Tuesday, November 19, 2013

Gastritis - Definition, Classification, Pathophysiology and Prevention

Definition of Gastritis

Gastritis is an inflammation localized or diffuse, in the gastric mucosa that develops when the mucosal protective mechanisms are filled with bacteria or irritants. (J. Reves, 1999).


Classification of Gastritis

Gastritis by type divided into 2 (two), namely :

1. Acute gastritis
Gastritis (inflammation of the gastric mucosa) is most often caused by carelessness diet, such as eating too much, too fast, eating food too much seasoning or infected food. Other causes include alcohol, aspirin, bile fefluks and radiation therapy. Gastritis can also be the first sign of acute systemic infection. Form a more severe acute gastritis caused by strong acid or alkali, which can lead to gangrene or perforation of the mucosa.

2. Chronic gastritis
Prolonged inflammation caused by both benign and malignant gastric ulcers, by the bacteria H. Pylori. Chronic gastritis may be classified as Type A or Type B. Type A occurs in gastric fundus or corpus. Type B (H. Pylori) the antrum and pylorus. May be related to the bacteria H. Pylori. Dietary factors such as hot drinks, seasonings, use of drugs, alcohol, smoking or reflux of intestinal contents into the stomach.


Pathophysiology of Gastritis

Foodstuffs, drinks, drugs and chemicals that go into the stomach causing irritation or erosion of the gastric mucosa to lose barrier (protective). Furthermore an increase in diffusion of hydrogen ions. Diffusion in mucosal disruption and increased gastric acid secretion is increased / lot. Stomach acid and digestive enzymes. Then invades the gastric mucosa and inflammatory reaction occurs. This is called gastritis. Response of the gastric mucosa against irritants are mostly with mucosal regeneration, therefore such disturbances often disappears by itself.

With the constant irritation, tissue become inflamed and can bleed.
The introduction of substances such as strong acids and bases are corrosive resulting in inflammation and necrosis of the stomach wall (gastritis corrosive). Necrosis can result in perforation of the stomach wall to the next due to bleeding and peritonitis.
Chronic gastritis can lead to a state of atrophy of the gastric glands and the state of mucosal thickening patches are gray or greenish gray (gastitis atrophic). The loss of the gastric mucosa will ultimately result in reduced gastric secretion and the onset of pernicious anemia. Atrophic gastritis may be a precursor to gastric carcinoma. Chronic Gastritis may also occur in conjunction with peptic ulcer or may occur after the action gastroyeyunostomía.


Prevention of Gastritis

Although infection of H. pylori can not always be prevented, here are some suggestions to reduce the risk of gastritis:

1. Eating correctly. Avoid foods that can irritate especially spicy foods, acidic, fried or fatty. Which is just as important as the selection of the right foods for health is how to eat it. Eat a sufficient amount, on time and done with ease.

2. Avoid alcohol. The use of alcohol can irritate and erode the mucous lining of the stomach and can cause inflammation and bleeding.

3. Do not smoke. Smoking affect the protective stomach lining, making the stomach more susceptible to gastritis and ulcers. Smoking also increases stomach acid, thereby delaying the healing of the stomach and is a major cause of gastric cancer. However, to be able to quit smoking is not easy, especially for heavy smokers. Consult with your doctor about methods that can help to stop smoking.

4. Do exercise regularly. Aerobic exercise can increase heart rate and breathing, also can stimulate bowel muscle activity that helps remove food waste from the intestines more quickly.

5. Control stress. Stress increases the risk of heart attack and stroke, lowers the immune system and can lead to skin problems. Stress also increases the production of stomach acid and slow down the speed of digestion. Because stress for some people can not be avoided, then the key is to control it effectively by way of a nutritious diet, adequate rest, regular exercise and adequate relaxation.

6. Replace pain medication. If possible, avoid the use of NSAIDs, this class of drugs will cause inflammation and will make existing inflammation worse. Replace with pain relievers containing acetaminophen.

