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Friday, August 24, 2012

Gastritis Nursing Concepts - Assessment

Assessments were conducted in patients with gastritis include:
  1. Activity / Rest
    • Signs: tachycardia, tachypnea / hyperventilation (in response to activity)
    • Symptoms: weakness, fatigue

  2. Circulation
    • Symptoms:
      • hypotension (including postural)
      • tachycardia, dysrhythmias (hypovolemia / hypoxemia)
      • weakness / weak peripheral pulses
        capillary refill underlayer / slowly (vasoconstriction)
      • skin color: pale, cyanosis (depending on the amount of blood loss)
      • weakness of skin / mucous membranes = sweating (shows status of shock, acute pain, psychological responses)

  3. Ego integrity
    • Signs: signs of anxiety, such as: anxiety, pallor, sweating, attention narrows, shaking, trembling voice.
    • Symptoms: acute or chronic stress factors (financial, labor relations), feeling helpless.

  4. Elimination
    • Signs:
      • Abdominal tenderness, distention
      • Bowel sounds: often hyperactive during bleeding, hypoactive after bleeding.
      • Stool Characteristics : diarrhea, blood dark, brownish or sometimes bright red, frothy, foul smell (steatorrhoea). Constipation can occur (changes in diet, use of antacids).
      • Urine output: decreased, concentrated.

    • Symptoms: a history of previous hospitalization for gastro intestinal bleeding or GI related problems, eg wound peptic / gastric, gastritis, gastric surgery, gastric irradiation area. Changes in bowel habit / characteristic stool.

  5. Food / fluid
    • Symptoms:
      • Vomiting: color: dark coffee or bright red, with or without blood clots.
      • Dry mucous membranes, decreased mucous production, poor skin turgor (chronic bleeding).

    • Symptoms:
      • Anorexia, nausea, vomiting (vomiting which extends suspected pyloric obstruction in relation to the outside of the duodenal injury).
      • Problems swallowing: hiccup
      • Heartburn, belching sour smell, nausea / vomiting

  6. Neurosensory
    • Symptoms:
      • Feeling beat, dizziness / light headaches, weakness.
      • Mental status: level of consciousness can be disturbed, ranges from slightly inclined sleeping, disorientation / confusion, fainting and coma (depending on the volume of circulation / oxygenation).

  7. Pain / Leisure
    • Signs: wrinkled face, be careful in the area of ​​pain, pallor, sweating, narrowed attention.
    • Symptoms: pain, described as sharp, shallow, burning, pain, sudden severe pain can be accompanied by perforation. Sense of discomfort / distress faint after eating a lot and lost a meal (acute gastritis). Pain epigastrum left till the middle / back or spreading to occur 1-2 hours after eating and lost with antacids (gastric ulcer). Pain epigastrum left until / or spread to the back occurred about 4 hours after eating when the stomach is empty and relieved by food or antacids (duodenal ulcer). There was no pain (esofegeal varices or gastritis).
      Trigger factors: food, cigarettes, alcohol, use of certain drugs (salicylates, reserpine, antibiotics, ibuprofen), psychological stressors.

  8. Security
    • Signs: an increase in temperature, spider angioma, palmar erythema (indicating cirrhosis / portal hypertension)
    • Symptoms: allergies to medications / sensitive eg ASA

  9. Counseling / Learning
    • Symptoms: the use of prescription / OTC containing ASA, alcohol, steroids. NSAIDs cause GI bleeding. Complaints can be accepted at this time due to (eg anemia) or diagnoses unrelated (eg, head trauma), intestinal flu, or episodes of severe vomiting. Long health problems eg cirrhosis, alcoholism, hepatitis, eating disorders (Doengoes, 1999, p: 455).

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