CHAPTER I

PRELIMINARY

A. Background
The country of Timor Leste is a young country getting more and more intensive by
building in all fields, the health field is one of them. Reflecting on a healthy, universal
well-being policy for all those listed in jurisdiction in the East Timor Republika law
number 57 which speaks in detail concerning the right to health care belongs to all
authentic East Timorese citizens without exception. But as far as this young nation's
children can be seen to avoid the success of health development should be given more
specific attention, that the number of supernatural power is inevitable.

In accordance with medic records of Hospital Nacional Guido Valadares in 2012

suffering of acute Gastritis reached 815 men with gastritis of men amounted to 321
people, while females numbered 503 chronic gastritis amounted to 431 men consisting of
213 men and women were 218 women still ranks most than men. While the interior room
Laki Hospital Nacional as a whole patient suffering from gastritis in 2011 amounted to 97
people so that support the orientation of the writer more excited choose the title of
nursing care of patients with Gastritis.Data recap year 2012 to December of patients
identified in cases of gastritis amounted to 30 people.

Departure from the nurse profession who bertangun in carrying out clinical health
services then one of the most common disorders occur in the clinic is gastric
pain.Bambung is a digestive organs in the human body that serves to store food, digest
food into smaller particles to be forwarded to The function of the stomach is to receive
food and work as a container for a short period of time, all prepared for digestion by the
intestines (pearce.2009).

A nursing profession has responsibilities in carrying out its role as an executor of the
nursery care which is a central part of the nursing process shown to individuals, families
and communities (yani, 2008).

According to (Pearce, 2009) implementing the role of health nurse is very necessary to
provide understanding to the family for their role in health midwives can run well. In line
with the increasing need for quality health services, the National Unity of Indonesia
(PPNI) in its National Workers pledges that nursing is professional. Professionals in
question include professional and professional education services.

Because of the disturbance in the stomach it is called Gastritis then according to (Efandi,
200), suggests Gastritis disease is inflammation of the stomach and is a frequent disorder
with the characteristics of anorexin, full and unpleasant taste in epigastrium nausea and
vomiting.

The main complaint of pasein with Gastristis is pain in the upper abdominal region, on
other complaints that lack of appetite, difficulty sleeping due to pain felt. In patients with
Gastritis nursing problems that must be addressed by nurses yaity pain, impaired nutrition
fulfillment less than body needs and disorders of sleep and rest patterns.

The main factor of its implementation is to eliminate the etiologies such as the stomach
diet with small portions but often and provide drugs that aim to regulate gastric acid
secretion in the form of H2 Antagonosis Receptor such as ranitidine, sucralfat, antacid
(Soeparman, 2010).

The incidence of Gastritis disease increases from 5-6 this year and attacks more men than
women. Men experience more Gastritis because of the habit of consuming alcohol and
smoking. Broadly speaking Gastritis can be divided into several kinds based on clinical
manifestations, typical histologic features, anatomical distribution and possible
pathogenesis Gastritis. Based on clinical manifestations, Gastritis can be divided into
acute and chronic. Problems that often arise in Gastritis generally experience nursing
problems painful pain disorders.

Doenges (2009), that nursing problems that arise in acute gastritis disease are pain
associated with increased stomach acid, less nutrition fulfillment needs than the body
needs associated with anorexia, wife pattern disturbances and sleep associated with pain
depression, anxiety associated with lack of knowledge, activity intolerance deals with
common weaknesses. Upper digestive disorders that arise from changes in lifestyle vary
widely from ulcers, varicose veins to bleeding with various causes.

Therefore, the author in the scope of his practice is obliged to fill the success of
improving the health status of the children of the Nation through the devotion and service
tampa pamrih with a nurse, so the authors raised the case of Gastritis representing this
paper as a clinic nurse who participated to build people's health in the country easily this.
B. Problem Formulation
How is the process of applying Nursing Care in patients with Gastritis through a nursing
process approach that includes assessment, nursing diagnosis planning, execution and
evaluation?

C. Purpose of Writing
1. General Purpose
Improve knowledge and understanding of writing in implementing through nursing in
patients according to each stage in nursing process in Gastritis case.
D. Special Purpose
a. Conduct Nursing Assessment in the same case with Gastritis
b. Able to formulate a nursing diagnosis that can be established in cases with Gastritis
c. Able to plan nursing care in cases with sertrengan Gastritis
d. Able to make the implementation of Nursing Care on pasein with Gastritis.
e. Able to evaluate nursing Asuha on care with Gastritis.
E. Benefits of Writing
1. For the Hospital
Provide a clear picture to the treatment patient in particular treatment on Gastritis
suffering to continue to maintain a healthy condition on a continuous basis after
completion of hospitalization.
2. For the Institution
a. Provide input to the institution in order to develop the standard of nursing care.
b. Creating a supportive environment in teaching and learning through education
activities for nursing staff.
c. As one of the requirements in supporting the continuing education program in the
growth of nursing professionals.
3. For Authors
a. Improve knowledge and experience in applying nursing care to patients with
Gastritis.
b. As an exercise applying one of the small elements of nursing tips to give comfort to
patients with Gastritis.
c. Applying theory acquired during college by practicing directly on the patient.
F. Scope
With time constraints, work and authorship so that this study is restricted only in Hospital
Nacional Guido Valadares (HNGV) Women's intema and intema room.
 CHAPTER II

LITERATURE REVIEW

A. Basic Concepts
1. Definition.
Gastritis is an inflammatory process in the mucosal layer and gastric sub-mucosa.
Histopologi can be proved by infiltration of inflammatory cells in the area. Gastritis is
one of the most common diseases in general internal medicine clinics (Herlan, 2011).

