PEPTIC ULCER

PEPTIC ULCER
DISEASE
DISEASE
PEPTIC ULCER
PEPTIC ULCER
DISEASE
DISEASE
Introduction
Peptic Ulcer
Ulcers average between one-uarter and one-!al" inc! in
dia#eter$ T!e% develop w!en digestive &uices produced in
t!e sto#ac!' intestines' and digestive glands da#age t!e
lining o" t!e sto#ac! or duodenu#$
T!e two i#portant digestive &uices are !%droc!loric acid and
t!e en(%#e pepsin$ )ot! substances are critical in t!e
brea*down and digestion o" starc!' "at' and proteins in
"ood$ T!e% pla% di""erent roles in ulcer+
,%droc!loric Acid$ A co##on #isbelieve is t!at e-cess
!%droc!loric acid' w!ic! is secreted in t!e sto#ac!' is
solel% responsible "or producing ulcers$
,$ p%lori- t!e bacteria t!at !as been t!e cause o"
#ost peptic ulcers$
Pepsin$ Is an en(%#e t!at brea*s down proteins in
"ood$ Since t!e sto#ac! and duodenu# are also
co#posed o" protein' !owever' t!e% too are
susceptible to t!e actions o" pepsin$
)icarbonate' w!ic! t!e #ucous la%er secretes'
neutrali(es t!e digestive acids$ ,or#one li*e
substances called prostaglandins !elp *eep t!e blood
vessels in t!e sto#ac! dilated' ensuring good blood
"low and protecting against in&ur%$
.Prostaglandins are also believed to sti#ulate
bicarbonate and #ucus production$
Patient Pro"ile

Patient/s 0a#e+ Criselda Llorente Siangco Se-+ 1e#ale

Age+ 23 %$o$

Status+ 4arried

Address+ Pigcarangan' Tubod' Lanao Del 0orte

Religion+ Ro#an Cat!olic

5ccupation+ !ousewi"e

Citi(ens!ip+ 1ilipino

C!ie" Co#plaints+ Palpitation 3#ont!s PTA 67S+

Date Ad#itted+ 8an$9':;<; )P+<;;7<:; ##,g

Ti#e Ad#itted+=+32 P# Te#p$ + 3>$< C

I#pression7Diagnosis+ ,6D7UTI7Acid PR+ ?2 )p#

Peptic Disease RR+ :2 Cp#

P!%sician+ Dra$ 4ar&ueta 5pa#en

Roo#+ Critical @ard

NURSING ASSESSMENT
Aeneral In"or#ation+
Patient/s 0a#e+ Criselda L$ Siangco
Se-+ 1 Age+ 23 %$o$
Religion+ Ro#an Cat!olic
5ccupation+ ,ousewi"e
Address+ Pigcarangan' Tubod' LD0
Status+ 4arried
Date Ad#itted+ 8an$9':;<;
C!ie" Co#plaints+ Palpitation 3 4ont!s
PTA
4ed+ 4etropolol Previousl% ad#itted
last 0ov$ Secondar% to palpitation7D-
,6D
I#pression7Diagnosis+ ,6D7UTI7 Acid
Peptic Disease
P!%sician+ Dra$ 4ar&ueta 5pa#en

