Sabtu, 01 September 2012

Nursing care Gastritis Patients

A.DEFINISI 
http://www.meddir.net/imagenes/tumores%20gastricos/gastritis.jpgGastritis is an inflammation of the lining of the stomach mucosa and sub-mucosa
(Mizivies)
Gastritis is an inflammation localized or diffuse gastric mucosa
develops when the mucosal protective mechanisms are consumed with
bacteria or irritants (j, reves, 1999)
Gastritis is an inflammation of the gastric mucosa is acute, krnik, diffuse and local
are caused by foods, drugs, chemicals, stress and
bacteria.

B.ETIOLOGIBased on the types of causes gastritis is divided into seven causes of gastritis patients
 
include: anti-inflammatory drugs oralgetik, eg aspirin, chemicals, eg lisol,smoking, alcohol (waspadji 1998). bacteria Group (revees, 2001) eat drinka hot, acidic foods, kafe'in, intestinal reflux, stomach.C.MANIFESTASI JALINISa.Gastritis acute.pain, epigastric, nausea, bloating, vomiting, hemtomesis, melena, and in one after another'' marked anemia post-circulation (Mansjoer, 1999)Chronic b.Gastritismost patients do not have any complaints, only some heartburn menguluhanorexia, NAVSEA and the physical examination no abnormalities encountered (Mansjoer, 1999)heartburn after eating, phlegm (burp) a sour taste in the mouth, nausea, vomiting
 
(Ester, 2001)D.PATOFISIOLOGIIn normal circumstances, the stomach acid and fepgin will not cause damage to the stomach due to gastric and duodenal mucosa there is a balance between aggressive factors (destroyer) and defensik factors (mucosal resistance) if for some reason, balance and endurance ganggun damaged mucosa. Mucosal damage resistance will occur behind the ion diffusion will cause damage to the gastric mucosa.Drugs, alcohol, bile salts, enzymes dn fankreas can merusk stomachand memungkunkan back diffusion of acid and pepsin in the stomach tissue, this causes inflammation of the gastric mucosal response against most irritantsis to regenerate mukosa.oleh because it is often ka disorder''li disappear by itself, with the constant irritation of tissue becomes inflamed and the inflammation can occur.The introduction of substances such as acid corrosive vocabulary and the resulting trade rektosis pad the stomach wall (gastritis corrosive) DAPT causes necrosis perforosinext to the wall of the stomach due to inflammation and pefitonotis.Chronic gastritis can lead to atrophy kedn gastric glands and to spotting mukos state-berck thickening gray or greenish gray (atrophic gastritis). The loss and the incidence of gastric mukos pernitiossa anemia.Atrophic gastritis may be a prelude to chronic gastritis gastric carcinoma dpat also coincided with pertikum ulcer.Increased sekreasi excessive stomach acid causing nausea and vomitingresulting in dehydration nd anoresia that cause problems and the risk of fluid volume deficit nutrition less than body requirements with increased secretion of gastric acid causes damage to the gastric mucosa and gastric mucosal irritation will result dn will cause pain.E.DATHWAY
F. DIAGNOSIS SUPPORTa. Endoscopyb. Gastric mucosal biopsyc. Analysis of gastric fluidsd. Examination biriume. Abdominal Radiologyf. Stool when melenaG. COMPLICATIONSa. Bleeding.b. Perforation.H.PENATA carrying on• Avoid alcohol and food until symptoms diminish• Diet is not menginitasi• When in need give fluids untravena• If the result of a strong acid or alkali dilute with ancard (aluminum hydroxide)• If due to strong alkaline aqueous use lemon juice or vinegar in diluteI. Nursing Diagnosis ARISINGa. Pain associated with the irritated mucosa of the gastric mucosagoals: reduced pain(Baugham, 2000)Intervention:1) Instruct to avoid foods and drinks that may irritate
      
Stomach.2) Assess the degree of pain and get comfort through the use of drugs and Meng
      
Avoid irritating substance.3) Encouragement of patients to report pain.4) Observation and note the location (scale 0-10) and the characteristics of the pain (live, lost, arise, colic)5) Observation vital signs.6) Record the response to the drug and report to the doctor if the pain is gone.7) Encourage use of relaxation techniques.8) Collaboration: give analgesics.Results are expected to:1) Pain is reduced.2) Reporting lost or uncontrolled pain3) Looks relaxed, able to rest or in sleep soundly.b.perubahan nutrition less than body requirements brhubungan with nutrient inputinadequate. (Baughman, 2000).GOAL:- Patients can increase input adequate nutrition and avoid foodsirritants.
Intervention:1) measuring input diit daily calories.2) Weigh the appropriate indications, compare changes in fluid status.3) Assist and encourage patients to eat and provide oral care before eating.4) Provide physical and emotional support for patients with acute gastritis.5) The urge patients to report any symptoms that decrease recurrent episodes of gastritis when mkanan entry.6) Avoid caffeine (caffeine increases the activity of the stomach and pepsin secretion.7) Avoid alcohol and smoking (nicotine menghmbat pnetriasi part of stomach acid in the duodenum), and nicotine increased muscular activity in the intestine causing nausea and vomiting.Expected results:1) The patient can increase the input of adequate nutrition and avoid irritating foods.2) Reporting and vomiting disappeared.3) Demonstrate progress to achieve and maintain weight loss.c. lack of knowledge associated with less information, complications, activity orfear and treatment (Carpenito, 20000.Intervention:1) assess the level of anxiety and additions to the disease process.2) Visiting with frequent or anyone nearby to stay with the patient.3) Use physical touch and language with positive techniques.4) Provide an environment that kondutif for informal discussion and express anxiety or fear and loss.5) Provide information concerning the conditions or procedures and diagnostic tests.6) Encouragement ask clarifying responsibilities are clearly consistent jik need.Results are expected to:1) Saying understanding of the inflammatory process and the likelihood of recurrencecomplications.2) increasing patient information about the disease.3) Identify lifestyle changes or improvements to prevent recurrence or the occurrence of complications.

  
d. Anxiety related to treatment, (baugham, 2000)Goal: less anxiety.Intervention:1) Provide a description of the frequent and information about procedures keperawtan.2) Involve the patient / significant other in the decision process.3) Prepare patients for additional diagnostic tests (endoscopy) / surgery.4) Use a calm approach and answer questions selengkp possible, explain all procedures and treatment measures.5) Perform emergency measures for client digest acidic or alkaline.6) Provide supportive therapy to patients and families during and after digesting the action of acid or alkali has been neutralized or dilute.Results are expected to:1) reduced anxiety, states of awareness and acceptance with juice
      
healthy ways.2) Demonstrate skills pemahamn problem, effective use of resources.3) Declare anxiety or fear can be reduced to the level in the handle.

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