Assessment and Possible Nursing Diagnosis for Gastritis

Gastritis is one of the most common gastrointestinal conditions encountered in clinical practice across the United States. For nursing students, mastering the assessment process and understanding possible nursing diagnoses is essential for safe, accurate, and patient-centered care. This article provides a complete, detailed, and easy-to-understand guide tailored for nursing students who want to strengthen their clinical reasoning surrounding gastrointestinal disorders.

What Is Gastritis?

Gastritis is an inflammation of the gastric mucosa. It can be acute, chronic, or erosive, depending on the severity and duration. Patients may present with mild discomfort or severe symptoms such as vomiting, hematemesis, or significant abdominal pain.

Types of Gastritis

• Acute Gastritis: Rapid onset; commonly caused by drugs, alcohol, or infection.
• Chronic Gastritis: Long-term mucosal inflammation often due to H. pylori or autoimmune factors.
• Erosive Gastritis: Characterized by erosion, bleeding, or ulceration of the stomach lining.

Etiology of Gastritis

• Helicobacter pylori infection
• Long-term NSAID use
• Alcohol consumption
• Smoking
• Stress-related mucosal damage
• Autoimmune gastritis
• Bile reflux
• Spicy or acidic foods (triggering factor)

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Comprehensive Nursing Assessment for Gastritis

The nursing assessment for gastritis includes subjective data, objective findings, health history, and diagnostic tests. A holistic assessment helps identify the underlying causes and guides effective nursing care planning.

1. Subjective Assessment (Patient Report)

• Epigastric pain (burning, cramping, or gnawing sensation)
• Nausea and vomiting
• Loss of appetite
• Belching and bloating
• Indigestion (dyspepsia)
• Feeling of fullness after eating small amounts

2. Objective Assessment (What the Nurse Observes)

• Epigastric tenderness on palpation
• Vomiting bile or undigested food
• Tachycardia (if dehydration occurs)
• Pale conjunctiva (possible GI bleeding)
• Positive fecal occult blood test

3. Focused Health History

Key questions include:

• Do you take NSAIDs, aspirin, or steroids regularly?
• How much alcohol, caffeine, or spicy foods do you consume?
• Are your symptoms worse before or after eating?
• Have you ever been diagnosed with H. pylori infection?
• Do you smoke?

4. Diagnostic Tests

• Endoscopy: Gold standard for diagnosing gastritis
• H. pylori breath test
• Stool antigen test
• CBC: Assess for anemia or infection
• B12 levels: For autoimmune gastritis
• Biopsy: Confirms inflammation and rules out malignancy

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Possible Nursing Diagnoses for Gastritis

Based on assessment findings, nursing students may identify several NANDA-I–based nursing diagnoses. These diagnoses guide the development of individualized care plans.

Common Nursing Diagnoses Include:

1. Acute Pain related to gastric mucosal inflammation
2. Nausea related to gastric irritation
3. Imbalanced Nutrition: Less Than Body Requirements related to decreased intake
4. Risk for Fluid Volume Deficit related to vomiting
5. Deficient Knowledge related to lack of understanding of disease process

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Nursing Care Plan (NCP) Table for Gastritis

Nursing Diagnosis	Goals / Expected Outcomes	Nursing Interventions	Rationales
Acute Pain related to gastric mucosal inflammation	Patient will report decreased abdominal pain within 24 hours. Pain score will decrease from 7/10 to 3/10.	Assess pain characteristics (location, intensity, duration). Administer antacids, PPIs, or H2 blockers as prescribed. Encourage small, frequent meals. Instruct patient to avoid irritants (alcohol, coffee, spicy foods).	Helps measure treatment response. Reduces gastric acidity and promotes mucosal healing. Prevents gastric overload. Reduces further irritation of the gastric mucosa.
Nausea related to gastric irritation	Patient will experience reduced nausea within 24 hours. Patient will tolerate oral intake without vomiting.	Administer antiemetics (ondansetron, promethazine) as ordered. Provide small, bland meals. Discourage strong odors in the environment. Monitor hydration status and urine output.	Controls symptoms and improves comfort. Reduces gastric irritation. Strong odors can trigger nausea. Detects early signs of dehydration.
Imbalanced Nutrition: Less Than Body Requirements related to decreased intake	Patient will maintain adequate nutritional intake. Weight will remain stable during hospitalization.	Monitor daily weight and food intake. Provide a non-irritating, soft or bland diet. Encourage oral hydration. Consult a dietitian for nutritional guidance.	Measures nutritional status accurately. Minimizes gastric irritation. Prevents dehydration. Ensures individualized nutrition support.

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Conclusion

Gastritis is a common condition that requires thorough nursing assessment and appropriate nursing care. By identifying signs and symptoms early, performing accurate diagnostic evaluations, and formulating suitable nursing diagnoses, nurses play a vital role in improving patient outcomes. For nursing students, mastering these concepts is essential to building strong clinical judgment and delivering safe and effective care.

Sources

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Gastritis.”
• Mayo Clinic. “Gastritis: Symptoms and Causes.”
• Ignatavicius, D. & Workman, M. Medical-Surgical Nursing. Elsevier.
• NANDA International. NANDA-I Nursing Diagnoses.

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