Gastritis Flashcards

Gastritis

Loss of Intrinsic Factor

• Gastritis can lead to a loss of intrinsic factor, a chemical in the stomach that aids in food breakdown and vitamin B12 absorption.
• A lack of vitamin B12 can cause hematologic issues.

Gastroparesis

• Gastritis can lead to gastroparesis, a condition characterized by decreased churning of food in the stomach.
• The stomach doesn't move properly to break down food.

Etiology and Risk Factors

• Excessive Alcohol Intake: A key factor to consider during patient assessments.
• Dietary Factors: Spicy and fried foods, as well as acidic foods, can worsen gastritis symptoms.
• NSAIDs: Patients taking NSAIDs regularly should take them with food to protect the stomach lining.
• Food Poisoning: Can cause gastritis due to vomiting and increased acid production.
• H. Pylori: Common bacteria found in patients with gastritis, potentially leading to peptic ulcer disease.
• Stress: Increases acid release in the stomach, contributing to gastritis.
• Smoking: A risk factor for gastritis.

Signs and Symptoms

• Abdominal Discomfort:
  • Patients may report stomach pain; clarify the location (upper or lower abdomen).
  • Use precise language to understand where the patient feels discomfort.
• Nausea: A common symptom.
• Bloating
• Indigestion
• Loss of Appetite
• Belching
• Burning Sensation: A hallmark symptom.

Medications to Treat Gastritis

• Antacids:
  • Often used as a first-line treatment.
  • Common in pregnant women due to increased pressure on the stomach.
  • Example: Tums (contains calcium).
• H2 Blockers:
  • Block histamine action, reducing acid production.
  • Examples:
    • Cimetidine (Tagamet)
    • Famotidine (Pepcid)
• Proton Pump Inhibitors (PPIs):
  • Used for chronic gastritis but can be used short-term to rule out gastritis or alleviate symptoms.
  • Stronger than H2 blockers; block cells that produce stomach acid.
  • Available over-the-counter.
  • Examples:
    • Omeprazole (Prilosec)
    • Esomeprazole (Nexium)
    • Lansoprazole (Prevacid)
• Antibiotics:
  • Used for patients with H. Pylori infection.
  • Common examples:
    • Azithromycin
    • Clarithromycin
    • Amoxicillin
    • Metronidazole

Nursing Interventions

• Symptom Management: Focus on alleviating symptoms and preventing complications.
• Prevent Complications: Untreated gastritis can lead to ulcers, bleeding ulcers, and dehydration.
• Monitor for Bleeding:
  • Look for blood in vomit.
  • Check for black, tarry stools with a distinct smell.
• Address Electrolyte Imbalances: Particularly in patients who are vomiting.
• Monitor for Medication Side Effects.
• Provide IV Fluids and Electrolyte Replacement: For patients in the ER with severe gastritis.
• Cancer Risk: Chronic irritation of tissue can lead to cellular changes and cancer.
  • Monitor patients carefully and consider endoscopy if symptoms persist despite treatment.

Laboratory Tests and Diagnostics

• Complete Blood Count (CBC):
  • Assess hemoglobin and hematocrit levels.
  • Monitor for anemia and dehydration, especially if bleeding is suspected.
• H. Pylori Test:
  • Blood tests and urea breath tests are commonly used.
• Comprehensive Metabolic Panel:
  • Liver function tests and creatinine levels to assess organ function.
• Stool for Blood:
  • Checks for gastrointestinal bleeding.
• Endoscopy:
  • Considered if symptoms persist, even with treatment.
  • Allows for biopsies to detect long-term issues or cancer.

Patient Education

• Avoid Irritants:
  • NSAIDs, spicy foods, and acidic foods.
• Lifestyle Changes:
  • Eat small, frequent meals.
  • Avoid eating close to bedtime.
  • Identify and avoid trigger foods.
• Maintain Healthy Weight:
  • Obesity can exacerbate gastritis.
• Medication Adherence:
  • Take medications as prescribed to manage symptoms and prevent progression.
• Awareness of Potential Complications:
  • Educate patients on signs of bleeding (bloody stools, bloody vomit) and other symptoms that warrant medical attention.