PUD Flashcards
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A) Bradycardia B) Numbness in the legs C) Nausea and vomiting D) A rigid, boardlike abdomen
Answer: D
Explanation: Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the mid-epigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the leg is not as associated finding.
Diagnostic testing is planned for a client with a suspected peptic ulcer. The nurse explains to the client that the most reliable test to determine the presence and location of an ulcer is
A. Endoscopy.
B. Gastric analysis.
C. A barium swallow test.
D. A serologic test for Helicobacter pylori.
Rationale: Endoscopy is the primary tool used to diagnose the source of upper gastrointestinal bleeding.
The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which sign/s/symptom/s of duodenal ulcer?
A) Weight loss
B) Nausea and vomiting
C) Pain relieved for 4 hours after food intake
D) Pain radiating down the right arm
Answer: C
Explanation: A frequent symptom of duodenal ulcer is pain that is relieved by food intake. Food is a buffer for the acid. These clients generally describe the pain as a burning, heavy, sharp, or “hungry” pain that often localizes in the mid-epigastric area. The client with duodenal ulcer usually does not experience weight loss or nausea and vomiting. These symptoms are more typical in the client with a gastric ulcer.
A client with peptic ulcer disease is taking a H2 Receptor. What is the expected outcome of this drug? A) Heal the ulcer B) Protect the ulcer surface from acids C) Reduce acid concentration D) Limit gastric acid secretion
Answer: D
Explanation: Histamine-2 (H@) receptor antagonists, such as ranitidine, reduce gastric acid secretion. Antisecretories, or proton pump inhibitors, such as omeprazole, help ulcers heal quickly in 4 to 8 weeks. Cytoprotective drugs, such as Carafate, protect the ulcer surface against acid, bile, and pepsin. Antacids reduce acid concentration and help reduce symptoms.
The nurse is caring for a client in the emergency department who is suspected of having appendicitis. Based on this data, which orders does the nurse anticipate from the healthcare provider? Select all that apply. A) A cephalosporin B) A barium enema C) Regular diet D) Pain medication E) Complete white blood cell count
Answer: A, D, E
Explanation: Pain medications will be ordered as will a complete white blood count, which will be elevated. A barium enema is not ordered, as this could cause perforation of the appendix and bowel. The client will take nothing by mouth, and the cephalosporins are the antibiotic of choice for antibiotic therapy
List the pathophysiology processes involved in appendicitis in sequential order.
A) The appendix becomes distended with fluid secreted by its mucosa.
B) Obstruction of the proximal lumen of the appendix is apparent.
C) Purulent exudate formed causes further distention of the appendix.
D) Pressure within the lumen of the appendix increases.
E) Tissue necrosis and gangrene result.
Answer: B, A, D, C, E
Explanation: Obstruction of the proximal lumen of the appendix is apparent in most acutely inflamed appendices. Following obstruction, the appendix becomes distended with fluid secreted by its mucosa. Pressure within the lumen of the appendix increases, impairs its blood supply, and leads to inflammation, edema, ulceration, and infection. The purulent exudate formed causes further distention of the appendix. If treatment is not initiated, tissue necrosis and gangrene result within 24-36 hours, leading to perforation (rupture).
