This document provides a lecture on gastritis and peptic ulcer disease. It outlines 11 nursing diagnoses related to these conditions, including pain, impaired nutrition, risk for dehydration, deficient knowledge, anxiety, risk of bleeding, activity intolerance, electrolyte imbalances, risk of infection, risk of perforation, and risk of pyloric obstruction. For each diagnosis, goals of care and interventions are described, such as pain management, dietary changes, fluid monitoring, education, and collaboration with medical teams for treatment.

1. GIT Medical Nursing
by :
Dr. Alshazaly abdoalghfar
BSN, RN, MSN, CNE PhD.

2. Gastritis and peptic
ulcer disease
Lecture 5
10/29/2023 shazalyhran@yahoo.com 2

4. Objectives
By the end of this lecture all of us well be able to
 Formulate the nursing process as a framework for care of
patients with gastritis and peptic ulcer disease.

5. Nursing process:
Nursing Assessment:
Assessment:
 Does the patient complains of heartburn, can not eat, nausea and vomiting?
 When the occurrence of symptoms, whether before eating, after eating, after
ingesting spicy foods, certain drugs or alcohol?
 What are the symptoms associated with anxiety, Stress, allergies, eating and
drinking too much or eating too fast?
 What are the symptoms diminish or disappear?
 Is there a history of previous gastric disease?
 Does the patient have vomiting blood?
 Is there any abdominal tenderness?
 Dehydration or change in skin turgor or dry mucous membranes?

6. ND 1:
 pain related to the effect of gastric acid secretion on damaged
tissue.
Goal:
 Relive pain.
Intervention:
 Review the level of pain.
 Encourage clients to learn relaxation techniques.
 Encourage clients to use diet as regular intervals.
 Encourage clients to avoid eating foods that stimulate an increase in
stomach acid.
 Collaboration with the medical team for the administration of anti-
analgesic.

7. ND 2:
 Imbalanced nutrition, less than body requirements, related to
inadequate intake of nutrients.
Goal:
 Maintain adequate nutrition.
Intervention
 Describe the client and family about the importance of food for
the body.
 Monitor the amount of food intake.
 Monitor and record the number of vomiting, frequency and color

8. Cont…
 Provide a varied diet according to his diet to stimulate appetite.
 Provide food in small portions but frequently.
 Collaboration with the medical team for the administration of anti-
emetic drugs.

9. ND 3:
 Risk for fluid volume deficit related to insufficient fluid intake and
excessive fluid loss subsequent to vomiting
Goal:
 Maintain fluid volume balance.
Intervention
 Assess the possibility of signs of dehydration and record intake and
output.
 Assess the balance of fluids and electrolytes every 24 hours.
 Encourage clients to keep the peroral intake is to eat and drink a
little but often.
 Encourage clients to avoid consuming foods and beverages that
contain caffeine.

10. ND 4:
 Deficient knowledge about prevention of symptoms and
management of the condition
Goal:
 Increase knowledge.
Intervention
 Explain to clients that can change diet after recovery.
 Explain to the client about medical procedures / treatments will be
done.
 Provide motivation to the client about his recovery

11. ND 5:
 Anxiety related to coping with disease.
Goal:
 Reduce anxiety.
Intervention
 Assess what patient wants to know about the disease,
and evaluate level of anxiety.
 encourage patient to express fears openly and without
criticism.
 Explain diagnostic tests and administering medications
on schedule.

12. Cont…
 Interact in a relaxing manner, help in identifying
stressors, and explain effective coping techniques and
relaxation methods.
 Encourage family to participate in care, and give emotional
support.

13. ND 6:
 Risk for bleeding related to ulceration and erosion into blood
vessels
Goal:
 Prevent bleeding.
Intervention:
 Monitor vital signs and oxygen saturation frequently .
 Assess pt for sign of bleeding and check stool and vomiting.
 Monitoring the hemoglobin and hematocrit.
 Monitor intake and output.
 I.V fluid and blood replacement.
 Endoscopic management may be require.

14. ND 7:
 Risk for Activity intolerance related to bleeding
Goal:
 Mantain activity of daily level.
Intervention:
 Monitor vital signs and oxygen saturation befor and after
activity.
 Maintain adequate rest.
 Management of bleeding to decrease losses.
 IV fluid and blood replacement to maintain fluid loss

15. ND 8:
 Risk for fluid and electrolyte imbalance related to vomiting
secondary of obstruction.
Goal:
 Maintain fluid and electrolyte .
Intervention:
 Check intake and output chart.
 Check serum electrolytes.
 IV fluid and electrolyte replacement.
 Avoid stress to decrease secretion of gastric acid and
decrease vomiting.
 Prepare pt for endoscopy or surgery

16. ND 9:
 Risk for infection or perotinitis related to perforation of ulcer.
Goal:
 Prevent infection.
Intervention:
 NG tube insertion to suction gastric contains.
 Monitor vital signs to assess sign of infection.
 Antibiotic administration.
 Prepare pt for surgical intervention to repair perforation.

17. ND 10:
 Risk for perforation related to erosion of ulcer.
Goal:
 Prevent infection.
Intervention:
 Reduce stress and any things that increase gastric secretion.
Nasogastric suction.
 Administration of H2-blockers and proton-pomp inhibitors.
 Antibiotic administration.
 Prepare pt for surgery

18. ND 11:
 Risk for pyloric obstruction related to scar of ulcer and tissue
spasm
Goal:
 Prevent the obstruction.
Intervention:
 gastric decompression.
 IV fluid , and correction of electrolyte imbalances.
 Some patients may require total parenteral nutrition (TPN) or
distal tube feeding .
 Prepare pt for surgery

19. Thank you
8/26/2022 shazalyhran@yahoo.com 19