Present Illness
Palpitation 3 #os$ PTA
8an$9':;<; B =+3; P4
Reaction to & Expectations
about Hospitalization
,P07 Ulcer
It can be treated
t!roug! !ospitali(ation
It can a""ect t!eir dail%
living
Ces' it can c!ange #%
abilit% to "unction as a
#ot!er and a wi"e
Sad and irritable
Lonel% and sad
Previous Illness
,6D
5ver "atigue
T!e% give t!eir care
Reactions about Treatment &
ia!nostic Proce"ures
It can relieve t!e pain
and cure #% illness
Is it reall% #a*e #e
"eeling wellD
A"raid
Nursin! Histor#
Normal Patterns o$
%unctionin! &prior to
a"mission'
(linical
Inspection
observation on
%irst a# o$
"ut#
)n*!oin! Appraisal
observation +
n"
"a# o$
"ut#
)t,er sources- lab. Exam
Results
Patterns o"
"unctioning+
Respiration
Tac!%pnea
Personal ,%giene+
Dail% )at!
)rus!ing o" teet!
3- a da%
E0or#al
EDr% S*in
E Dr% scalp
E0or#al
Nursin! Histor# Normal
Patterns o$ %unctionin!
&prior to a"mission'
(linical Inspection
observation on
%irst a# o$ "ut#
)n*!oin! Appraisal
observation +
n"
"a# o$
"ut#
)t,er sources- lab.
Exam Results
Co##unication F
Special senses+
0o di""iculties in
spea*ing' !earing'
seeing and
understanding
Slig!tl% read F write
Englis!
Coping wit! Stress+
ERest
E1a#il%
Circulation+
Etac!%cardia
ETa*e #edication
E@ea* 6oice
EIrritable
E0or#al PR
E0or#al )P
EIrritable' tense
Nursin! Histor#
Normal Patterns o$
%unctionin! &prior to
a"mission'
(linical Inspection
observation on %irst
a# o$ "ut#
)n*!oin!
Appraisal
observation +
n"

"a# o$ "ut#
)t,er sources- lab. Exam
Results
1ood F 1luid
Inta*e+
4ealsD 3- a da%
Snac*D Seldo#
ContentD Rice F
vegetables
< cup o" co""ee
ever% #orning
Li*e all *inds o"
"ood
E9G *g
E9/2
Epale s*in
Epoor appetite
ED9 0SS <L B:;
gtts7#ins
Results U7A
Color-lig!t %ellow
Transparenc%- clear
Speci"icit%- <$;;9 p,
G$9
Albu#in-negative
Sugar- negative
PUS <-:
R) <-:
@)C- <;$<:
,gb$ -<<G
,ct$ -;$39
0eutrop!il- ;$>3
L%#p!oc%te- ;$:9
Eosinop!ils- ;$;:
DAT
Nursin! Histor#
Normal Patterns o$
%unctionin! &prior to
a"mission'
(linical Inspection
observation on %irst
a# o$ "ut#
)n*!oin! Appraisal
observation +
n"
"a# o$
"ut#
)t,er sources- lab.
Exam Results
E-ercise+
,i*ing F stretc!ing
wit!in 3; #ins$
Twice a wee*
Rig!t ,anded
Pain7Disco#"ort+
E Epigastric pain
ETa*e #edication
Regulator%
4ec!anis#
EDi((%
Acute Pain
Te#p- 3>$<C
Dr% s*in
Nursin! Histor#
Normal Patterns o$
%unctionin! &prior to
a"mission'
(linical Inspection
observation on %irst
a# o$ "ut#
)n*!oin! Appraisal
observation +
n"
"a# o$
"ut#
)t,er sources- lab.
Exam Results
Eli#ination+
6oidD- 3-9- a da%
)owel 4ove#entD
5nce a da%
E 6oid- :- E 6oid- :-
Results U7A
Color-lig!t %ellow
Transparenc%- clear
Speci"icit%- <$;;9
p, G$9
Albu#in-negative
Sugar- negative
PUS <-:
R) <-:
@)C- <;$<:
,gb$ -<<G
,ct$ -;$39
0eutrop!il- ;$>3
L%#p!oc%te- ;$:9
Eosinop!ils- ;$;:
Nursin! Histor#
Normal Patterns o$
%unctionin! &prior to
a"mission'
(linical Inspection
observation on %irst
a# o$ "ut#
)n*!oin! Appraisal
observation +
n"
"a# o$
"ut#
)t,er sources- lab.
Exam Results
Rest and sleep+
Sleep ? !ours a
da%
RetiringD <;P4
ArisingD 9P4
0o di""icult% in
sleeping
Sta%ing sleep wit!
!usband
Inter"eres sleep
wit! noise
: Pillows
? !ours
0ature o" sleepD
0or#al
Nursin! Histor#
Normal Patterns o$
%unctionin! &prior to
a"mission'
(linical Inspection
observation on %irst
a# o$ "ut#
)n*!oin! Appraisal
observation +
n"
"a# o$
"ut#
)t,er sources- lab.
Exam Results
Recreational7
Diversion+
Done "or "unD
Pla%ing cards
Past ti#e w!ile illD
Sleep
,ealt! Supervision+
Ta*e 4edicine as
prescribed
Illness send to
bedD 1ever' ,P0'
epigastric pain
Reason "or
consulting DoctorD
To relieve pain F to
Hnow #% !ealt!
status
Do w!en angr%D
@ent to uite place
ANAT)M/ & PH/SI)0)G/
Digestive S%ste#

