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Sunday, August 26, 2012

Nursing Diagnosis Knowledge Deficit - Gestational Diabetes Mellitus

Nursing Diagnosis for Gestational Diabetes Mellitus : Knowledge Deficit : the diabetic condition, prognosis and the need for action.

Expected outcomes:
  1. Participate in the management of diabetes during pregnancy.
  2. Expressing an understanding of the procedures, laboratory tests and activities involving the control of diabetes.
  3. Demonstrate proficiency own monitor and insulin administration.

Intervention:

1. Assess knowledge of the processes and actions, including the relationship of the disease with diet, exercise, stress and insulin requirements.
Rational: Gestational Diabetes Mellitus risk of glucose uptake in cells that are not effective, the use of fats and proteins for energy excessively and cellular dehydration when water flows out of the cell by hypertonic glucose concentration in serum.

2. Provide information about the workings and the adverse effects of insulin and review the reasons for avoiding oral hypoglycemic drugs.
Rationale: Metabolic Changes in prenatal causes insulin needs change. First trimester insulin requirement is low but becomes two times and four times during the second and third trimester. Although insulin does not cross the placenta, oral hypoglycemic agents and potential harm to the fetus.

3. Describe normal weight gain.
Rational: calorie restriction caused ketonemia can cause fetal damage and inhibit optimal protein utilization.

4. Provide information about the need for a light training program.
Rationale: Exercise after meals can help prevent hypoglycemia and stabilize glucose irregularities, unless there is excess glucose, which exercise can improve ketoacidosis.

5. Provide information on the effects of pregnancy on diabetic conditions and future expectations.
Rationale: Increased knowledge can reduce fear, increase cooperation, and help reduce fetal complications.

6. Discuss recognize the signs of infection.
Rationale: It is important to seek medical attention early to avoid complications.

7. Encourage maintained home assessment on levels of serum glucose, insulin dose, diet and exercise.
Rationale: When reviewed by the practitioner care giver, the diary can be helpful for evaluation and treatment.

8. Aids to the study of glucose, are instructed to accompany it with milk 8 oz and check the glucose level in 15 minutes.
Rationale: The symptoms of hypoglycemia such as diaphoresis, tingling sensations and palpitations with glucose levels below 70 mg / in need of immediate action. The use of glucagon as a combination of milk may increase serum glucose levels without the risk of turning into hyperglycemia.
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Definition, Causes, Symptoms and Pathophysiology of Diverticular Disease

Nursing Care Plan for Diverticular DiseaseDefinition of Diverticular Disease

Diverticular disease is a common condition that affects the digestive system. It occurs when a small bulge or pouch (usually called diverticula) form in the colon wall. Diverticular disease is a common disease suffered, but most people do not experience any symptoms. The disease is becoming increasingly common in the current one is getting old. Diverticular disease occurs when a small area of the intestinal lining to weaken and bulge or pouch formed over the years. This is known as diverticular. Diverticular mostly found at the bottom of the large intestine in some people even found at the bottom of the bowels.

Causes of Diverticular Disease

Low-fiber diet, particularly the lack of fruits and vegetables, and red meat and high fat is the main cause of diverticular disease. This is rare in vegetarians and in some parts of the world where high fiber intake. Field commonly affected bowel diverticular disease.

Symptoms of Diverticular Disease

The symptoms of diverticular disease are usually felt in the lower left abdomen. The pain can occur after eating. It may disappear after flatulence or bowel movements. Other symptoms include:
  • Bloating
  • Constipation
  • Diarrhea
  • Persistent abdominal pain and getting worse, starting from below the navel and then moves to the left side down (though it can appear on the right for Asians due to genetic differences)
  • Fever (high temperature)
  • Frequent urination and sometimes painful
  • Change in bowel habits
  • Nausea and vomiting
The pain and disturbed bowel function is lost and back again from time to time and found blood in the stool. This is due to the weakening of blood vessels in the diverticular. If the blood comes from the gut most often seen as blood in the stool. The blood that comes from a higher place in the digestive system, such as the abdomen, dirt tends to be black and live. Sometimes scar tissue forms around an inflamed diverticula, and this can lead to a narrowing or blockage of the intestine. If the diverticula widespread, they can cause the lining of the abdomen (peritoneum) becomes inflamed and swollen. This is called peritonitis.

