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.

»»  READMORE...

Nursing Management of Sleep Disorders in the Elderly

The following Nursing Management of Sleep Disorders in the Elderly

1. Primary Prevention

• Fully asleep, but not excessive, in order to feel fresh and healthy the next day, restriction of sleep can amplify sleep, excessive time in bed seem related to fragmented sleep and shallow.
• Regular waking time in the morning, strengthens the circadian cycle and lead to a regular sleep onset.
• Stable amount of exercise each day can deepen sleep, but exercise is only performed occasionally can not improve sleep the following night.
• Noises can interfere with sleep, even if the sound does not wake a sleeping person and can not remember in the morning. Soundproof the bedroom can help sleep for people who have to sleep near the noise.
• Although the room is too warm can interfere with sleep, but there is no evidence to suggest that the room is too cold can help you sleep.
• Hunger interferes with sleep.
• Sleeping pills may sometimes be used to advantage, but that chronic use, are not effective in most patients with insomnia.
• Caffeine can interfere with sleep in the day, though at those who think so.
• Alcohol helps tense people fall asleep more easily to help, but sleep is then intermittent.
• People who feel angry and frustrated because they could not sleep, trying hard not to fall asleep but should turn on the lights and do other things differently.
• Chronic tobacco use can interfere with sleep.

Another act of primary prevention include:

• Mattress that allows the proper body alignment.
• Room temperature should be cold enough (less than 24C), so feel comfortable
• Caloric intake should be at least at bedtime.
• Moderate exercise during the day or in the evening is the recommended.

2. Secondary Prevention

Assessment by the nurse should include the following factors:

• How well the elderly are at home sleeping?
• When the elderly go to bed and wake up?
• Any habit that happens at bedtime?
• How many the amount of and exercises who done every day?
• Is the best position is preferred when in bed?
• What kind of environment is preferred treason?
• What is the temperature like?
• How much ventilation is desired?
• What activities are carried out several hours before bedtime?
• What are the medications sleeping or other medications which used when ahead of the sleep are routinely?
• How much time is spent in the hobby?
• Perceptions of life satisfaction and health status?

As always, validate the assessment history with family members or caregivers is essential to ensure the accuracy and assessment.

Diary of sleep is the best way of assessment for the elderly. This information provides an accurate record of trouble sleeping. To get a true picture of sleep disturbance experienced by the elderly at home or in health facilities, daily records were made 3 to 4 weeks. Records shall include the following factors:

• How often the help given to prescribe pain, unable to sleep or use the bathroom.
• When the person gets out of bed?
• How many times a person is awake or asleep at the time observed by the nurse or care giver.
• Confusion or disorientation occur.
• The use of sleeping pills.
• Estimated person gets up in the morning.

3. Tertiary Prevention

If there is a sleep disorder such as Sleep Apnea life threatening, the condition of patients requiring rehabilitation through measures such as removal of the tissue that blocks the mouth, which affect the airway. Today many sleep disorders centers are available throughout the country to help evaluate sleep disorders. These places are usually associated with clinical and medical research institutes or universities, complete with medical devices that can detect sophisticated electrical recording in the brain and airway obstruction. These data to help the best treatment for sleep difficulties and rehabilitation of the elderly.

»»  READMORE...

Nursing Management for Pneumonia

Nursing Management for Pneumonia

Assessment for Pneumonia

1. Activity / rest

• Symptoms: weakness, fatigue, insomnia
• Signs: lethargy, decreased activity tolerance.

2.Circulation

• Signs: tachycardia, the appearance of redness, or pale.

3. Food / fluid

• Symptoms: loss of appetite, nausea, vomiting, history of diabetes mellitus
• Symptoms: Abdominal consistency, dry skin with poor turgor, cachexia appearance
• (malnutrition).

4. Neuro-sensory

• Symptoms: headache frontal area (influenza)
• Symptoms: mental destruction (confused)
  

5. Pain / comfort

• Symptoms: headache, chest pain (increased by coughing), imralgia, arthralgia.
• Signs: protecting the sore area (sleeping on the affected side to restrict the movement)

6. Breathing

• Symptoms: a history of chronic UTI, tachypnoea (shortness of breath), dyspnea.

mark:

• o Sputum: pink, rusty
• o perfusion: a flat area of consolidation of deaf
• o premikus: taksil and vocals gradually increased with the consolidation
• o decreased breath sounds
• o Color: pale / cyanotic lips and nails

7. Security

• Symptoms: a history of immune system disorders such as: AIDS, steroid use, fever.
• Signs: sweating, chills over and over, shaking

8. Education / learning

• Symptoms: a history of surgery, chronic alcohol use
• Mark: indicates the average length DRG treated 6-8 days
• Repatriation plan: assistance with personal care, home maintenance tasks.

