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Peptic Ulcer Disease

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Rochelle Bucaneg

on 16 February 2015

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Transcript of Peptic Ulcer Disease

Ackley, B. & Ladwig, G. (2011). Guide to Nursing Diagnoses. In Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed.). St. Louis, MO: Mosby.

Lewis, S. L., Bucher, L., Dirksen, S. R., & Heitkemper, M. M. (2014). Medical-Surgical Nursing: Assessment and management of clinical problems (9th ed.). St. Louis, MO: Mosby.

Understanding Peptic Ulcer Disease. (2015).
Digestive Conditions
. Retrieved from http://www.gastro.org/patient-center/digestive-conditions/peptic-ulcer-disease

What is peptic ulcer disease? (2013). Retrieved from http://www.webmd.com/digestive-disorders/digestive-diseases-peptic-ulcer-disease?page=1#1
Health history
Current medical history
: Hypertension, fell and hurt his back and knee 5 months ago

Past medical history
Smoked for 15 years and has been nicotine free for the last 10 years.

Family medical history
Zollinger-Ellison syndrome (maternal side)
Labs & Diagnostic Studies
Upper GI Series (Barium Swallow)
Fecal Occult Blood Test (FOBT)
Complete Blood Count (CBC)
Complete Metabolic Panel (CMP)
ALT/AST (Liver Enzymes)
H. Pylori test (Breath, Blood, Stool)
Collaborative Management
Treatment regimen
: adequate rest, drug therapy, eliminate smoking, dietary and lifestyle modifications, and long term follow-up care.
Nursing Management
Acute pain R/T irritated mucosa from acid secretion AEB pain of 9/10 on a numeric scale.

Peptic Ulcer Disease
Thank you!
Rochelle Bucaneg, John Griffin, Nicole Nuneviller, Shayanne Pontin
Vital Signs
Temperature: 99.7 F
Pulse: 90
Respirations: 22
SpO2: 97% RA
Blood pressure: 140/88
Pain: 9/10 - sharp, achy, and radiates to back
Collaborative Management
Health care team
Primary care provider
Case management
What is PUD?
Peptic Ulcer Disease is a condition when the GI mucosa erodes from the digestive action of hydrochloric acid and pepsin.
Types: Gastric ulcers and Duodenal ulcers.
Peptic ulcers are classified as acute or chronic.
H. pylori is associated with peptic ulcer development.
NSAIDSs and aspirin are responsible for non-H. pylori peptic ulcers.
Lifestyle factors such as psychologic stress, coffee and alcohol consumptions, and smoking cause and/or inhibit healing of ulcers.
S.E. is a 49 year old Caucasian male, working as a prosecuting attorney.

S.E. have been complaining of abdominal pain and heartburn specifically at night.
Histamine (H2)-Receptor Blockers
Proton Pump Inhibitors (PPIs)
Other drugs
Drug Therapy
Nutritional Therapy
Non specific
Avoid foods and drinks that cause distressing symptoms:
Hot and Spicy Foods
Carbonated Drinks
Surgical Therapy
Partial Gastrectomy
Short term:
Patient will state a pain level of 3/10 or less by the end of hospital stay.

Long term:
Patient will control his pain by use of various pharmaceutical agents and implementing preventative measures to avoid future occurrences with peptic ulcer disease.
Assess patient for abdominal pain
Documenting the severity and type of pain after each patient interaction
Educate the patient on the medication regimen
Educate the patient on methods of preventing peptic ulcer disease

Teaching Points

Teach about pain management
Teach about proper nutritional habits
Teach the importance of smoking cessation
Patient has met the goal by verbalizing his pain 3/10 or less on a 10/10 pain scale.

Patient has met the goal by successfully verbalizing an understanding in how the medication regimen will help control his pain and treat his stomach ulcer.
Nursing Management
Ineffective health maintenance R/T lack of knowledge regarding health practices to prevent ulcer formation AEB patient putting off his doctor visit to address his stomach pain.
Short term:
Patient will provide verbal feedback on the importance of not delaying seeking medical help when health issues arise by end of shift.

Long term:
Patient will have made beneficial lifestyle changes that will assist in the prevention of peptic ulcer development by the follow up appointment.
Educate about the disease process, prevent and treatment
Include the patient in creating a guideline to help manage lifestyle
Assess for complications

Teaching Points
Educate about disease process, prevention, and treatment
Teach about peptic ulcer disease
Teach about compliance
Patient has met the goal by actively participated in creating his own care plan.

Patient has met the goal by verbalizing an understanding of peptic ulcer disease and how it has affected his life.

Patient has met the goal by complying with his preventative care measurements at time of follow up appointment.
An EGD is the most accurate way of diagnosing PUD.
CBC will indicate anemia. (Low H&H)
Liver enzymes are elevated with PUD because the ulcer can affect adjacent organs.
According to the Gastroenterological Association, “Helicobacter pylori infection is the most common cause of ulcers.”
Labs & Diagnostic Studies
CMP will indicate electrolyte imbalances
Full transcript