Digestive s%ste# is t!e series o" tube-li*e organ t!at converts our #eals
into c!e#ical co#pound t!at can be absorbed b% t!e bod%/s cells$ It also
separates out unneeded #aterials and "lus!ed t!e# out o" t!e bod%$ In all
t!ere/s about 3;-"oot-long.=-#eter-longI tube t!at begins wit! t!e #out!'
w!ere "ood enters t!e bod%' and ends wit! t!e anus' w!ere solid wastes
are e-pelled$ Along t!e wa%' "ood is bro*en down' sorted' and reprocessed
be"ore being circulated around t!e bod% to nouris! and replace cells and
suppl% energ% to our #uscles$
Mout, & T,roat

T!e digestive process begins !ere' w!ere "ood is grind into pieces and
prepared "or deliver% to t!e sto#ac!$ It t!en enters t!e p!ar%n-' or
t!roat a #uscular "unnel t!at pus!es t!at c!ewed "ood into t!e esop!agus
w!ile si#ultaneousl% bloc*ing o"" t!e trac!ea. @ind pipeI$
Salivar# Glan"s* T!ree pairs o" salivar% glands secrete saliva' a #i-ture o"
water' en(%#es and glue% protein called 4ucin' into t!e #out! to #oisten
t!e "ood$ En(%#es in t!e saliva interact wit! "ood and begin t!e process o"
c!e#ical digestion$
Teet,* )on% structures t!at tear' c!op' and grind "ood "or swallowing$
S!arp incisors and pointed canines in t!e "ront o" t!e #out! are designed
to tear into toug! "oods' w!ile "lattened pre#olars and #olars in t!e bac*
grind grains and plant #atter$
Ton!ue- T!is #uscular organ #aneuvers "ood around during c!ewing and
#i-es it wit! saliva to "or# a wet lu#p called a )5LUS$ T!e top and sides
o" t!e tongue are covered wit! little pro&ection called papillae' #an% o"
w!ic! contains taste buds$
Esop,a!us* T!e esop!agus is <;-inc!-long.:9-c#-longI #uscular tube t!at
connects t!e p!ar%n- to t!e sto#ac! $ @!en "ood enters t!e esop!agus' a
wave o" #uscular contractions called PERISTALSIS pus! and pull t!e "ood
to t!e sto#ac!$ 4ucus secretion *eep t!e lu#p o" "ood' or bolus sliding a
#ere "our to eig!t seconds$
Upper Esopa,a!eal Sp,incter* T!is valve' "ound &ust below t!e
intersection o" t!e t!roat and esop!agus' is a ring o" #uscles t!at rela-es
to let "ood enter t!e esop!agus$
Stomac,* t!is #uscular' e-pandable 8-s!aped pouc! is responsible "or
!olding and digesting "ood' as well as re#oving it/s nutrients$ @!en "ood
enters t!e sto#ac!' its #uscular walls contact and c!urn t!e "ood wit!
power"ul gastric acids t!at *ill bacteria and brea* down proteins$ T!e
result is a crea#% substance called C,C4E w!ic! t!e sto#ac! stores until
it is read% "or release into t!e s#all intestine$
0iver- weig!ing in at 3 pounds.<$3HgI' t!is wedge-s!aped organ is t!e bod%/s
largest gland$ T!e liver is an accessor% organ "or t!e digestive s%ste#$
A#ong its #an% roles is deto-i"ication o" t!e blood$ It also creates bile'
w!ic! is used to brea* down "ats$
Gall 1la""er* t!is plu#-si(e' green' #uscular sac !angs "ro# t!e liver$ T!e
gall bladder collects' stores' and concentrate bile "ro# t!e liver$
