The nurse is caring for a patient with gastritis. Which of the following interventions would be appropriate for a patient with acute gastritis?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

Nausea and vomiting are primary symptoms of acute gastritis, which is the inflammation of the stomach lining.
Administering an antiemetic, such as a phenothiazine, is a key supportive measure to manage these symptoms.
Controlling vomiting is essential to prevent dehydration, electrolyte imbalance, and further irritation to the gastric mucosa, promoting patient comfort and stability.

Option A: While monitoring for bleeding is crucial in gastritis, the characteristic sign of upper GI bleeding is melena (black, tarry stools) or hematemesis (vomiting blood). Bloody diarrhea (hematochezia) typically indicates bleeding in the lower gastrointestinal tract.
Option B: This statement is factually incorrect and represents a significant patient education error. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are common and well-known causes of acute erosive gastritis.
Option D: During the acute phase of gastritis, the stomach needs to rest to allow the inflamed mucosa to heal. The standard practice is to keep the patient NPO (nothing by mouth) until symptoms subside.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing interventions for acute gastritis to guide bedside assessment, documentation, and the next nursing action.
The primary goal in managing acute gastritis is to prevent complications. Uncontrolled vomiting can quickly lead to dehydration and electrolyte disturbances, which can be life-threatening, especially in elderly or frail patients.
Nurses must be vigilant in monitoring for signs of hemorrhagic gastritis, a severe complication. This includes checking vital signs for tachycardia and hypotension, and examining vomit and stool for evidence of bleeding.
What if the patient develops severe, persistent vomiting despite the phenothiazine? The nurse should notify the provider immediately, anticipate orders for IV fluids and alternative antiemetics, and prepare for potential nasogastric (NG) tube placement for gastric decompression.

How to Approach the Question

First, identify the patient's condition: acute gastritis. This means there is active inflammation of the stomach lining.
Think about the goals of care for any acute inflammatory process: rest the affected area and manage symptoms.
Evaluate each option based on these goals. Does the intervention rest the stomach and/or manage a key symptom?
Eliminate option D because a regular diet would further irritate the inflamed stomach, violating the principle of rest.
Eliminate option B because it is factually incorrect; aspirin is a common cause of gastritis.
Compare options A and C. While monitoring for bleeding (A) is important, the sign mentioned (bloody diarrhea) is less typical for gastritis than melena or hematemesis. Option C directly addresses a very common and distressing symptom (vomiting), which aligns with the goal of symptom management and preventing dehydration. Therefore, C is the most appropriate intervention.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 139-141

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