ST.

ANTHONY COLLEGE OF ROXAS CITY

San Roque Extension, Roxas City

College of Nursing

LEVEL III

-ACUTE GASTRITIS-
(A CASE STUDY)

In partial fulfillment
Of the requirements in
RLE NCM 116

Submitted by:

SARAH L. RODAJE S.N

BSN III

Submitted to:

NITA A. AMMOGAO, R.N.

Instructor

MAY 13, 2021

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

II. TABLE OF CONTENT

Title Page………………………………………………………………………………………………….I

Table of Content……………………………………………………………………………………….II

Introduction……………………………………………………………………………………………..III

Objectives………………………………………………………………………………………………..IV

Textbook Discussion………………………………………………………………………………….V

Anatomy and Physiology……………………………………………………………………………VI

Pathophysiology……………………………………………………………………………………….VII

Vital Information……………………………………………………………………………………….VIII

Laboratory and Diagnostic Test…………………………………………………………………..IX

Drug Tabulation…………………………………………………………………………………………X

Nursing Care Plan………………………………………………………………………………………XI

Discharge Planning…………………………………………………………………………………….XII

Acknowledgement……………………………………………………………………………………..XIII

Bibliography………………………………………………………………………………………………XIV
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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

III. INTRODUCTION

Acute gastritis is an inflammation of the stomach lining that occurs after eating

certain foods producing discomfort, nausea and vomiting. . The causes of acute

gastritis include: medications such as nonsteroidal anti-inflammatory drugs (NSAIDs)

and corticosteroids, bacterial infections such as H. pylori. Helicobacter pylori (H. pylori)

bacteria are a common cause of digestive illnesses, including gastritis (the irritation

and inflammation of the stomach lining), peptic ulcers (sores in the lining of the

stomach, small intestine, or esophagus), and even stomach cancer later in life. These

bacteria are found worldwide, but especially in developing countries, where up to 10%

of children and 80% of adults are likely to have had an H. pylori infection, usually

without any symptoms.

One of the common causes of mortality in children worldwide is the digestive

disorders such as acute gastritis, acute gastroenteritis and diarrhea. Most common

cause of acute gastritis is in older children. In the developing countries like in

Southern and Eastern Europe, Mexico, South America, Africa, and Asian countries,

children in the age group of 2 to 8 years acquire the acute gastritis at a rate of about

10% per year. It means 10% out of every 1,000 people around the world are

estimated to have acute gastritis. According to Department of Health (DOH), data back

in 2013, the mortality rate of acute gastritis in children aged 2-9 years old was about

3.5 % out of 100,000 populations in the Philippines.

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

IV. OBJECTIVES

GENERAL OBJECTIVES

 This case study seeks to demonstrate the student’s knowledge regarding the

general health and disease condition of a patient with diagnosis, its disease

process, possible complications, treatment plan and nursing interventions.

SPECIFIC OBJECTIVES

SKILLS:

 Demonstrate adept observation skills by being able to identify signs and

symptoms manifested in Acute Gastritis with moderate Dehydration.

 Accurately present a thorough general assessment of the client which includes

clinical and physical assessment taking.

 Provide patient health teachings to the family of the client.

KNOWLEDGE:

 Acquire adequate knowledge on Acute Gastritis with moderate Dehydration.

 Understand the pathophysiology of the case being presented.

 Understand the role of drug therapy in managing the client’s diagnosis.

ATTITUDE:

 Be able to recognize the client’s condition and advocate appropriate nursing

interactions.

 Encourage interaction to the family of the patient to establish rapport.

 Apply the Vincentian core values in planning the nursing care.

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

V. TEXTBOOK DISCUSSION

Gastritis is a term which encompasses a series of conditions that present with

inflammation of the gastric mucosa. It is classified based on a time course as either

acute or chronic.

Acute Gastritis is the inflammation of the gastric mucosa lasting several hours

to a few days while Chronic Gastritis is a prolonged inflammation of the stomach

that may be caused by either benign of malignant ulcers of the stomach and bacteria.

CAUSES

 Dietary Indiscretion – most often cause of Acute Gastritis.

 Other causes of Acute Gastritis – include overuse of aspirin and other non-

steroidal anti-inflammatory drugs (NSAIDs), excessive alcohol intake, bile reflux

and radiation therapy. A more severe form of acute gastritis is caused by the

ingestion of strong acid or alkali, which may cause the mucosa to become

gangrenous or to perforate.