7. Follow the doctor's recommendations.

Nursing Care Plan for Gastritis

Monday, November 18, 2013

Urinary Tract Infection : Definition, Classification, Etiology, Signs and Symptoms

Definition

Urinary Tract Infection (UTI) is a state of the invasion of microorganisms in the urinary tract. (Agus Tessy, 2001)

Urinary Tract Infection (UTI) is a bacterial infection of the state of the urinary tract. (Enggram, Barbara, 1998)


Classification

Classification of urinary tract infections as follows:
  1. Bladder (cystitis)
  2. Urethra (urethritis)
  3. Prostate (prostatitis)
  4. Kidneys (pyelonephritis)

Urinary Tract Infection (UTI) in the elderly, can be divided into :

1 . Uncomplicated (simple)
Simple UTI that occurs in patients with urinary tract is not good, normal anatomic and functional. This UTI in elderly patients, especially regarding women and the infection just about superficial bladder mucosa.

2 . Complicated
Often cause a lot of problems because they are often difficult to eradicate germs, germs are often resistant to multiple kinds of antibiotics, frequent bacteremia, sepsis and shock. The UTI occurs when the circumstances are as follows :
  • Abnormal urinary tract abnormalities, such as stone, reflex vesico urethral obstruction, bladder atony, paraplegia, permanent bladder catheter and prostatitis.
  • Abnormalities of renal physiology : renal failure acute and chronic renal failure.
  • Immune disorders
  • Infections caused by virulent organisms such as prosteus spp, which produce urease.

Etiology

1. The types of microorganisms that cause UTI, among others:
  • Pseudomonas, Proteus, Klebsiella: the cause of complicated UTI.
  • Escherichia Coli : 90% cause of uncomplicated UTI (simple).
  • Enterobacter, epidemidis staphylococci, enterococci, and-others.

2. The prevalence of UTI in the elderly, among others:
  • Residual urine in the bladder is increased due to the bladder emptying less effective.
  • Decreased mobility.
  • Nutrition is often poor.
  • Decreased immune system, either cellular or humoral.
  • Barriers to the flow of urine.
  • Loss of bactericidal effect of prostate secretions.

Signs and Symptoms

1. Signs and symptoms of lower UTI are:
  • Frequent pain and a burning sensation when urinating.
  • Spasame the bladder and suprapubic area.
  • Hematuria.
  • Back pain can occur.

2. Signs and symptoms of upper UTI are:
  • Fever.
  • Chills.
  • Pelvic pain and waist.
  • Pain when urinating.
  • Malaise.
  • Dizziness.
  • Nausea and vomiting.
Urinary Retention related to Benign Prostatic Hyperplasia (BPH)

Nursing Care Plan for Urinary Tract Infection

Nanda for Urinary Tract Infection

Altered Urinary Elimination - NCP Urinary Tract Infections

Nursing Care Plan for Urinary Tract Infections

A urinary tract infection (UTI) is an infection that affects part of the urinary tract.
Symptoms from a lower urinary tract include painful urination and either frequent urination or urge to urinate (or both), while those of pyelonephritis include fever and flank pain in addition to the symptoms of a lower UTI.

Nursing Diagnosis : Altered Urinary Elimination related to mechanical obstruction of the bladder or other urinary tract structures.

Outcomes:
Improved elimination pattern , not the signs urinary disorders : urgency , oliguric , dysuria

Intervention:

1. Monitor input and output and urine characteristics.
Rational: provides information about kidney function and presence of complications.

2. Encourage increased fluid intake.
Rationale: increased hydration washes the bacteria.

3. Assess complaints of the urinary bladder.
Rational: urinary retention may occur causing tissue distension (bladder / kidney).

4. Observation of changes in the level of consciousness.
Rational: accumulation of uremic and electrolyte imbalances can be toxic to the central nervous system.

5. Monitor laboratory tests; electrolytes, BUN, creatinine.
Rational: monitoring of renal dysfunction.

6. Take action to maintain acidic urine: input increase berry juice and give medications to increase uric acid.
Rational: uric acid deter the growth of bacteria. Increased input preformance juice can affect the treatment of urinary tract infections.

Followers