PUD - Peptic Ulcer Disease

[Pages:1]PUD - Peptic Ulcer Disease

Med Surg: GI - Gastrointestinal

Pathophysiology

PUD (Peptic Ulcer Disease) happens when gastric acids erode

Peptic Ulcer Disease

the gastric lining creating open sores / holes in the esophagus,

stomach, or duodenum.

Signs & Symptoms

G Gastric Ulcer G Gut Paint with food

D Duodenal Ulcer D Don't have pain with food

Dyspepsia: Burning Pain "Epigastric" "Back"

Gastric Ulcer (stomach)

PAIN Increased with food NCLEX TIP 30 - 60 min. after meals

Weight LOSS Vomits blood "Hematemesis"

Duodenal Ulcer (intestine)

PAIN Decreased with food NCLEX TIP 2 - 3 hours after meals Worse at NIGHT

Weight Gain Blood in stool "melena" (dark tarry stool)

Complication

Perforation = Peritonitis & Sepsis Report to HCP! Fever (over 100.3F) Rebound tenderness "Rigid" or "board-like abdomen" Increasing Pain, tenderness Restless Fast HR & RR

(tachycardia / tachypnea)

Hemorrhage (bleeding)

Melena (black tarry stools) Hematemesis (vomiting of blood)

Gastric outlet obstruction

Saunder's

Client with ... a peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?

A rigid, board-like abdomen

HESI

Which complications does the nurse monitor for while assessing a patient with peptic ulcer disease (PUD)? Select all that apply.

Perforation Hemorrhage Gastric outlet obstruction Hematemesis and melena

Diagnostics

Esophagogastroduodenoscopy (EGD) Perforation = Peritonitis & Sepsis

PRIORITY - Report to HCP! Fever (over 100.3F)

Upper GI Series with barium contrast

NCLEX TIP

1 HCP

Pharmacology

> 100.3 oF

Antibiotics: H. Pylori bacteria

Amoxicillin Clarithromycin Tetracycline Metronidazole Bismuth (brand: Pepto-Bismol)

Acid reducers

Antacids Histamine receptor blockers

Ranitidine PPIs: Proton pump inhibitors

Omeprazole

Mucosal protectants

Sucralfate Misoprostol

Client Education:

NPO (no eating or drinking) No smoking 8 hours BEFORE the procedure

Expected: During: Abdominal cramping After: Chalky white stool

Flush the Contrast Increase fluid intake Kaplan Take Laxatives

Causes & Risk

1. H. Pylori bacteria 2. NSAIDs

Naproxen Indomethacin Ibuprofen 3. Stress (prolongs the ulcer) - Nursing school / NCLEX

H.Pylori

NAPROXEN Indomethacin

HESI

A patient ... is diagnosed with Helicobacter pylori (H. pylori) peptic ulcer disease. The nurse anticipates administering which drugs? Select all that apply. Bismuth Tetracycline Metronidazole

HESI

Which classes of drugs are used to reduce the symptoms of peptic ulcers? Select all that apply.

Antacids Mucosal healing agents Proton pump inhibitors Histamine receptor blockers

Patient Education

Diet

Avoid Spicy, Fatty, Fried, Acidic foods NO Caffeine (coffee, Soda, tea) NO Alcohol NO Cigarettes (tobacco)

Decrease Stress

Avoid NSAIDs

Naproxen Indomethacin Ibuprofen

Report black tarry stools to HCP!

Common NCLEX Question

The nurse is educating the client on peptic ulcer prevention. Which statement by the client shows correct understanding? Select all that apply.

1. "I will not drink beer at the

party this weekend"

2. "I will avoid using naproxen"

3. "I should avoid drinking excess

coffee or soda"

4. "I will start smoking cessation"

5. "I will avoid spicy foods but

fried chicken is ok"

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