Classification Dosage Effects

Betahistine Treatment of 16 mg ÷ tab Betahistine has a very SE: Headache,occasional

dihydrochloride Meniere’s TID PRN for strong affinity as an drowsiness, nausea, indigestion.

Classification: syndrome, dizziness atagonist for histamine Hз

Histamine-like symptoms of receptors and a weak

AE: Mild gastric complaints such
antivertigo drug which may affinity as an agonist for
as vomiting, stomach pain and
include vertigo, histamine H1 receptors.
bloating
tinnitus, hearing Betahistine is thought to
loss and nausea. work by increasing the
blood flow around the inner
ear and prevents symptoms
from developing.
Omeprazole Used as an 40 mg It suppresses SE: Diarrhea from an Advise patient to

Classification: option to IVTT OD stomach acid Headaches,nausea and infection with avoid alcohol

Protonpump treat secretion by specific vomiting clostridium difficile and foods that

inhibitor duodenal inhibition of the h+ bacteria. may cause and

AE: Stomach pain and
ulcer,gastric and K+. In patient with increase in GI
constipation
ulcer and ATPase system known irritation.
reflux found at the hypersensivity to
esophagitis secretory surface of any component of
and gastric parietal cells. formulation.
Zollinger-
Ellison
syndrome,if
oral
treatment is
not effective.
Paracetamol May be given 500mg 1tab It produces SE: Paracetamol ( Amectan) is Educate patient on the safe use of
parentally for the q4 hrs PRN analgesia by raising contraindication for patient amectan containing products and
short-term the threshold of the Rash and Swelling known to have the risk of overdose.
Amcetan treatment of the pain center in the hypersensivity to the drug or
AE:
Classification: moderate pain, brain and by any of the ingredients.
particularly after obstructing impulses Low blood pressure and fast heartbeat
Analgesic / surgery and fever. at the pain
Antipryetic mediating
chemoreceptors. The
drug produces
antipyresis by an
action on the
hypothalamus; heat
dissipation is
increased as a result
of vasodilation and
increased peripheral
blood
flow.

Classification: Ciprofloxacin is only 500 mg Ciprofloxacin acts on SE: Ciprofloxacin is Monitor signs of allergic reaction
indicated in infection bacterial contraindicated in persons and anaphylaxis including
Cifroloxacin caused by susceptible Tab BD topoisomerase II Nausea, vomiting,stomach pain, with a history of pulmonary symptoms tightness in
bacteria. (DNA) and heartburn,diarrhea, vaginal itching/ or hypersensivity to the throat and chest.
topoisomerase IV. discharge, pale skin , unsual tiredness, ciprofloxacin or any of the
Quinolone Ciprofloxacin sleepiness quinolones.
Antibiotics targeting of the alpha AE:
subunits of DNA
gyrase prevents it Rash, hives, hoarseness, trouble or
from supercoiling the swallowing, or any swelling of your
bacterial DNA which hands, face , mouth, or throat
prevent DNA
replication.
Rebamipide It is 100 mg helps in replacement • Skin: Rash, pruritus, contraindicated Monitor patient
Classification: indicated Orally 3x of lost tissue by drug-eruption-like in patients with response to the
anti-gastritis during a day increasing the eczema known history of drug (relief of GI
and anti-gastric bleeding, expression of • Gastrointestinal: Cons drug symptoms
erosion, epidermal growth tipation, bloating, hypersensitivity. caused by
redness, and factor (EGF) and EGF diarrhea, nausea, hyperacidity).
edema (all receptors. vomitting,
signs of stomach upset, Monitor the
gastric heartburn, abdominal effectiveness of
mucosal pain, belching, taste comfort
lesions) that abnormality measures and
occur in • Others: Cold sweat, compliance with
acute difficulty breathing the regimen.
gastritis and
acute
exacerbation
of chronic
gastritis.
Medical Management
 Treatment of gastritis depends on the specific cause. Acute gastritis caused by
nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of
those substances.

Medications used to treat gastritis include:

Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your
doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin XL)
and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the
bacterium. Be sure to take the full antibiotic prescription, usually for 7 to 14 days, along
with medication to block acid production. Once treated, your doctor will retest you for
H. pylori to be sure it has been destroyed.

Medications that block acid production and promote healing. Proton pump
inhibitors reduce acid by blocking the action of the parts of cells that produce acid.
These drugs include the prescription and over the counter medications omeprazole
(Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix) and
others.
Long-term use of proton pump inhibitors, particularly at high doses, may increase
your risk og hip, wrist and spine fractures. Ask your doctor whether a calcium
supplement may reduce this risk.

Medications to reduce acid production. Acid blockers- also called histamine

(H-2) blockers – reduce the amount of acid released into your digestive tract,
which relieves gastritis pain and encourages healing. Available by prescription or
over the counter, acid blockers include famotidine (Pepcid), cimetidine (Tagamet
HB) and nizatidine (Axid AR).