Pathophysiology of Diverticular Disease

Diverticular disease is a term used to describe diverticulitis and diverticulosis. Diverticulosis refers to the yolk outside the intestinal mucosa of non-inflammatory. Divertikulisis is beyond yolk stuck or herniation of the intestinal mucosa muscle wrapping around the colon, usually the sigmoid colon. Diverticular disease is common in men and women and at the age of 45 years, and obese people. This case occurs in approximately one third of the population over 60 years old. Low-fiber diet linked to the occurrence of diverticular, because this diet lowers bulk in the stool and predispose to constipation. In the presence of muscle weakness in the colon, can improve intramular pressures that can cause diverticular formation. The cause of diverticulosis include intestinal atrophy or muscle weakness, increased intramural pressure, obesity, and chronic constipation. Diverticulosis occurs when food is not digested clog diverticulum, causing decreased blood supply to the area and trigger intestinal bacterial invasion into the diverticulum. Diverticula have a narrow intestinal lumen as a bottle neck. The weak point in the intestinal muscles there in the branches of blood vessels that penetrate the colonic wall. The weak point is creating intestinal protrusion area when there is an increase in intraluminal pressure. Diverticula often occur in the sigmoid colon due to high pressure in this area is needed to remove feces into the rectum. Diverticulitis may be acute or chronic. If not infected diverticula (diverticulosis), these lesions cause little problem. However, if the fecalith not watered and flowing of the diverticulum, fecalith can become trapped and cause irritation and inflammation (diverticulitis). Area inflamed clogged blood and can bleed. Diverticulitis can lead to perforation if the masses are trapped in the diverticulum erode the intestinal wall. Chronic Diverticulitis can lead to increased scarring and narrowing of the lumen of the intestine ultimately, potentially causing obstruction. Meckel's diverticulum is intestinal yolk formation, investigation of embryonic development found in the ilium of 10 cm from the cecum. Yolk is lined by gastric mucosa or pancreatic tissue may contain. Mucosal lining of the stomach sometimes cause ulceration and bleeding or perforation. In addition, the inflamed diverticula can and attached to the umbilicus by fibrous bands and became the focus of the selection of the intestine that causes obstruction. Action against the state include the diverticulum surgery.
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Nursing Diagnosis for Suicide

Nursing Care Plan for Suicide


Definition

Suicide is any activity which, if not prevented can lead to death (Gail w. Stuart, Mental Nursing, 2007).

Suicide is the idea, signaling and suicide attempts, which often accompany depressive disorders and often occurs in adolescents (Harold Kaplan, Synopsis of Psychiatry, 1997).


Etiology

Is universal: due to the inability of individuals to solve problems

Divided into:

1. Genetic factors (based on research):
  • 1.5 to 3 times more suicidal behavior occurs in individuals who are first-degree relatives of people with mood disorders / depression / who had made ​​a suicide attempt.
  • More common in monozygotic twins than in dizygotic twins.
2. Biological factors:
Usually due to chronic diseases / medical conditions, for example:
  • Stroke
  • Disorders / cognitive impairment (dementia)
  • Diabetes
  • Coronary artery disease
  • Cancer
  • HIV / AIDS
  • etc.
3. Psychosocial and Environmental Factors:
  • Theories Psychoanalytic / psychodynamic: Theory Freud, namely that the lost object associated with aggression and anger, negative feelings about themselves, and the last depression.
  • Cognitive Behavioral Theory: Theory Beck, the growing negative cognitive patterns, low self-regard
  • Environmental stressors: loss of family, deception, lack of social support systems.

Suicidal behavior is divided into 3 categories:

1. Suicide threats: there are verbal and non-verbal warnings, threats showed ambivalence someone to death, if not get a response it will be interpreted as support for the suicide.