Gastritis is a gastric mucosal inflammation that can be acute, chronic diffusion and local
and there are two types of gastritis that occur namely acute superficial gastritis and
chronic atrophic gastritis (Brunner, 2008).

Gastritis is local inflammation or spreads in the gastric mucosa, which develops when the
protective mechanism of the mucosa is filled with bacteria or other irritant substances
(Charlene, 2006). Based on the above three conclusions, the authors conclude that
gastritis is actually a process of inflammation of the sub-mucosal layer and gastric
mucosa due to bacteria or that other acute or chronic.

2. Classification of Gastritis
a. Acute Gastritis
It is a clear, acute clinical abnormality with distinctive signs and symptoms. Usually a
commonly discovered disease, usually benign and self-limited, is a disease of gastric
mucosal responses to local irritants. Endotokson bacteria (after eating contaminated food)
alcohol, caffeine and aspirin are frequent causative agents. Other drugs, such as NSAIDs
(Indomethacin, naproxen), sulfonamide, steroids and digitalis are also involved. Some
spiced foods including vinegar, pepper, or mustard, can cause symptoms that lead to
gastritis, Mansyur (2000). If alcohol is taken with aspirin, the effect will be more
damaging than the effect of each agent separately.

Diffuse haemorrogic erosive gastritis usually occurs in heavy drinkers and aspirin users
and may result in the need for gastric resection. This serious illness will be considered not
due to stress, because both have many similarities.

Destruction of the gastric mucosal barrier is thought to be a pathogenic mechanism that

causes injury.In superficial gastritis, the mucosa is reddened, edematous, and covered by
an inherent mucus, small erosion and bleeding often arise. The degree of inflammation
varies greatly.
3. Etiology
Some things that can cause the protective layer of the stomach are:
a. Bacterial Gastricis
1. Helicobacter Pylori Bacterial infection living in the mucosal wall of the gastric wall is
thought to be transmitted by oral route or by eating or drinking that is contaminated
by this bacterium. It often occurs in childhood and can last a lifetime if nurses do not.
2. Campylobater Pyloroides bacterial infection.
b. Gastritis due to Acute Stress
a. Severe disease or trauma (injury) that occur suddenly,
b. Distinction
c. Severe infection
d. Cederanua itself may not recognize the stomach as it does in widespread burns or
injuries that cause severe bleeding.
c. Chronic Erosive Gastritis
a. An inflammatory nonsteroid (AINS) such as Aspirin, Profen's mother and Naproxen
can cause bleeding seprti stomach by lowering Prostaglandin in charge of protecting
the stomach wall.
b. Crohn's disease symptoms stomach pain and diarrhea in fluid form. May cause
chronic inflammation of the gastrointestinal wall but, sometimes it can also cause
peeradagan on the stomach wall.
c. Alcohol use is excessive, alcoholic and irritating and erodes mucosa in the gastric
wall and makes the gastric wall more susceptible to stomach acid in normal coarse.
d. Eosionophilic Gastritis
Occurs as a result of allergic reactions to roundworm infection Eosinophils
accumulate on the stomach wall.
e. Gastritis Hypothesis and Anthropy
But because of abnormalities Autoimmune atropine Gastritis occurs when the body's
immune system attacks cells that are in the wall of the stomach. This leads to
peradagan and gradually dilutes the stomach wall, destroys the gastric acid glands and
interferes with the production of intrinsic factors (ie, a substance that helps the body
to absorb vitamin B12) ) vitamin B12 deficiency eventually, can lead to pernicious
Anemia, a serious condition if not treated immediately can affect the entire system in
the body.
f. Meiner Disease
The stomach wall becomes thick, the folds are wide, the gland enlarges and has a
fluid filled cyst, about 10% of these suffer from gastric cancer.
a. Plasma Cell Gastritis
Plasma cells (one type of white blood cell) are collected in the inner wall of the stomach
and other ortans.
g. Bile Rufluk Disease
Bile (bile) is a fluid that helps digest fats in the body. This liquid is produced by the
liver. When released, the bile passes through a series of small channels and into small
intestines.

Under normal conditions, a ring-shaped Sphincter muscle (Pylonic Valve) will

prevent bile from flowing back into the stomach. But if the valve is not working
properly, then the bile will enter the stomach and cause inflammation and Gatritik.

a. Radiation and Chemotherapy

Treatment of cancer such as chemotherapy and radiation can lead to inflammation of the
stomach wall and can further develop into Gastriris and Peptic Ulcer. When the body is
exposed to a small amount of radiation, the damage is usually temporary, but in large
doses will cause the damage becomes permanent and can erode the stomach wall and
damage the gastric acid producing glands.

4. Clinical manifestations
Clinical manifestations of acute gastritis may vary from unclear abdominal complaints,
such as anorexia or nausea, to more severe symptoms such as epigastrum pain, vomiting,
bleeding and hematemesis. In some cases when symptoms are prolonged and resistant to
treatment, additional diagnostic measures may be required such as endoscopy, mucosal
biopsy and gastric fluid analysis to clarify the diagnosis.

Acute gastritis is usually their when the causative agents can be removed. Anti-vomiting
medications can help relieve nausea of fluid and electrolyte balance by providing
intravenous fluids. The use of H¬2 inhibition (such as rantidine) to reduce the secretion
of the sukralfat or antacial stomach acid, can speed healing (Price, 1995).