Pancreas- T!is long organ' positioned be!ind t!e sto#ac!' produces insulin
and en(%#es t!at aid digestion$ Pancreatic en(%#es !elp digest "ood in t!e
s#all intestine' w!ile insulin !elps regulate t!e a#ount o" sugar in t!e
blood$
Intestines* T!e s#all intestine #easures :; "eet.G#etersI in lengt! and <
inc!.:$9c#I in dia#eter$ T!ousands o" "olds and #illions o" "inger-li*e
pro&ection called 6ILL increase t!e sur"ace are o" t!e s#all intestine
'w!ic! absorb =;J o" nutrients and water t!e bod% will receive "ro#
digested "ood$
uo"enum* T!is is t!e "irst portion o" t!e s#all intestine' w!ere secretion
"ro# t!e liver and pancreas are received and #ost o" t!e c!e#ical
digestion ta*es place$
2e3unum* T!is is t!e long' coiled #iddle portion o" t!e s#all intestine t!at
stretc!es "ro# t!e duodenu# to t!e ileu#$
Ileum* t!is is t!e "inal portion o" t!e s#all intestine' w!ere re#aining
nutrients are absorbed and utili(ed$
T!e Large Intestine absorb t!e last bits o" nutrients and water "ro#
indigestible "oods' co#pacts t!e re#aining #atter' and eli#inates it as
"eces$
Ascen"in! (olon* t!e large intestine surrounds t!e s#all intestine li*e an
inverted C$ T!e "irst portion o" t!e large intestine' t!e ascending colon' is
sti#ulated verticall% on t!e rig!t side o" t!e bod%$ T!e ascending colon
e-tracts re#aining #oisture "ro# "ood be"ore its e-cretion$
Transverse (olon* Connecting t!e ascending and descending colons' t!is
part o" t!e large intestine is situated !ori(ontall% above t!e s#all
intestine$
escen"in! (olon* 1ound on t!e le"t side o" t!e bod%' t!e descending'
or le"t colon' stores stool t!e will be e#ptied into t!e rectu#
Rectum* 5nl% 9 inc!es.<:c#I long' t!e rectu# sits &ust above t!e anal
canal$ 1eces are stored !ere brie"l% prior to de"ecation$
Anus* T!is ring o" #uscles is t!e e-ternal opening o" t!e rectu#'
t!roug! w!ic! "ecal #atter is e-pelled$ Peristaltic waves in t!e colon
and contraction o" t!e abdo#inal #uscles trigger de"ecation$
PATH)PH/SI)0)G/
Damage to mucosa with
alcohol abuse, smoking, use
of NSAIDs
Infection with Helicobacter
Pylori
Damaged mucousal
Erosion of mucous
membrane
ow function of mucosal
cells! low "uality of
mucous
Erosi#e gastritis
Se#ere ulcerations$
Signs and symptoms:
%E&igastric &ain
%Hematemesis
%&ale
%&yrosis
'ucosal ulcerations
DIAA05STIC TEST

)ariu# 4eal K-ra%

Aastroscop%

Endoscop%

Upper Aastrointestinal .AII series

)lood ,$ P%lori Test

)reat! ,$ P%lori Test

,elicobacter p%lori Stool Antigen .,pSAI

Test

Sto#ac! biops%

Tissue ,$ P%lori Test

4EDICAL 4A0AAE4E0T

A0TI)I5TICS
-#etrodina(ole ' a#o-icillin '
clarit!ro#%cin
-to eradicate !$p%lori
-surgical intervention

PR5T50 PU4P I0,I)IT5RS

-clansopra(ole ' o#epra(ole
Proton pump in,ibitors .or LPPILsI are a
group o" drugs w!ose #ain action is
pronounced and long-lasting reduction o"
gastric acid production$