 Helicobacter Pylori Infection – it evolved to penetrate the mucoid lining of

the stomach in order to penetrate the gastric mucus lining of the stomach and

thereby establish infection.

SIGN AND SYMPTOMS

Some patient may not show signs of gastritis but when they do, they may exhibit:

 Nausea

 Vomiting – food contents or blood

 Indigestion
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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

 Abdominal bloating

 Loss of appetite

 Black tarry stools

COMPLICATIONS

If gastritis is not treated, the following complications may result:

 Gastric ulcers

 Gastric bleeding

 Stomach cancer (rare)

DIAGNOSIS

The following may be utilized to diagnose gastritis:

 Upper endoscopy

 Test blood, breath, or stool for H. Pylori

 Barium swallow or upper GI series- these are x-rays to visualize esophagus all

the way down to the small intestine to see if any ulcers are present.

TREATMENT

The following treatments may be used to treat gastritis:

 Antibiotics- to kill the H. pylori bacteria if found in the digestive tract.

 Proton pump inhibitor- to reduce stomach acid.

 Histamine H2 antagonist- to reduce the amount of gastric acid that is released

into the digestive tract.

 Antacids- to neutralize gastric acid.

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

VI. ANATOMY AND PHYSIOLOGY

STOMACH

The stomach is a muscular organ located on the left side of the upper abdomen. The

stomach receives food from the esophagus. As food reaches the end of esophagus, it

enters the stomach through a muscular valve called the lower esophageal sphincter.

The stomach secretes acid and enzymes that digest food. The stomach muscles

contract periodically, churning food to enhance digestion.

4 REGIONS OF THE STOMACH

 Cardia – is the first part of the stomach below the esophagus. It contains the

cardiac sphincter, which is a thin ring of muscle that helps to prevent stomach

contents from going back up into the esophagus.

 Fundus- it is located inferior in the diaphragm. It is the rounded are that lies

to the left of the cardia.

 Body- is the largest and

main part of the stomach.

This is where food is mixed

and starts to break down.

 Pylorus- is the part of the

stomach that connects to

the small intestine. This

region includes the pyloric sphincter, which is a thick ring of muscle that acts as
 ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

valve to control the emptying of stomach contents into the duodenum. The

pyloric sphincter also prevents the contents of the duodenum from going back

into the stomach.

LAYERS OF THE STOMACH WALL

 Mucosa - has glands that produce stomach acid and other important

compounds. One example is the enzyme pepsin. While the stomach acid breaks

down food and protects it from infection, pepsin breaks down protein.

 Submucosa- it is the next layer that covers the mucosa. It is made up of

connective tissue that contains larger blood and lymph vessels, nerve cells and

fibers. The blood supply of the submucosa provides nutrients to the wall of the

stomach.

 Muscularis propria - is the next layer that covers the submucosa. It is the

main muscle of the stomach and its function is to move and mix the stomach

contents.

 Serosa - is the fibrous membrane that covers the outside of the stomach. It

has a smooth, slippery surface and secrets a thin, watery secretion known as

serous fluid. The smooth, wet surface of the serosa helps to protect the

stomach from friction as it expands with food and mixes to mix and propel the

food.
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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

VII. PATHOPHYSIOLOGY
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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

VIII. VITAL INFORMATION

Name of the Patient: A.M. M.

Age: 5 years and 6 months old

Sex: Female

Citizenship: Filipino

Religion: Roman Catholic

Date of Birth: September 8, 2016

Chief Complaint: Vomiting

Date Admitted: February 8, 2021

Admitting Diagnosis: Acute Gastritis with moderate DHN

Attending Physician: Dr. C.

Final Diagnosis: Acute Gastritis with moderate DHN

Source of Information: Mother and Chart

CLINICAL ASSESSMENT

 PAST MEDICAL HISTORY

The patient was admitted last October 2019 at Roxas Memorial Provincial Hospital due

to complaints of cough and fever and the admitting/final diagnosis of Pediatric

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
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Community Acquired Pneumonia Type C (PCAP C). The patient has a complete history

of immunizations.