2. Suicide attempts: all actions by individuals against self can lead to death if not prevented.

3. Suicide: going after missed or ignored warning signs, people who commit suicide do not even really want to die may be dead.


Symptom
  • Despair
  • Self-blame
  • Feelings of failure and worthlessness
  • Oppression
  • Insomnia is settled
  • Weight loss
  • Speaking of slow, fatigue
  • Pulling away from the social environment
  • Suicidal thoughts and plans

Assessment of risk factors for suicidal behavior
  • Gender: increased risk in men
  • Age: older, more problems
  • Relationship Status: married to lower the risk, life itself is a problem.
  • Family history: increased if there is a family with attempted suicide / substance abuse.
  • Originator (life events that just happened): Loss of a loved one, unemployment, gets embarrassed in the social environment, etc..
  • Personality factors: more often the introverted personality / shut down.
  • Other: Studies show that the white race more at risk of suicidal behavior.

Nursing Diagnosis for Suicide
  1. Anxiety
  2. Adjustment disorder
  3. Low Self-Esteem
  4. Ineffective individual coping
  5. Ineffective family coping
  6. Disturbed Sleep Pattern
  7. Social isolation
  8. Disturbed Thought Processes
  9. Risk for Violence: Self-Directed
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Saturday, August 25, 2012

Nursing Care Plan for Brain Tumor

Definition

Brain tumors are lesions because there is pressure both benign and malignant space that grows in the brain, meninges and the skull.

Etiology
  • History of head trauma
  • Genetic factors
  • Exposure to chemicals that are carsinogenik
  • Certain viruses
Pathophysiology

Brain tumors occur because of proliferation or growth of abnormal cells very rapidly in areas central nervous system (CNS). These cells will continue to evolve urge healthy brain tissue around it, causing neurological disturbances (focal disruption caused by the tumor and increased intracranial pressure).

Clinical manifestations
a. Headache
The pain is deep, constant, dull and sometimes it is terrific. Usually most severe in the morning and aggravated during activity, which usually causes an increase in intra-cranial pressure is coughing, bending and straining.

b. Nausea and vomiting
As a result of stimulation of the medulla oblongata

c. Papilledema
Venous stasis causing swelling of optic nerve papilla.

Nursing Care Plan for Brain Tumor

Nursing Assessment

a. Identification of risk factors for exposure to radiation or chemicals that are carcinogenic.

b. Identify the signs and symptoms are: headache, vomiting, and decreased vision or double vision.

c. Identify any changes in client behavior.

d. Observation of hemiparese or hemiplegia.

e. Changes in sensation: hyperesthesia, paresthesia.

f. Observation of sensory changes: asteregnosis (not able to feel the sharp edges), agnosia (not able to recognize objects in general), apraxia (not being able to use the tool properly), agraphia (can not write).

g. Observation of vital signs and level of consciousness.

h. Observation circumstances fluid and electrolyte balance.

i. Psychosocial: personality and behavioral changes, difficulty making decisions, anxiety and fear of hospitalization, diagnostic tests and surgical procedures, a change in the role.


Nursing Diagnosis for Brain Tumor

1. Ineffective tissue perfusion related to circulatory damage caused by a tumor suppression.

2. Pain (Acute / Chronic) related to increased intracranial pressure.

3. Knowledge Deficit: the condition and treatment needs related to the inability to know the information.
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Typhoid Fever - 5 Nursing Diagnosis and Interventions

Nursing Care Plan for Typhoid Fever : Nursing Diagnosis and Interventions

1. Activity intolerance related to mandatory bed rest.

Intervention:
1) Provide assistance to meet their daily needs such as food, drink, change clothes and watch oral hygiene, hair, genetalia, and nails.
Rationale: To provide assistance to the client to avoid the onset of complications associated with the movement who violate program bedrest.

2) Involve the family in the fulfillment of ADL.
Rationale: Participation family is very important to facilitate the nursing process and prevent further complications.

3) Explain the purpose of bed rest to prevent complications and speed up the healing process.
Rationale: Rest decrease intestinal mobility also decreases the rate of metabolism and infection.