Nursing Management for Pneumonia


A. Effective airway, pulmonary ventilation is adequate and there is no secret buildup.

Plan of action:
1) Monitor respiratory status every 2 hours, examine an increase in respiratory status and abnormal breath sounds.
2) Perform percussion, vibration and postural drainage every 4-6 hours.
3) Give appropriate oxygen therapy program.
4) Help cough up secretions / suction lenders.
5) Give the comfortable position that allows the patient to breathe.
6) Create a comfortable environment so that patients can sleep in peace.
7) Monitor blood gas analysis to assess respiratory status.
8) Give drink.
9) Provide sputum for culture / sensitivity test.

B. Patients showed improvement of ventilation, gas exchange and the optimal oxygenation of tissues adequately.

Action Plan:
1) Observe level of consciousness, respiratory status, signs of cyanosis every 2 hours.
2) Give Fowler's position / semi-Fowler.
3) Give oxygen according to the program.
4) Monitor blood gas analysis.
5) Create a quiet environment and patient comfort.
6) Prevent the occurrence of fatigue in patients.

3. Patient will maintain normal body fluids.

Action Plan:
1) Record fluid intake and output. Encourage mothers to give fluids orally tetaap à avoid milk is thick / cold drinking à stimulate coughing.
2) Monitor fluid balance à mucous membranes, skin turgor, rapid pulse, decreased consciousness, vital signs tyanda.
3) Maintain the accuracy of the droplet infusion according to the program.
4) Perform oral hygiene.

4. Patients can perform activities according to the conditions.

Action Plan:
1) Assess the patient's physical tolerance.
2) Assist patients in activities of daily activities.
3) Provide age-appropriate games with the activity of patients who did not spend much energy à adjust activities to the condition.
4) Give the O2 according to the program.
5) Give the energy needs.

Nursing Interventions for Pneumonia

»»  READMORE...

Nursing Management and Diagnosis for CHF

Definition :

A state of pathophysiological abnormalities in cardiac function resulting in heart failure to pump blood to meet the metabolic needs of tissues and or ability only if accompanied by elevation of left ventricular filling pressure.

Etiology :
A. mechanical abnormalities

• Increased burden of the central (aortic stenosis), peripheral (systemic hypertension)
• Increase in volume load (initial load increase)
• Obstruction of the ventricular filling (stenosis mitralis / trikuspidalis)
• Pericardial tamponade
• Restriction endocardium / myocardium
• Ventricular aneurysm.

B. Abnormalities of the myocardium
1. Primary

• Cardiomyopathy
• Myocarditis
• The metabolic abnormalities
• Toxicity (alcohol, cobalt)

2. Dis-dynamic abnormalities, secondary

• K (-) O2
• The metabolic abnormalities
• Inflammation
• Systemic Diseases
• COPD

C. Changes in heart rhythm

• Cardiac arrest
• Fibrillation
• Tachycardia / bradycardia
• Electric Asinkroni

Signs and symptoms of CHF

1. Left heart failure

• Fatigue
• Weak
• Cyanosis
• Dyspnea
• Cough
• Orthopnea
• Anorexia
• Tachypnea
• The first heart sound decreases
• Wet crackles pleural effusion

2. Right heart failure

• Weight loss
• Ankle edema
• Abdominal distention
• Pain subkostal
• Pulsation neck region
• Jaundice
• Tired
• Edema, ascites
• Increased jugular venous pressure

Complication

• Cardiac asthma? due to bronchospasm occurs at night or in the activity
• Non-productive cough due to lung congestion
• Haemoptysis
• Dysphagia due to distension of the pulmonary venous atrium or
• Containment of systemic veins - JVP increased
• Hepatomegaly
• Peripheral edema
• Ascites and anasarka
• Increase in body weight due to water retention and sodium
• Peripheral vasoconstriction? release of body heat (-)
• Abnormalities of liver function, prothrombin time emanjangan light.

Nursing Management of CHF

Goal :
- Reducing the workload of the heart
- A third of selective manipulation of the main determinants of myocardial function, namely:

• the initial load
• the load end
• contractility

- Achieve the desired clinical response

Guidelines:
1. Limitation of physical activity

• Avoid strenuous work
• Stop the heavy exercise

2. sodium restriction
3. digitalis glycosides
4. diuretics

• Diuretics
• Potassium-sparing diuretics

5. vasodilator
6. inotropic agents
7. specific actions:

• Consideration tranpalntasi
• Assisted circulation:

Nursing Diagnosis for CHF

1. Decreased cardiac output related to mechanical factors (preload, afterload, contractility)
2. Impaired gas exchange related to alveolar capillary membrane due to increased pulmonary capillary pressure
3. Changes in nutritional status: less than body requirement related to the absorption of nutrients secondary to decreased cardiac output.
4. Activity intolerance related to decreased cardiac output.

»»  READMORE...