Gastritis Nursing Diagnosis & Care Plan


Gastritis Nursing Diagnosis and Care Plan

Contents 

Gastritis

Pathophysiology: 

Gastritis is the inflammation of the stomach lining due to the injury of the mucosal layer that serves as a protectant from its stomach acid. Exposure of the mucosa to stomach acid can lead to swelling, inflammation, and pain.

There are two types of gastritis:

  • Acute Gastritis – short-lived without any longterm damage 
  • Chronic Gastritis – longterm damage to the gastric mucosa 

Causes: 

  • Helicobacter pylori 
  • Long term use of NSAIDs
  • Aspirin 
  • Alcohol
  • Excessive amounts of caffeine
  • High stress levels 
  • Smoking 
  • Intolerance to spicy/citric food

Signs & Symptoms: 

  • Nausea and vomiting
  • Sudden gastric pain 
  • Gastric bleeding 
  • Heartburn 
  • Anorexia 

Diagnostic Tests:

  • Extraction of gastric mucosal sample(biopsy) via endoscopy. 

Nursing Diagnosis for Gastritis

  • Imbalanced Nutrition: Less Than Body Requirements 
  • Acute Pain 
  • Risk for Deficient Fluid Volume 
  • Knowledge Deficit 

Nursing Care Plans for Gastritis 

Imbalanced Nutrition: less than body requirements r/t insufficient absorption of nutrients 

Expected Outcome: The patient can absorb an adequate amount of nutrients

Assessment and Interventions:

Obtain the patient’s weight and other body measurements. 

The admission weight serves as a baseline metric and helps guide interventions. 

Obtain information about the patient’s eating habits. 

Some food items can exacerbate the symptoms of gastritis. Acidic or citrus food items may worsen symptoms. 

Place the patient NPO (nothing by mouth) in case of vomiting. 

In the acute case of gastritis, gastric rest may be indicated. If the symptoms subside, the nurse may slowly introduce ice chips, and after that, clear liquids if tolerated.

Monitor lab values such as CBC, PTT, platelet count, and fibrinogen.

These values may provide information about possible bleeding.

Discourage the patient from consuming spicy foods, caffeine, and alcohol. 

Acidic food items, such as tomatoes, or citrus items, may worsen the patient’s condition and interfere with the treatment and the healing process. 

Anticipate total parenteral nutrition (TPN). 

Especially during flare-ups of gastritis, the patient might not be able to tolerate oral intake. 

Consult a dietitian if indicated. 

The patient might need an addition of supplements to compensate for insufficient nutrient intake. 

The patient might need an addition of supplements to compensate for insufficient nutrient intake. 

Administer medications as prescribed. Patients typically receive medications that coat the stomach lining and serve as a barrier. They also reduce gastric acid secretion. Such medications include H2- receptor antagonists known as famotidine (Pepcid) or nizatidine (Axid), or proton pump inhibitors, such as omeprazole (Prilosec) or pantoprazole (Protonix).

Encourage small, frequent meals rather than three full meals. 

The patient might tolerate frequent small portions better. 

Educate the patient about medications. 

Patients might be sent home with new medications. Knowledge about newly prescribed medication promotes patient safety. 

Acute Pain r/t inflammation of the gastric lining 

Expected Outcome: The patient verbalizes pain as being controlled at an acceptable level. 

Assessment and Interventions:

Assess the patient’s pain level at least every four hours. Use a pain assessment tool to assess pain. Note the characteristics of pain:

Onset
Quality
Severity
Location 
Duration

Detailed information about the patient’s pain levels allow for more targeted pain management. 

Assess for contributing factors that cause pain. 

Spicy food and large portion sizes might contribute to making the pain worse. Also, different medications such as NSAIDs, aspirin, or corticosteroids, might worsen gastritis. 

Teach other pain management techniques. 

Relaxation techniques might be beneficial since stress can contribute to the worsening of gastritis. 

Administer gastric medications as prescribed. 

The origin of the patient’s pain is due to gastritis. Medications that are indicated to treat gastritis may mitigate the inflammation process and, therefore, alleviate pain. 

Risk for Fluid Volume Deficit: Risk factors: Vomiting; Decreased intake 

Expected Outcome: The patient will have a stable fluid volume as evidenced by normal blood pressure, at least 30ml hourly urine output, and elastic skin turgor. 

Assessment and Interventions:

Assess for signs of dehydration. 

Vital signs, especially blood pressure, urine output, and skin turgor, provide information about the patient’s hydration status. 

Monitor how many times the patient vomits and note the amount of emesis each time. 

Frequent vomiting causes fluid loss and can lead to dehydration. 

Monitor the patient’s BP and HR. 

If intravascular volume decreases, the BP will drop, and the HR will increase to compensate and maintain cardiac output.

Monitor electrolytes closely. 

Frequent vomiting can cause a loss of electrolytes, especially potassium. 

Assess the patient’s skin turgor and mucus membranes. 

Non-elastic skin turgor and dry, cracked mucus membranes are signs of dehydration. 

Monitor urine output hourly and note the color. 

Urine output should be at least 30ml per hour. A decrease in urine output may be a sign of dehydration. Dark and amber urine can be signs of dehydration. 

Anticipate parenteral hydration measures. 

Often patients cannot take in oral fluids. Patients then receive fluids intravenously to replace lost fluid volume. 

Administer antiemetics as prescribed. 

Antiemetics will reduce the feeling of nausea and vomiting and, therefore, the risk of insufficient fluid volume. 

Provide oral care frequently. 

Often patients are unable to eat or drink, which can leave the mouth dry. 

Knowledge Deficit r/t unfamiliarity with the disease process

Expected Outcome: The patient will verbalize information about the causes, treatment, and prevention of gastritis. 

Assessment and Interventions:

Assess the patient’s knowledge about gastritis. 

This information provides a baseline for further educational content. The patient might not be aware of the disease process, the causes, and its treatment. 

Teach the patient not to take additional medication over the counter. 

Many people don’t know that two medications with different brand names may have the same active ingredients. That way, the patient might end up taking multiple doses of the same drug. 

Teach about appropriate eating intervals and the types of food in case of a flare-up.

The patient might not know that spicy food can cause gastritis. Things to avoid: spicy food, heavily seasoned food, acidic food, smoking, alcohol, NSAIDs. As mentioned earlier, small frequent,  and rather bland meals are advisable. 

Click Here for A Comprehensive Knowledge Deficit Care Plan

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References:

Ignatavicius, D., & Workman, M. (2016). Medical-surgical nursing (8th ed.). Elsevier.

Silvestri, L. (2014). Saunders comprehensive review for the NCLEX-RN examination. Elsevier/Saunders.

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