 PRESENT MEDICAL HISTORY

Hours prior to admission, the client experienced abdominal pain and vomiting of prior

ingested food and two more episodes. The mother brought the child to Saint Anthony

College of Roxas City INC (Hospital) on February 8, 2021, 9:05 PM for admission and

was admitted due to the chief complaint of abdominal pain and vomiting and the

admitting diagnosis of Acute Gastritis with moderate Dehydration with the following

data:

Hrs PTA – 3 AM – (+) Abdominal pain

Hrs PTA – 7 PM – (+) Vomiting of prior ingested food and 2 more episodes

 FAMILY HISTORY

The grandmother at the matriarchal side of the client has hypertension while the

grandfather is diabetic. On the patriarchal side of the client, both the grandmother and

grandfather have hypertension which carried over to some of their children, specifically

the first and third child. The rest of the family members are well and alive.

PHYSICAL ASSESSMENT

BODY METHODS OF FINDS INTERPRETATION

PARTS/SYSTEM ASSESSMENT
SKIN Inspection Skin appears warm to touch NORMAL
and presence of rashes.
HAIR Inspection Hair is black in color. No NORMAL
presence of lice.
HEAD Inspection Head is normocephalic and NORMAL
symmetrical.
No presence of lesions.
NAILS Inspection Nails are trimmed and pale in NORMAL
Palpation color. Smooth and intact with
epidermis.
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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
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EYES Inspection Both eyes are brown in color. NORMAL

Eyes are in good alignment.
The eyelids are normal that
retract far enough.
EARS Inspection Both ears are symmetrical. No NORMAL
discharge to the opening of
the ear canal.
NOSE Inspection The nose appeared NORMAL
symmetric, straight and
uniform in color. There was
no presence of discharge or
flaring.
MOUTH Inspection Lips are pink in color. Dental curvy due to
Has dental curvy on the upper poor hygiene.
front of the teeth.
Buccal membrane is pink and
no presence of lesions.
BREAST Inspection Nipples are pink in color with Normal
Palpation no presence of lumps, masses
and tenderness.
NECK Inspection The neck is symmetrical. No NORMAL
Palpation swelling and lymph nodes
enlargement.
BACK Inspection Normal symmetry and NORMAL
Palpation deviation of the spinal
column. No presence of
lesions.
ABDOMEN Inspection Skin of abdomen is free of NORMAL
Palpation striae, scars lesions or rashes.
Auscultation Abdomen is flat and
symmetric with no bulges or
lumps.
RESPIRATORY Auscultation Normal respiratory rate of 22 NORMAL
SYSTEM breaths per minute and
regular in rhythm
CARDIO Auscultation No presence of heart murmur NORMAL
VASCULAR sounds.
SYSTEM
UPPER Inspection Warm to touch. Normal NORMAL
EXTREMITIES Palpation palmar crease. There is no
presence of lumps, discharges
or lesions. No presence of
swelling and edema.
LOWER Inspection No presence of swelling and NORMAL
EXTREMITIES Palpation edema.

GENERAL APPRAISAL

Speech: The client can speak well.

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

Hearing: Both ears can hear sounds with good auditory acuity to normal voice.

Mental Status: Oriented to people with short span of attention.

Emotional Status: Has separation anxiety from her mother and being irritable.

GENOGRAM

Well and Alive Well and Alive

32 30

Well and Alive

ACUTE Well and Alive
8
GASTRITIS 2 years old
5

LEGEND:

PATIENT FEMALE MALE

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

IX. LABORATORY AND DIAGNOSTIC TEST

Macroscopic
Color Pale Straw
Transparency Slightly Hazy
Sugar Negative
Bilirubin Negative
Ketone Negative
Specific Gravity 1.010
Blood Negative
pH 6.5
Protein Negative
Urobilinogen Normal
Nitrite Negative
Leuko Esterase Negative

Microscopic
Amphorous Phosphates
RBC FEW
WBC 0-2 / hpf
Epithelial Cells 0-2 / hpf
Bacteria FEW

Result Reference Values Significance

Hematocrit 0.36 vol (fr) 0.35 – 0.45 Normal
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Hemoglobin 122 gms/L 115 – 155 Normal

RBC 4.5 x 10^12/L 4.00 – 5.20 Normal
WBC 9.5 x 10^12/L 5.0 – 14.5 Normal
Segmenters H 79 % 32 – 54 Infection
Basophil 0% 0–1 Normal
Eosinophil 1% 0–1 Normal
Lymphocyte L 13 28 – 48 Infection
Monocyte H7% 3–6 Infection
MCV 80 fL 77 – 95 Normal
MCH 27 pg 25 – 33 Normal
MCHC 35 g/dL 32 – 36 Normal
RDW 13 % 11.5 – 15.0 Normal
Platelet Count 290 x 10^9/L 150 – 450 Normal

