Podcast
Questions and Answers
A client with chronic gastritis related to pernicious anemia is most at risk for which complication?
A client with chronic gastritis related to pernicious anemia is most at risk for which complication?
- Increased risk of stomach cancer. (correct)
- Acute gastric bleeding.
- Gangrenous tissue development.
- Pyloric stenosis due to scarring.
Which instruction should a nurse prioritize when educating a client newly diagnosed with nonerosive gastritis?
Which instruction should a nurse prioritize when educating a client newly diagnosed with nonerosive gastritis?
- Adhere strictly to a bland diet for life.
- Undergo testing and treatment for _Helicobacter pylori_. (correct)
- Eliminate all caffeine intake immediately.
- Consume large meals to neutralize stomach acid.
A client with a history of heavy NSAID use is diagnosed with erosive gastritis. Which mechanism most likely contributed to this condition?
A client with a history of heavy NSAID use is diagnosed with erosive gastritis. Which mechanism most likely contributed to this condition?
- Increased production of intrinsic factor.
- Excessive secretion of gastric mucus.
- Inhibition of prostaglandin synthesis. (correct)
- Stimulation of parietal cell activity.
A client presents with hematemesis and reports prolonged NSAID use. Which type of gastritis is the client most likely experiencing?
A client presents with hematemesis and reports prolonged NSAID use. Which type of gastritis is the client most likely experiencing?
A client is diagnosed with gastritis following exposure to contaminated food. Which bacterial organisms are most likely the cause?
A client is diagnosed with gastritis following exposure to contaminated food. Which bacterial organisms are most likely the cause?
What physiological change can lead to anemia in clients with gastritis?
What physiological change can lead to anemia in clients with gastritis?
A client with gastritis reports increased abdominal pain after consuming spicy and fatty foods. What is the appropriate nursing recommendation?
A client with gastritis reports increased abdominal pain after consuming spicy and fatty foods. What is the appropriate nursing recommendation?
An older adult client is diagnosed with gastritis. Which age-related physiological change increases their risk for developing this condition?
An older adult client is diagnosed with gastritis. Which age-related physiological change increases their risk for developing this condition?
A client with chronic erosive gastritis is admitted. Which assessment finding would be most indicative of a potential complication?
A client with chronic erosive gastritis is admitted. Which assessment finding would be most indicative of a potential complication?
A nurse is caring for a client with severe acute gastritis experiencing continuous vomiting. Which acid-base imbalance is the client at risk for?
A nurse is caring for a client with severe acute gastritis experiencing continuous vomiting. Which acid-base imbalance is the client at risk for?
A client with a history of gastritis reports taking ibuprofen regularly for joint pain. The nurse should provide education addressing which potential risk?
A client with a history of gastritis reports taking ibuprofen regularly for joint pain. The nurse should provide education addressing which potential risk?
A nurse is preparing to insert a nasogastric (NG) tube for gastric lavage in a client with active gastric bleeding. What is the priority nursing action before initiating the lavage?
A nurse is preparing to insert a nasogastric (NG) tube for gastric lavage in a client with active gastric bleeding. What is the priority nursing action before initiating the lavage?
A client diagnosed with gastric outlet obstruction secondary to gastritis is likely to exhibit which primary symptom?
A client diagnosed with gastric outlet obstruction secondary to gastritis is likely to exhibit which primary symptom?
A nurse is monitoring a client with gastritis for signs of dehydration. Which assessment finding is the most reliable indicator of fluid volume deficit?
A nurse is monitoring a client with gastritis for signs of dehydration. Which assessment finding is the most reliable indicator of fluid volume deficit?
A client with chronic gastritis is receiving discharge instructions. Which statement indicates the need for further teaching?
A client with chronic gastritis is receiving discharge instructions. Which statement indicates the need for further teaching?
Which lifestyle modification is MOST beneficial for a client seeking to manage gastritis symptoms and promote healing of the gastric mucosa?
Which lifestyle modification is MOST beneficial for a client seeking to manage gastritis symptoms and promote healing of the gastric mucosa?
Which instruction regarding post-procedure care should a nurse prioritize when educating a client who has undergone an upper endoscopy?
Which instruction regarding post-procedure care should a nurse prioritize when educating a client who has undergone an upper endoscopy?
