PUD

Question 1

Peptic Ulcer Disease

Answer 1

A condition characterized by the erosion of the GI mucosa by the HCL and pepsin

Question 2

Gastric Ulcers

Answer 2

Occur in the stomach

Question 3

Duodenal Ulcers

Answer 3

Occur in the duodenum

Question 4

Goals of treating peptic ulcers

Answer 4

1. Relieve symptoms
2. Heal Ulcer
3. Destroy H. pylori bacteria

Question 5

Destroying H. Pylori Bacteria

Answer 5

1. Antibiotics
2. Acid suppression Medicaitons
3. Other Medications
4. Take medications for 1-4 weeks

Question 6

Symptoms of Complications of a Peptic Ulcer

Answer 6

1. Bloody or black stools
2. Vomiting blood
3. Dizziness or faintness
4. Weight loss
5. Persistent Full feeling
6. Severe pain

Question 7

Causes of Peptic Ulcers

Answer 7

1. Excessive alcohol consumption, smoking, drugs (esp. aspirin and NSAIDs)
2. H. Pylori bacteria
3. Stress and excessive acid secretion

Question 8

Assessment of Gastric Ulcers

Answer 8

• Burning/Gaseous pain in L. epigastric
• Pain 1-2 hours after meals
• If ulcer is deep, pain with meals
• Occasional N/V

Question 9

Assessment of Duodenal Ulcer

Answer 9

1. Burning/Cramping Pain
2. Midepigastric
3. Pain 2-4 hours after eating
4. Pain relief with antacids and food

Question 10

Diagnostic Testing for Peptic Ulcers

Answer 10

• Endoscopy-esophagogastro-duodenoscopy
• Serum antibody test for H. pylori
• Urea breath test to determine active infection. Urea is a byproduct of metabolism of H. pylori

Question 11

Nursing Diagnoses for peptic ulcers

Answer 11

1. Acute Pain r/t gastric inflammation and irriation
2. Deficient Fluid Volume r/t bleeding, vomiting
3. Nausea r/t acute exacerbation of disease
4. Deficient Knowledge r/t lack of exposure
5. Risk for bleeding

Question 12

Assessment of PUD

Answer 12

• VS (CHECKING FOR HEMMORHAGE)
• Pain assessment and treatment

Question 13

Medications

Answer 13

1. Antacids
2. Histamine H2 receptor blockers
3. Mucosal protective
4. Proton pump inhibitors
5. Antibiotic (if H. pylori)

Question 14

Nutrition for PUD

Answer 14

• No specific diet restrictions
• Eliminiate foods that cause discomfort and symptoms
• Food known to irritate gastric muscoa
  
  • hot, spicy foods
  • alcohol
  • carbonated beverages
  • caffeine

Question 15

Signs and symptoms to report: signs of perforation, hemorrhage, or obstruction

Answer 15

Increase in pain, nausea and vomiting, black tarry stools, blood emesis

Question 16

Lifestyle Changes of Peptic Ulcers

Answer 16

• Avoid alcohol
• NSAID and ASA use
• Stress reduction
• Caffeine
• Smoking cessation

Question 17

Surgerical Management when mediations fail

Answer 17

1. Gastrectomy
2. Vagotomy
3. Pyloroplasty

Question 18

Gastrectomy

Answer 18

Partial or total removal of stomach

Question 19

Vagotomy

Answer 19

Partial or total severing of vagus nerve, decreases stimulus of HCL acid

Question 20

Pyloroplasty

Answer 20

Surgical enlargement of pyloric sphincter

Question 21

Hemorrhage VS Changes

Answer 21

Increase in pulse

Decrease in BP

Increase In RR

Question 22

Signs of bleeding

Answer 22

Hematemesis, hemoptysis, tarry black stools

Question 23

Signs of Perforation

Answer 23

1. Sudden, severe abdominal pain
2. Rigid, board like abdomen
3. Drawing up of knees (fetal position)
4. Shallow, grunting respirations
5. Increase in Pulse
6. Decrease BP
7. Increase in RR
8. Increase in Temp

Question 24

Signs of Gastric Outlet Obstruction

Answer 24

1. Vomiting is the cardinal sign, nonbilious/undigested food
2. May tolerate liquids better than solids