2. Risk for fluid volume deficit related to the intake is less, nausea, vomiting / excessive spending, diarrhea, body heat.

Intervention:
1) Monitor the status of hydration (moisture of mucous membranes, skin turgor, adequate pulse, blood pressure orthostatic) if needed.
Rationale: Changes in hydration status, mucous membranes, skin turgor describe the severity of dehydration.

2) Monitor vital signs
Rationale: Changes in vital signs to describe the general state of the client.

3) Monitor the input of food / liquid and count daily calorie intake.
Rationale: Provides guidelines to replace fluids.

4) Encourage the family to help patients eat.
Rationale: Family as the driving fluid needs of clients.

5) Collaborate with other medical team for IV fluid administration.
Rationale: Giving IV fluids to meet fluid needs.


3. Imbalanced Nutrition, Less Than Body Requirements
related to less intake due to nausea, vomiting, anorexia, or diarrhea due to excessive output.

Intervention:
1) Monitor the amount of nutrients and calories.
Rationale: Knowing the cause of the less intake so as to determine appropriate and effective intervention.

2) Monitor the weight loss.
Rational: Cleanliness nutrients can be known through increased weight 500 g / week.

3) Monitor the environment during the meal.
Rationale: A comfortable environment can reduce stress and more conducive to eating.

4) Monitor nausea and vomiting.
Rationale: Nausea and vomiting affect nutrition.

5) Involve the family in the client's nutritional needs.
Rationale: Increasing the role of the family in nutrition to accelerate the healing process.

6) Instruct the patient to enhance the protein and vitamin C.
Rationale: Protein and vitamin C to meet nutritional needs.

7) Provide food selected.
Rational: To assist in fulfilling the nutritional needs.

8) Collaboration with a nutritionist to determine the amount of calories and nutrients it needs patients.
Rationale: Helps in the healing process.


4. Acute pain related to inflammation of the small intestine.

Intervention:
1) Assess the level of pain, location, duration, intensity and characteristics of pain.
Rationale: Changes in the characteristics of the pain may indicate the spread of diseases / complications occur.

2) Review the factors that increase pain and decrease pain.
Rational: It can pinpoint the factors that trigger or aggravate (such as stress, food intolerance) or identify the occurrence of complications, as well as help in making the diagnosis and therapeutic needs.

3) Give warm compresses on the area of pain.
Rationale: For the pain disappeared.

4) Collaborate with other medical team in the delivery of analgesics.
Rational: Analgesic can help reduce pain.


5. Knowledge Deficit: conditions of disease, treatment and prognosis needs related to lack of information or inadequate information.

Intervention:
1) Assess the extent of knowledge of the client's family about his illness.
Rationale: Knowing the mother's knowledge about the disease typhoid fever.

2) Give health education about the disease and treatment of clients.
Rationale: In order for the client's mother found out about the disease typhoid fever, causes, signs and symptoms, as well as the care and treatment of typhoid fever.

3) Give the family an opportunity to ask if there is not yet understood.
Rationale: In order to understand more about the family disease.
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Nursing Assessment of Typhoid Fever by Doenges

Nursing Assessment According to Doenges (1999: 476-485) are:

a. Activity and Rest.
Symptoms: weakness, fatigue, malaise, feeling anxious and anxiety, restriction of activities / work in relation to the disease process.

b. circulation
Signs: Tachycardia (fever response, the inflammatory process and pain), relative bradycardia, hypotension including postural, skin / mucous membranes poor turgor, dry, dirty tongue.

c. Ego integrity
Symptoms: Anxiety, emotional, upset eg feelings of helplessness / no hope.
Signs: Refuse, narrowed attention.

d. elimination
Symptoms: Diarrhea / constipation.
Signs: Decreased bowel / no peristalsis increased in constipated / a peristaltic.

e. Food / fluid
Symptoms: Anorexia, nausea and vomiting.
Signs: Decreased subcutaneous fat, weakness, muscle tone and poor skin turgor, mucous membranes pale.

f. Hygiene
Signs: The inability to maintain self-care, body odor.

g. Pain / comfort
Symptoms: Hepatomegaly, Spenomegali, epigastric pain.
Symptoms: Tenderness in the right hipokondilium or epigastrium.

h. security
Symptoms: Increased body temperature of 38 C - 40 C, blurred vision, mental delirium / psychosis.

i. Social interaction
Symptoms: Decreased relationships with others, relating to conditions in nature.

j. Counseling / Learning
Symptoms: A family history of inflammatory bowel diseased.
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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).