A client who has undergone an upper endoscopy reports a sore throat and is drowsy. Which finding should prompt the nurse to suspect a complication rather than expected post-procedure effects?
A client who has undergone an upper endoscopy reports a sore throat and is drowsy. Which finding should prompt the nurse to suspect a complication rather than expected post-procedure effects?
In planning care for a client with gastritis, which dietary modification should the nurse recommend to minimize gastric irritation?
In planning care for a client with gastritis, which dietary modification should the nurse recommend to minimize gastric irritation?
A nurse is teaching a client about managing gastritis. What manifestations should the nurse include as potential signs of gastric bleeding that require medical attention?
A nurse is teaching a client about managing gastritis. What manifestations should the nurse include as potential signs of gastric bleeding that require medical attention?
A client with gastritis is prescribed a histamine2 receptor antagonist. Which statement indicates the client understands how to correctly take the medication?
A client with gastritis is prescribed a histamine2 receptor antagonist. Which statement indicates the client understands how to correctly take the medication?
When teaching a client about antacids, which instruction is most important for the nurse to include to ensure the client's safety and the medication's effectiveness?
When teaching a client about antacids, which instruction is most important for the nurse to include to ensure the client's safety and the medication's effectiveness?
A client is prescribed a proton pump inhibitor (PPI) for long-term management of acid reflux. What potential adverse effect should the nurse educate the client to monitor for?
A client is prescribed a proton pump inhibitor (PPI) for long-term management of acid reflux. What potential adverse effect should the nurse educate the client to monitor for?
What is the primary action of sucralfate in treating gastrointestinal ulcers?
What is the primary action of sucralfate in treating gastrointestinal ulcers?
A client is prescribed a combination of antibiotics to eradicate H. pylori. Which instruction is most important for the nurse to emphasize to ensure effective treatment?
A client is prescribed a combination of antibiotics to eradicate H. pylori. Which instruction is most important for the nurse to emphasize to ensure effective treatment?
A client taking aluminum hydroxide for occasional heartburn reports persistent constipation. What is the most appropriate nursing intervention?
A client taking aluminum hydroxide for occasional heartburn reports persistent constipation. What is the most appropriate nursing intervention?
A client with a history of gastritis is prescribed famotidine. Which statement by the client indicates a need for further teaching regarding this medication?
A client with a history of gastritis is prescribed famotidine. Which statement by the client indicates a need for further teaching regarding this medication?
A client is diagnosed with H. pylori and prescribed clarithromycin, amoxicillin, and a proton pump inhibitor. Which statement best explains the purpose of this combination therapy?
A client is diagnosed with H. pylori and prescribed clarithromycin, amoxicillin, and a proton pump inhibitor. Which statement best explains the purpose of this combination therapy?
A nurse is educating a client with chronic gastritis about lifestyle modifications. Which recommendation is most appropriate for the client to implement immediately?
A nurse is educating a client with chronic gastritis about lifestyle modifications. Which recommendation is most appropriate for the client to implement immediately?
A client with a peptic ulcer is scheduled for a partial gastrectomy. What information should the nurse provide regarding this surgical intervention?
A client with a peptic ulcer is scheduled for a partial gastrectomy. What information should the nurse provide regarding this surgical intervention?
Before administering nizatidine intravenously, what action should the nurse take to minimize the risk of adverse effects?
Before administering nizatidine intravenously, what action should the nurse take to minimize the risk of adverse effects?
Flashcards
Gastritis
Gastritis
Inflammation of the stomach lining, acute or chronic, erosive or nonerosive.
Nonerosive Gastritis Cause
Nonerosive Gastritis Cause
Most often caused by Helicobacter pylori (H. pylori) infection.
Erosive Gastritis Cause
Erosive Gastritis Cause
Likely caused by NSAIDs, excessive alcohol, or radiation treatment.
