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Peptic Ulcer Disease

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mhemhe mhe

on 12 March 2015

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Transcript of Peptic Ulcer Disease

Peptic Ulcer Disease
Presented By:
Pamela Agina
Jamesia Fransaw
Jasmine Hooper
Crystal Johnson
Elizabeth Mosely

Anatomy & Philosophy of Gastrointestinal System

Peptic Ulcer Disease Pathophysiology Overview
Treatment and Therapies
Diet plays an important role in treatment of PUD
Nursing Implication
Clinical Manifestations
Common ulcer symptoms include:
Pain
A burning, aching pain between the navel & the breastbone (may radiate to the back)
Belly pain that can last from a few minutes to a few hours & that usually goes away for a while after taking an acid reducer.
Weeks of pain that comes & goes and may alternate with pain-free periods.
Appetite
Loss of appetite & weight loss
Bloating or nausea after eating

In memory of the Duodenum & Stomach
Medications
Assessment
:
1Assess for chronic use of certain medications (such as aspirin, steroids).
2. complaints that brought client to the hospital.
3. Obtain history of onset and progression of symptoms.
5. Assess connection of pain attacks to meals, certain drugs, ingestion of coffee, alcohol.
4. Obtain information of diet, use of alcohol and tobacco, ingestion of irritating foods, previous diseases or infections of GI tract, emotional stress.
6. Perform complete physical assessment including weight, vital signs, signs of GI bleeding, and acute abdomen.
7. Assess diagnostic tests and procedures for abnormal values.











Oral Cavity
Esophagus
Stomach
Duodenum
Jejunum
Ileum
Cecum
Colon
Rectum
Anus


prilosec,
prevacid,
pepcid
nexium
antibiotics ( if cause of ulcer is H. Pylori)

Nursing Process for Peptic Ulcer Disease
Assessment
Assess for chronic use of certain medications (such as aspirin, steroids).
Obtain information of
diet,
use of alcohol and tobacco,
ingestion of irritating foods,
previous diseases or infections of GI tract,
emotional stress.
5. Assess connection of pain attacks to meals, certain drugs, ingestion of coffee, alcohol.
6. Perform complete physical assessment including weight, vital signs, signs of GI bleeding
7. Assess diagnostic tests and procedures for abnormal values.
Nursing Diagnosis Statements


Increased risk of GI bleeding and perforation of stomach, related to gastric or intestinal wall erosion.
Increased risk of anemia due to acute or chronic GI bleeding, related to ulcer
Pain and heartburn, related to diagnosis of peptic ulcer.
Appetite changes and weight changes due to symptoms of the ulcer.

Goals


1. Reduce or completely eliminate contributing factors.
2. Assist with stress management.
3. Promote adequate nutrition.
6. Relief or diminish symptoms related to peptic ulcer
4. Decreased anxiety with increased knowledge of disease, it treatment, way of prevention and follow-up.


Implementation


1. Reports increased comfort, decreased anxiety.
2. Verbalizes absence of heartburn and pain.
3. No evidence of nausea, vomiting, GI bleeding
4. Maintains stable vital signs, fluid balance, and body weight.
5. Laboratory tests results shows no abnormalities.
6. No postoperative complications.
7. Demonstration of understanding of disease progress, diagnostic and treatment procedures, prevention, and need for follow-up.

Application to Minority Health
Complications
Evaluation

Environmental Factors
Named for anatomical location: gastric and duodenal
Primary Cause: Increased gastric acid
Increased secretion of hydrochloric acid
pepsin
Imbalance gastric lumenal factors
Degradation of defense function of the gastric mucosal barrier
Natural Defenses Against Ulcer Formation
Peptic Ulcer disease prevalence is decreasing in the West, except certain populations such as immigrants.
Duodenal ulcers, there is a male predominance. 10 times as common in men than in women. Ages 35-45
Gastric ulcers are more evenly distributed between men and women. Ages 50-60
Mucus
Secretion of bicarbonate
Mucosal blood flow
Epithelial Cell Defense
Diagnosis
If left untreated, peptic ulcers can result in:
Internal bleeding, hemorrhaging
Perforation- when an ulcer erodes through all the layers of the stomach or duodenum wall. This puts you at risk for infection
Outlet obstruction caused by edema or scar tissue that interferes with the free passage of gastric contents.
1
.
Tests for H. pylori
using your:
•Blood
•Breath
•Stool

2. Using a scope to examine your upper digestive system (endoscopy)

3. X-ray of your upper digestive system
Article Review
Patient: Ian Shumberg, 42
Vital signs are normal, burning pain in upper level abdomen (5), 2 to 4 hours after eating, tarry stools
Smoker
Overweight
Dx: PUD of duodenum
Education enhances healing
Take acid-reducing medication along with antibiotics
Avoid foods that stimulate gastric acid
Manage stress appropriately

References
Barba, K., Fitzgerald, P., & Wood, S. (2007).
Managing peptic ulcer disease. Nursing, 56hn1-2, 4.
Grossman, S., & Porth, C. (2014).
Porth's
pathophysiology: Concepts of altered health states
(Ninth ed.). Philadelphia: Wolters Kluwer Health.
Full transcript