Ch. 47: Gastritis, Peptic Ulcers, GI Bleeding & Gastric Cancer

What is gastritis?

Inflammation of the gastric mucosa (stomach lining).

What are some risk factors for gastritis?

Long-term NSAID use, alcohol, coffee, caffeine, stress, cigarette smoking, radiation therapy, corrosive substance ingestion, steroids, aldosterone antagonists, SSRIs.

What are the two types of gastritis?

Erosive (causing ulcers) and nonerosive; acute or chronic.

What are common assessment findings in gastritis?

Epigastric pain, dyspepsia (heartburn), gastric bleeding (hematemesis, melena), nausea/vomiting, anorexia.

How is gastritis diagnosed?

EGD (esophagogastroduodenoscopy) with biopsy.

What nursing care is recommended for gastritis?

Eliminate causative factors, limit distressing foods, adopt a bland/non-spicy diet, avoid alcohol and tobacco, and promote stress reduction.

What patient education is important for preventing gastritis?

Maintain a balanced diet, regular exercise, stress-reduction techniques, and avoid smoking and alcohol.

What is Peptic Ulcer Disease (PUD)?

A condition where gastrointestinal mucosal defenses are impaired, exposing the epithelium to stomach acid and pepsin.

What are the types of peptic ulcers?

Duodenal ulcers (most common), gastric ulcers, and stress ulcers (less common).

What are the common causes of peptic ulcers?

Infection by H. pylori and long-term, chronic use of NSAIDs.

What are the assessment findings for peptic ulcers?

Localized gastric mucosal lesions and ulcers, constant pain radiating to the back or upper quadrant.

What complications can arise from peptic ulcers?

Hemorrhage (hematemesis, melena), perforation, pyloric obstruction, intractable disease.

What is the nursing management for peptic ulcers?

Pain relief, eliminate causes, heal ulcerations, and prevent recurrence.

What medications are commonly used for peptic ulcers?

Proton Pump Inhibitors (PPIs) and two antibiotics for 10-14 days; sometimes bismuth is added.

What are the signs of upper GI bleeding?

Frank, bright red bleeding or dark 'coffee grounds' appearance, hematemesis.

What are the common causes of lower GI bleeding?

Polyps, diverticulitis, inflammatory disease, cancer, or hemorrhoids.

What is the nursing management for gastrointestinal bleeding?

Supportive therapy to prevent hypovolemic shock, monitor vital signs, replace fluid volume, and administer packed RBCs.

What is gastric cancer?

Cancer cells form in the lining of the stomach, severely altering stomach function.

What are the early assessment findings of gastric cancer?

Often asymptomatic, dyspepsia, and abdominal discomfort.

What are the advanced signs of gastric cancer?

Anemia, occult blood in stool, hypoalbuminemia, abnormal liver tests, elevated carcinoembryonic antigen.

How is gastric cancer diagnosed?

EGD with biopsy allows direct visualization and biopsies of lesions.

What is the preferred treatment for gastric cancer?

Surgical resection (total or subtotal gastrectomy) is preferred, along with combination chemotherapy and radiation therapy.