Gastritis Nursing Diagnosis and Nursing Interventions

Management of Acute Gastritis and Chronic Gastritis
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Management of Acute Gastritis and Chronic Gastritis

Gastritis is inflammation of the gastric mucosa.

Gastritis is divided into 2, namely:
  1. Acute gastritis
    One form of acute gastritis are frequently encountered in the clinic is acute erosive gastritis. Acute erosive gastritis is an acute inflammation of the gastric mucosa to erosive damage. Called when the erosive damage is not deeper than the muscularis mucosa.

  2. Chronic gastritis
    Chronic gastritis is an inflammation of the chronic gastric mucosal surface.
    Chronic gastritis is an inflammation of the mucosal surface of the stomach caused by either prolonged benign and malignant gastric ulcers or by bacteria helicobacter pylori. (Brunner and Suddart, 2000, p: 188).

Causes

The cause of gastritis is an anti-inflammatory analgesic drugs, especially aspirin; chemicals, such lisol; smoking; alcohol; physical stress caused by burns, sepsis, trauma, surgery, respiratory failure, kidney failure, damage to the central nervous system; gastrointestinal reflux (Inayah , 2004, p: 58).

Gastritis can also be caused by medications, especially aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), can also be caused by impaired microcirculation of the gastric mucosa such as trauma, burns and sepsis (Mansjoer, Arif, 1999, p: 492).

Gastritis Clinical Manifestations

Dyspepsia syndromes such as epigastric pain, nausea, bloating and vomiting is one of the complaints that often arise. Gastrointestinal bleeding was also found in the form of hematemesis and melena, followed by signs of anemia after bleeding. Usually if done anamnesa deeper, there is a history of the use of drugs or certain chemicals. Patients with gastritis also accompanied by dizziness, weakness and discomfort in the abdomen (Mansjoer, Arif, 1999, p: 492-493).

Management of Gastritis

Treatment of gastritis include:
  1. Overcoming medical emergencies occur.
  2. Overcoming or avoiding the cause if it can be found.
  3. Giving drugs antacids or gastric ulcer medications to another.

In gastritis, management can be done by:

Management of Acute Gastritis
  • Instruct patient to avoid alcohol.
  • If the patient is able to eat by mouth nutritious diet is recommended.
  • If symptoms persist, fluids should be given parenterally.
  • If bleeding occurs, do gastromfestinal channel management to hemorrhage.
  • To neutralize the acids commonly used antacids.
  • To neutralize the alkali used diluted lemon juice or vinegar diluted.
  • Emergency surgery may be needed to remove gangrene or perforation.
  • The reaction needed to overcome obstruction gastric pylorus.

Management of Chronic Gastritis
  • Can be overcome by modifying the patient's diet, eating soft diet was given little but more often.
  • reduce stress
  • H. Pylori treated with antibiotics.
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Sunday, August 12, 2012

Why does Coffee Cause Gastritis?

According Warianto (2011), coffee is a drink that consists of different types of materials and chemicals; including fats, carbohydrates, amino acids, vegetable acid called phenol, vitamins and minerals.

Coffee is known to stimulate the stomach to produce stomach acid, creating an environment that is more acidic and can irritate the stomach. There are two elements that can affect the health of the stomach and the stomach lining, namely caffeine and chlorogenic acid.

The study, published in Gastroenterology found that various factors such as acidity, caffeine or other mineral deposits in the coffee can trigger high stomach acid. So that no single component should be responsible (Anonymous, 2011).