Acute Gastritis
Acute Gastritis
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Chronic Gastritis
Chronic Gastritis
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Expected Findings of Gastritis
Expected Findings of Gastritis
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Risk Factors for Gastritis
Risk Factors for Gastritis
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Erosive Gastritis Signs
Erosive Gastritis Signs
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Gastric Bleeding
Gastric Bleeding
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Cause of Gastric Outlet Obstruction
Cause of Gastric Outlet Obstruction
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Electrolyte Imbalance in Gastritis
Electrolyte Imbalance in Gastritis
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Gastritis-related Dehydration
Gastritis-related Dehydration
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NSAIDs and Gastritis
NSAIDs and Gastritis
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Gastritis (Acute vs. Chronic)
Gastritis (Acute vs. Chronic)
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Nursing actions for Gastric Bleeding
Nursing actions for Gastric Bleeding
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Stool Occult Blood Test
Stool Occult Blood Test
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Urea Breath Test
Urea Breath Test
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Upper Endoscopy
Upper Endoscopy
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Histamine2 (H2) Antagonists
Histamine2 (H2) Antagonists
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Antacids
Antacids
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Proton Pump Inhibitors (PPIs)
Proton Pump Inhibitors (PPIs)
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Anti-ulcer/Mucosal Barriers
Anti-ulcer/Mucosal Barriers
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Antibiotics (for H. pylori)
Antibiotics (for H. pylori)
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Coffee-Ground Emesis
Coffee-Ground Emesis
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Black, Tarry Stools (Melena)
Black, Tarry Stools (Melena)
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Partial Gastrectomy
Partial Gastrectomy
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H.pylori Gastritis
H.pylori Gastritis
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IV fluids
IV fluids
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Nutritionist's Recommendation
Nutritionist's Recommendation
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Esomeprazole
Esomeprazole
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Study Notes
- Gastritis is the inflammation of the stomach lining, which can be erosive or nonerosive and either acute or chronic.
Types and Causes of Gastritis
- Nonerosive gastritis is often caused by Helicobacter pylori (H. pylori) infection and can be acute or chronic.
- Erosive gastritis is commonly associated with NSAIDs, alcohol use disorder, or recent radiation treatment.
- Acute gastritis has a sudden onset and short duration, and severe cases can lead to gastric bleeding; strong irritants can cause gangrenous tissue, perforation, and scarring, potentially leading to pyloric stenosis.
- Chronic gastritis can be linked to autoimmune diseases like pernicious anemia, as well as H. pylori infection.
- Extensive damage to the gastric mucosal wall can lead to erosive gastritis (peptic ulcers) and increase the risk of stomach cancer.
Health Promotion and Disease Prevention
- Reduce anxiety related to gastritis.
- Follow a prescribed diet.
- Reduce or eliminate alcohol use.
- Monitor for indications of GI bleeding.
- Adhere to the prescribed medication regimen.
- Eat small, frequent meals, avoiding irritating foods and beverages.
- Report constipation, nausea, vomiting, or bloody stools.
- Stop smoking.
Risk Factors
- Family history of H. pylori infection or gastritis
- Prolonged use of NSAIDs or corticosteroids
- Excessive alcohol use
- Bile reflux disease
- Advanced age
- Radiation or chemotherapy
- Smoking
- Caffeine intake
- Excessive stress
- Exposure to contaminated food or water
- Bacterial infections (H. pylori, Salmonella, Staphylococci, or Escherichia coli)
Expected Findings
- Dyspepsia and general abdominal discomfort
- Hiccuping
- Upper abdominal pain or burning that may increase or decrease after eating
- Nausea and vomiting
- Reduced appetite and weight loss
- Abdominal bloating or distention
- Hematemesis (bloody emesis) and stools positive for occult blood
- Gastric hemorrhage
- Anorexia
- Anemia
- Intolerance of spicy and fatty foods
- Rapid onset of manifestations with acute gastritis
- Black, tarry stools and coffee-ground emesis with erosive gastritis
Laboratory Tests
- CBC to check for anemia:
- Females: Hgb less than 12 g/dL, RBC less than 4.2 cells/mcL
- Males: Hgb less than 14 g/dL, RBC less than 4.7 cells/mcL
- Blood and stool antibody/antigen tests for H. pylori
- Stool specimen to test for occult blood
- Urea breath test to measure H. pylori
Upper Endoscopy
- Education:
- NPO status after midnight before the procedure
- Arrange for transportation after the procedure
- Throat soreness is common post-procedure
- Monitor for chest or abdominal pain, fever, nausea, vomiting, and abdominal distention (indications of perforation)
Nursing Care
- Monitor fluid intake and urine output.