Medications that neutralize stomach acid. Your doctor may include an antacid
in your drug regimen. Antacids neutralize existing stomach acid and can provide
rapid pain relief. Side effects can include constipation or diarrhea, depending on
the main ingredients. These help with immediate symptom relief but are generally
not use as a primary treatment. Proton pump inhibitors and acid blockers are
more effective and have fewer side effects.
Health Education Plan
 Learning Content Outline Method of Time Instructio Expected
Objective Instruction n
Resource
s
After 30 Minutes of After 30 minutes.
health teaching the Of health
patient will be able to Teaching patient
will able to:
- Acute Gastritis is a Understand what
1)Enumerate the sudden inflammation
DISCUSSTION 10 VISUAL- is acute gastritis
Treatment of Acute or swelling in the lining
Gastritis of the stomach. Minutes AID and aware on
how will it be
Taking ”HISTAMINE prevented.
BLOCKERS
“Medication ‘helps to
reduce the amount of
acid released in your
GI tract.
- Eating light meals
and must reduce
alcohol consumption
2)IDENTIFY THE - The common sign
SIGNS AND and symptoms of
A.G. are the
SYNTOMS OF following
GASTRITIS
- STOMACH
DISCOMFORED
PAIN
- Loss of appetite
- NAUSEA
- Vomiting
- Feeling fullness
DISCUSSTION 10 VISUAL-
in Abdomen after
Minutes AID
eating
3)HEALTHY DAILLY - Eating light meals
EATING PLAN throughout the day
and avoiding hot and
spicy food is advice
sable among patients
with A.G.
- Acidic food such as
tomatoes and some
fruits, including fatty
foods and fried DISCUSSTION 10 CHART
delicacies as well as Minutes
alcohol must be
avoid to reduce the
production of acidity
4)ENUMERATE FOR - Adopt a healthy eating
THE GUIDELINE FOR patter at the appropriate
THE GENERAL calorie level with a
POPULATION variety of nutrients
among all foods groups
that doesn’t add more 10 VISUAL-
acidity in the stomach Minutes AID Enumerate the
DISCUSSTION dietary guideline
- Maintain body weight for recommended
in a healthy rage and general population
encourage not to eat
citrus fruits.

5)VERBALIZE WHEN TO - Call your healthcare

SEEK MEDICAL CARE provider right away if you
have any symptoms of
A.G.
- Ask for help if you are Patient verbalize
having problem in
DISCUSSTION 5 Minutes CHART when to call healthy
indigestion and pain in care provider for
the upper area of your help
abdomen.
PROGNOSIS AND RECOMMENDATIONS
 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. Most people who have acute gastritis are
asymptomatic or only exhibit minor symptoms including nausea, vomiting, belching,
nausea, and loss of appetite. Due to gastric erosions and mucosal ulcerations, some
people may develop upper gastrointestinal bleeding in more severe circumstances. This
can then result in melena, which are foul-smelling, black feces brought on by the
digestive process of blood in the gastrointestinal tract, and hematemesis, or the vomiting
of blood. The goal of acute gastritis treatment is to reduce the inflammation's underlying
causes. When the lining of your stomach is compromised or injured, acute gastritis
develops. This enables stomach irritation brought on by digestive acids. Your stomach
lining can be harmed by a variety of factors. The following conditions are listed as acute
gastritis causes by the National Institutes of Health (NIH): medications such as
nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. These are the most
common causes of acute gastritis. bacterial infections such as Helicobacter pylori.
Between 20 and 50 percent of acute gastritis cases in the United States are caused by H.
pylori. excessive alcohol consumption.
Other, less common causes include: viral infections, extreme stress,
autoimmune disorders, which may cause the immune system to attack the
stomach lining digestive diseases and disorders such as Crohn’s, bile
reflux, cocaine use ingesting corrosive substances such as poison, surgery,
kidney failure, being on a breathing machine (NIH, 2011). The prevalence
of gastritis in the study area was 78.8%. Specifically, 48.9% and 29.9% had
acute and chronic gastritis, respectively. The study found that low income
and taking medicinal drugs was slightly significantly contributed to higher
gastritis status; however, being younger age was slightly significantly
contributed to lower gastritis status. Furthermore, the results indicated that
eating spiced foods (Adjusted Odds Ratio (AOR) = 1.508; 95% CI: 1.046,
2.174), lack of physical exercise regularly (AOR = 1.780; 95% CI: 1.001,
3.168), stress (AOR = 2.168; 95% CI: 1.379, 3.4066), and substance use
(AOR = 1.478; 95% CI: 1.093, 1.999) were significantly contributed to
higher gastritis status.
 The group had successfully made this case study through our unity
and effort and through the help of our dear clinical instructors. Our group
would like to recommend this work to the patients who have acute gastritis
about the: Effective measures for the primary prevention of gastritis that
includes: Avoiding long term or extended use of medications such as
NSAIDs (e.g. aspirin, naproxen, ibuprofen). Abstaining from excessive
alcohol consumption is recommended Smoking cessation. Decreasing
consumption of excessive amounts of caffeine or acidic beverages. Avoiding
spicy foods. Abstaining from illicit drugs such as cocaine. Avoiding or
reducing stress which may trigger excessive gastric acid secretion
Inculcating healthy eating habits, exercising regularly and maintaining
healthy body weight may help in avoiding gastritis.
Effective measures for primary prevention of the H. pylori
infection include:

• Hand washing (antibacterial soaps).

• Avoid contaminated food and water
• Maintain proper hygiene (hand sanitizers, antiseptic washes)
• Avoid close contact with infected family members ( e.g.,
kissing, by sharing eating utensils and drinking glasses)

H. pylori eradication is the treatment of choice for patients

with peptic ulcer disease and low-grade MALT lymphoma. Test
and treat strategy is recommended for to prevent peptic ulcer
disease in NSAID users and for patients with non-ulcer
dyspepsia.
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