Caffeine can cause stimulation of the central nervous system (brain), respiratory system and cardiovascular system. Therefore, no wonder every cup of coffee in reasonable amounts (1-3 cups), your body feels refreshed, excited, thinking power more quickly, not easily tired or sleepy. Caffeine can cause central nervous system stimulation, thereby increasing the activity of the stomach and gastrin on gastric secretion and pepsin. The hormone gastrin released by stomach has the effect of gastric secretion which is very acidic sap of the gastric fundus. Increased secretion of acid can cause irritation and inflammation of the gastric mucosa (Okviani, 2011).

Thus, digestive disorders are vulnerable are often owned by people who drink coffee are gastritis (inflammation of the lining of the stomach). Some people who have digestive problems and discomfort in the abdomen or stomach are usually advised to avoid or limit drinking coffee, so the condition is not worse. (Warianto, 2011).
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Eating Patterns that Cause Gastritis

According to Farida Yayuk Baliwati (2004), the occurrence of gastritis can be caused by bad diet and irregular, the frequency of meals, type and amount of food, so that the stomach becomes sensitive when stomach acid to rise.

1. Frequency of Eating

Frequency of eating is the number of daily feeding in both qualitative and quantitative. Processed foods naturally in the body through the digestive tools from the mouth to the small intestine. Old food in the stomach depends on the nature and type of food. If on average, usually between 3-4 hours empty stomach. This feeding schedule was then fit to empty the stomach (Okviani, 2011).

People who have irregular eating patterns susceptible to disease gastritis. At the time of the stomach should be filled, but left empty, or delayed filling, sour stomach will digest the mucosal lining of the stomach, causing pain (Ester, 2001).

Naturally, the stomach will continue to produce acid in the stomach every time a small amount, after 4-6 hours after meal blood glucose levels usually have much absorbed and used up, so the body will feel hungry and when it is stimulated gastric acid number. If someone is late to eat up to 2-3 hours, then the stomach acid produced and over-the more so that it can irritate the gastric mucosa and cause pain around the epigastrium (Baliwati, 2004).

Irregular eating habits will make it difficult to adapt to the stomach. If it is prolonged, excessive production of stomach acid so it can be irritating to the mucosal lining of the stomach and may progress to peptic ulcer. This can cause intense pain and nausea. These symptoms can go up into the esophagus causing a burning sensation burning (Nadesul, 2005). Gastric acid production is affected by the regulation include cephalic, the setting up by the brain. The presence of food in the mouth will reflexively stimulate gastric acid secretion. In humans, seeing and thinking about food can stimulate gastric acid secretion (Ganong 2001).

2. Type of Food

Type of food is a variation of a food that if eaten, digested, and absorbed at least the arrangement will result in a healthy and balanced menu. Provides a variety of foods depends on the person, certain foods can cause indigestion, as well as spicy foods (Okviani, 2011).

Consuming excessive spicy foods, will stimulate the digestive system, especially the stomach and intestines to contract. This will cause a burning sensation and pain in the gut is accompanied by nausea and vomiting. The symptoms are making people increasingly reduced appetite. When the habit of eating spicy food more than once a week for at least 6 months left to constantly irritate the stomach known as gastritis (Okviani, 2011).

Gastritis can be caused also from the foods that do not match. Certain foods that can cause gastritis, such as raw fruit, raw meat, curry, and food containing cream or butter. Not that the food is not digested, but because the stomach takes longer to digest food gets forward earlier and slow The rest of his intestines. As a result, the stomach contents and gastric acid stay in your stomach for a long time before passing into the duodenum and spent acid causes a burning sensation in the pit of the stomach and can irritate (Iskandar, 2009).

3. The Portion or Amount of Food

The portion or amount of food, as well as the dose is a measure of food consumed at each meal. Everyone must eat foods in the correct amount of fuel for all the needs of the body. If excessive food consumption, the excess will be stored in the body and cause obesity (overweight). In addition, food in large portions may lead to reflux of stomach contents, which in turn makes the power of the stomach wall decreased. Such conditions can lead to inflammation or injury to the stomach (Baliwati, 2004).
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