PUD Flashcards
Peptic Ulcer Disease
A condition characterized by the erosion of the GI mucosa by the HCL and pepsin
Gastric Ulcers
Occur in the stomach
Duodenal Ulcers
Occur in the duodenum
Goals of treating peptic ulcers
- Relieve symptoms
- Heal Ulcer
- Destroy H. pylori bacteria
Destroying H. Pylori Bacteria
- Antibiotics
- Acid suppression Medicaitons
- Other Medications
- Take medications for 1-4 weeks
Symptoms of Complications of a Peptic Ulcer
- Bloody or black stools
- Vomiting blood
- Dizziness or faintness
- Weight loss
- Persistent Full feeling
- Severe pain
Causes of Peptic Ulcers
- Excessive alcohol consumption, smoking, drugs (esp. aspirin and NSAIDs)
- H. Pylori bacteria
- Stress and excessive acid secretion
Assessment of Gastric Ulcers
- Burning/Gaseous pain in L. epigastric
- Pain 1-2 hours after meals
- If ulcer is deep, pain with meals
- Occasional N/V
Assessment of Duodenal Ulcer
- Burning/Cramping Pain
- Midepigastric
- Pain 2-4 hours after eating
- Pain relief with antacids and food
Diagnostic Testing for Peptic Ulcers
- 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
Nursing Diagnoses for peptic ulcers
- Acute Pain r/t gastric inflammation and irriation
- Deficient Fluid Volume r/t bleeding, vomiting
- Nausea r/t acute exacerbation of disease
- Deficient Knowledge r/t lack of exposure
- Risk for bleeding
Assessment of PUD
- VS (CHECKING FOR HEMMORHAGE)
- Pain assessment and treatment
Medications
- Antacids
- Histamine H2 receptor blockers
- Mucosal protective
- Proton pump inhibitors
- Antibiotic (if H. pylori)
Nutrition for PUD
- No specific diet restrictions
- Eliminiate foods that cause discomfort and symptoms
- Food known to irritate gastric muscoa
- hot, spicy foods
- alcohol
- carbonated beverages
- caffeine
Signs and symptoms to report: signs of perforation, hemorrhage, or obstruction
Increase in pain, nausea and vomiting, black tarry stools, blood emesis
Lifestyle Changes of Peptic Ulcers
- Avoid alcohol
- NSAID and ASA use
- Stress reduction
- Caffeine
- Smoking cessation
Surgerical Management when mediations fail
- Gastrectomy
- Vagotomy
- Pyloroplasty
Gastrectomy
Partial or total removal of stomach
Vagotomy
Partial or total severing of vagus nerve, decreases stimulus of HCL acid
Pyloroplasty
Surgical enlargement of pyloric sphincter
Hemorrhage VS Changes
Increase in pulse
Decrease in BP
Increase In RR
Signs of bleeding
Hematemesis, hemoptysis, tarry black stools
Signs of Perforation
- Sudden, severe abdominal pain
- Rigid, board like abdomen
- Drawing up of knees (fetal position)
- Shallow, grunting respirations
- Increase in Pulse
- Decrease BP
- Increase in RR
- Increase in Temp
Signs of Gastric Outlet Obstruction
- Vomiting is the cardinal sign, nonbilious/undigested food
- May tolerate liquids better than solids