- Administer IV fluids as prescribed.
- Monitor electrolytes.
- Help identify trigger foods.
- Provide small, frequent meals and encourage slow eating.
- Advise avoiding alcohol, caffeine, and irritating foods.
- Assist in identifying ways to reduce stress.
- Monitor for gastric bleeding (coffee-ground emesis, black, tarry stools) and anemia (tachycardia, hypotension, fatigue, shortness of breath, pallor, lightheadedness, chest pain).
Medications
- Histamine2 antagonists: Decreases gastric acid output by blocking gastric histamine2 receptors:
- Nizatidine
- Famotidine
- Cimetidine
- Administer 1 hr before or after antacids.
- Monitor for neutropenia.
- Dilute and administer slowly IV to prevent bradycardia.
- Client education: Avoid smoking and alcohol, take oral dose with meals, take famotidine 1 hr before meals or at bedtime, wait 1 hr before or after taking antacids, and monitor for GI bleeding.
- Antacids: Increase gastric pH, neutralize pepsin, and improve mucosal protection:
- Aluminum hydroxide
- Magnesium hydroxide with aluminum hydroxide
- Do not give to clients who have acute kidney injury or chronic kidney failure.
- Monitor for aluminum toxicity and constipation with aluminum antacids, and for diarrhea or hypermagnesemia with magnesium antacids. Client education: Take on an empty stomach and wait 2 hr before taking other medications.
- Proton pump inhibitors: Reduce gastric acid by blocking acid production:
- Omeprazole
- Lansoprazole
- Rabeprazole sodium
- Pantoprazole
- Esomeprazole
- Can cause nausea, vomiting, and abdominal pain.
- Client education: Take esomeprazole 60 min before eating, do not crush or chew enteric-coated or sustained-release medications, effects may take up to 4 days, and take medication with or without food as instructed.
- Anti-ulcer/mucosal barriers: Inhibit acid and form a protective coating over mucosa:
- Sucralfate
- Administer 30 min before or after antacids.
- Client education: Take on an empty stomach, avoid smoking and alcohol, and continue medication even if manifestations subside.
- Antibiotics: Eliminate H. pylori infection:
- Clarithromycin
- Amoxicillin
- Tetracycline
- Metronidazole
- Monitor for increased abdominal pain and diarrhea.
- Monitor electrolytes and hydration.
- Use cautiously in clients who have kidney or hepatic impairment.
- Client education: Complete the prescribed dosage and notify the provider of persistent diarrhea.
Therapeutic Procedures
- Partial gastrectomy: Removal of the affected portion of the stomach, prescribed for ulcerations or significant bleeding when nonsurgical interventions are ineffective
Complications
- Gastric bleeding:
- Causes: Severe acute gastritis or chronic erosive gastritis
- Nursing Actions:
- Monitor vital signs and airway.
- Provide fluid replacement and blood products.
- Monitor CBC and clotting factors.
- Insert an NG tube for gastric lavage (confirm placement before instillation).
- Monitor NG tube for blood and prevent gastric dilation.
- Client education: Monitor for slow gastric bleeding (coffee-ground emesis; black, tarry stools) and seek immediate attention for severe pain or vomiting blood; adhere to medication regimen.
- Gastric outlet obstruction: - Cause: Severe acute gastritis that extends to the stomach muscle - Nursing Actions: - Monitor fluids and electrolytes. - Replace fluids and electrolytes; monitor I&O. - Insert an NG tube to empty stomach contents. - Prepare for a diagnostic endoscopy. - Client education: Seek medical attention for continuous vomiting, bloating, and nausea.
- Dehydration:
- Cause: Loss of fluid due to vomiting or diarrhea
- Nursing Actions:
- Monitor fluid intake and urine output.
- Provide IV fluids.
- Monitor electrolytes.
- Client education: Contact a provider for vomiting and diarrhea.
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Description
Gastritis involves stomach lining inflammation, either erosive or nonerosive, acute or chronic. Causes include H. pylori, NSAIDs, and alcohol. Prevention focuses on reducing anxiety, diet, limiting alcohol, and monitoring for bleeding.