XII. DISCHARGE PLAN

Exercise
Treatment Lansoprazole (Prevacid) FDT 15 mg / Tab X 4
days
Health Teaching  Described to the client and mother the
signs and symptoms to be reported
immediately
 Advised family to immediately consult
to her physician if signs and symptoms
of the disease recur.
 Get plenty of rest. Adequate rest is
important to maintain progress toward
full recovery.
 Drink lots of fluids, especially water.
Liquids will keep patient from
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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

becoming dehydrated.
 Encouraged patient to wash her
hands.
Diet Any foods that could aggravate the
symptoms should be eliminated. Foods such
as milk, tea, colas and chocolate should be
consumed in small amounts or eliminated if
possible. Bedtime eating should be avoided
as it increases nocturnal acid secretions.

Spirituality  Encouraged patient to thank God

despite all of the circumstances
they’ve experienced.
 Told client to pray every night before
bed.
Outpatient Follow-Up Follow-up care on February 15, 2021
(11:00 AM) at SACH OPD

XIII. ACKNOWLEDGEMENT

No one who achieves success does so without acknowledging the help of

others. The wise and confident acknowledge this help with gratitude.

-Alfred North Whitehead-

The completion of this case study could not have been possible without the

participation and assistance of some whose names may not all be enumerated. Their

help is sincerely full of gratitude from yours truly. However, I would like to express my

deepest gratitude to the following.

 ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

To the Lord Almighty, the giver of life and wisdom, source of physical and spiritual

strength, knowledge and ability and opportunity to make this case study and to

persevere and complete it. Without his blessings, this success would have not been

possible.

To my dear parents who unconditionally and wholeheartedly support my dreams and

goals in life, their willingness to invest and participate on my academic performances,

without them I may not be able to continue and pursue this profession.

To Ms. Rubilyn Sumaylo, RN, MSN., Dean of the College of Nursing, for making this

rotation possible, thus allowing us to further enhance and strengthen our knowledge,

skills, and attitude and for lifting our spirits during the backbreaking rotations.

To Mrs. Nita A. Ammogao, RN., our clinical instructor for this last rotation, for her

endless support, kindness and understanding during the rotation, for sharing her

knowledge and expertise, experiences and words of encouragement.

To Mrs. Ethel Bergantinos, RN, MSN., Mrs. Maureen Tajolosa RN., Mrs. Edrelyn

Venturanza RN., MSN., and Mrs. Betty S. Miranda, RN., MAN., our clinical instructors

from the previous rotations, for imparting their skills and experiences, kindness and

patience and for honing the student nurses’ skills as well.

To my classmates who are always understanding and responsive whenever I have

some clarifications and questions, for their contribution and effort to complete this

case study, remained patient and determined in times of difficulty and endured the

pressure, for encouraging one another, and for the sacrifices made for the completion

of this case study.

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SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

To all the people who believe in me, I am beyond grateful that despite of the new

normal learning I have their supports and encouragements which inspire me to do

better and continue the journey towards my dream profession.

Sarah L. Rodaje S.N

BSN III STEM

XIV. BIBLIOGRAPHY

Gastritis

Gastritis is a general term for a group of conditions with one thing in common:

inflammation of the lining of the stomach. The inflammation of gastritis is most often

the result of infection with the same bacterium that causes most stomach ulcers.

Acute Gastritis
 ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
SAN ROQUE EXTENSION, ROXAS CITY, CAPIZ 5800
COLLEGE OF NURSING

Acute Gastritis is the inflammation of the gastric mucosa lasting several hours to a few

days.

Chronic Gastritis

Chronic Gastritis is a prolonged inflammation of the stomach that may be caused by

either benign of malignant ulcers of the stomach and bacteria.

Helicobacter pylori (H. pylori)

Helicobacter pylori (H. pylori) bacteria are a common cause of digestive illnesses,

including gastritis (the irritation and inflammation of the stomach lining), peptic ulcers

(sores in the lining of the stomach, small intestine, or esophagus), and even stomach

cancer later in life.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to

relieve pain, reduce inflammation, and bring down a high temperature. They're often

used to relieve symptoms of headaches, painful periods, sprains and strains, colds and

flu, arthritis, and other causes of long-term pain.