Discharge And Home Healthcare Guidelines

Teach the patient the importance of compliance with palliative and follow-up care. Be sure the patient understands all medications, including the dosage, route, action, and adverse effects.

360 Gastritis

Teach the patient the signs and symptoms of infection and how to care for the incision. Instruct the patient to notify the physician if signs of infection occur. Encourage the patient to seek psychosocial support through local support groups (e.g., I Can Cope), clergy, or counseling services. If appropriate, suggest hospice services. Teach the patient methods to enhance nutritional intake to maintain ideal body weight. Several small meals a day may be tolerated better than three meals a day. Take liquid supplements and vitamins as prescribed. Refer the patient to the dietitian for a consultation. Teach family members and friends prevention strategies. Strategies include increasing the intake of fresh fruits and vegetables that are high in vitamin C; maintaining adequate protein intake; and decreasing intake of salty, starchy, smoked, and nitrite-preserved foods.


DRG Category: 182 Mean LOS: 4.3 days Description: MEDICAL: Esophagitis,

Gastroenteritis, and Miscellaneous Digestion Disorders, Age > 17 with CC

GGastritis is any inflammatory process of the mucosal lining of the stomach. The inflammation may be contained within one region or be patchy in many areas. Gastric structure and function are altered in either the epithelial or the glandular components of the gastric mucosa. The inflammation is usually limited to the mucosa, but some forms involve the deeper layers of the gastric wall. Gastritis is classified into acute and chronic forms.

ACUTE. The most common form of acute gastritis is acute hemorrhagic gastritis, also called acute erosive gastritis. The gastric erosions are limited to the mucosa, which have edema and sites of bleeding. Erosions can be diffuse throughout the stomach or localized to the antrum.

CHRONIC. The three forms of chronic inflammation of the gastric mucosa are superficial gastritis, atrophic gastritis, and gastric atrophy. Superficial gastritis, the initial stage in the development of chronic gastritis, leads to red, edematous surface epithelium, small erosions, and decreased mucus content. The gastric glands remain normal. With atrophic gastritis, inflammation extends deeper into the gland area of the mucosa with loss of parietal and chief cells. Atrophic gastritis further develops into the final stage of chronic gastritis—gastric atrophy. In this stage, there is a total loss of glandular structure.

Chronic gastritis has also been classified as type A and type B. Type A chronic gastritis, the less common form, involves the body of the stomach (fundus) rather than the antrum. Type B gastritis is a more common nonautoimmune inflammation of the lining of the stomach. It primarily involves the antrum but can affect the entire stomach as age increases. Patients with chronic gastritis have an increased risk (10%) for gastric cancer or may develop chronic iron deficiency. Untreated gastritis can also lead to hemorrhage and shock, gastric perforation, gastrointestinal (GI) obstruction, and peritonitis.

Alkaline reflux gastritis is inflammation caused by reflux of bile and pancreatic secretions that disrupt the mucosal layer of the stomach and lead to burning epigastric pain, nausea, and emesis. Alkaline reflux gastritis is a known compliction of the Billroth II gastrojejunostomy surgical procedure.

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