PUD

Question 1

Major causes

Answer 1

• NSAIDs (inhibit prostaglandin synthesis, irritate gastric mucosa)
• H.pylori (disrupts mucosal barrier of stomach)
• Gastritis

Question 2

Desc the bleeding in a patient with peptic ulcers

Answer 2

Bleeding may be sudden, severe or it may be insidious producing occult blood in the stool

Question 3

When does the pain occur?

Answer 3

Between meals when stomach is empty

Question 4

Complications

Answer 4

• haemorrhage
• obstruction
• perforation

Question 5

Treatments

Answer 5

• eliminate cause
• relieve ulcer symptoms
• heal ulcer crater: acid-neutralising drugs, antacids, proton-pump inhibitors

Question 6

Nur management

Answer 6

• pain relief
• reduce anxiety
• explain all procedures & treatment
• I/O
• s/s of anemia & bleeding
• focus abdominal assessment

Question 7

Management of ___________ (potential complication):

• immediate surgery: Laparotomy Gastrectomy
• vital signs
• s/s of dehydration, hypovolaemic shock, sepsis
• maintain NBM
• I/O
• blood transfusion
• NGT
• Vasopressin by IV (reduce bleeding)

Answer 7

Management of perforation (potential complication)

• immediate surgery: Laparotomy Gastrectomy
• vital signs
• s/s of dehydration, hypovolaemic shock, sepsis
• maintain NBM
• I/O
• blood transfusion
• NGT
• Vasopressin by IV (reduce bleeding)

Question 8

Management of _____________(potential complication):

• assess for evidence of bleeding, hematemesis or melena, & symptoms of shock & anaemia
• treatment: IV fluids, NGT, saline, oxygen
• treatment for shock: monitor V-S and urine output
• may require endoscopic coagulation or surgy

Answer 8

haemorrhage

Question 9

Symptoms of pyloric obstruction (intestinal obstruction)

Answer 9

nausea
vomiting
constipation
epigastric fullness
anorexia
weight loss (later)

Question 10

Management of _____________ (potential complication):

• NGT to decompress stomach
• provide IV fluids & electrolytes
• balloon dilation or surgery may be required

Answer 10

pyloric obstruction