)is#ut! salts
-suppress or eradicate !$p%lori

S#o*ing reduction and rest

Dietar% #odi"ication

Surgical procedure
-vagoto#%
-)illrot! I and )illrot! II

4a!otom#
-A va!otom# is a surgical
procedure t!at is per"or#ed onl%
in !u#ans$ It is resection
.re#oval o"' or at least severingI
o" part o" t!e vagus nerve$

Antrecto#% .billrot! II
- is t!e resection' or surgical
re#oval' o" a part o" t!e sto#ac!
*nown as t!e antru#$ T!e antru# is
t!e lower t!ird o" t!e sto#ac! t!at
lies between t!e bod% o" t!e sto#ac!
and t!e p%loric canal' w!ic! e#pties
into t!e "irst part o" t!e
s#all intestine$

Aastro&e&unosto#% .)illrot! III

-AI surger% A procedure in w!ic!
t!e duodenu# is e-cised or b%passed
and t!e sto#ac! is end-to-end
anasto#osed to t!e &e&unu#

15LL5@ UP C,ECH UP
0URSI0A 4A0AAE4E0T

4onitor I F 5

4onitor t!e pt$ !gb' !ct' F

electrol%tes level

Ad#inistered prescribed I6 "luids F

blood replace#ent i" acute bleeding
is present

Cessation o" S#o*ing

Encourage bed rest

Provide s#all "reuent #eals

@atc! "or diarr!ea caused b% antacids F ot!er

#eds$

Advice pt$ to avoid e-tre#el% !ot F cold "oods' to

c!ew t!oroug!l% F to eat in a leisurel% "as!ion

Ad#inister #eds$ Properl% F to teac!

pt$ do set duration o" eac!
#edication

Stress relie"

E-ercises

Li"est%le c!anges

Instead o" #eat c!ange it to 1ruits F vegetables

t!at are ric! in "iber diet

4oderate a#ount in drin*ing o" #il* .:-3 cups a

da%I

4ini#i(e drin*ing o" co""ee F carbonated

beverages

0o to spices F peppers

4ini#i(e use o" garlic in "oods

Encourage olive oil in coo*ing o" "oods$

Drug Stud%
Drug 0a#e Classi"ication Indication Contraindication Adverse E""ect 0sg$
Consideration
Dose' route'
"reuenc%
1erose#ide
Diuretices'
loop
Ede#a "ro# !eart
"ailure' !epatic
s%ndro#eM #ild-to-
#oderate ,P0M
ad&unct treat#ent in
acute pul#onar%
ede#a or
!%pertensive crisis$
Contraindicated
inpatients
!%pertensive to
t!ese drugs F in
pt$ wit! anuria'
!epatic co#a or
severe
electrol%te
depletion$
T!erapeutic
dose co##onl%
causes
#etabolic F
electrol%te
disturbance'
particularl%
potassiu#
depletion$ It
also #a% cause
!%pergl%ce#ia'
!%perurece#ia'
!%poc!lore#ic
al*alosis F
!%po#agnese#i
a$
Aive diuretics
in #orning to
ensure t!at
#a&or diuresis
occurs be"ore
bedti#e$
Ta*e sa"et%
#easures "or
all a#bulator%
pt$ until
response to
diuretics in
*nown
<; #g slow
I6TT
Drug 0a#e Classi"ication Indication Contraindication Adverse E""ect 0sg$ Consideration Dose' route'
"reuenc%
Captopril Angiotensiv
e-
converting
en(%#e
in!ibitors
,%pertension'
!eart "ailure'
L6D' 4I' and
diabetic
nep!ropat!%
Contraindicated in
pt$ !%persensitive
to t!ese drugs
Angioede#a o"
t!e "ace F
li#its' drugs'
coug!'
d%sgeusia'
"atigue'
!eadac!e'
!%per*ate#ia'
!%potension'
proteinuria'
ras! F
tac!ucardia
I" pt$ !as i#paired
renal "unction' give
a reduced dosage
I" pt$ beco#es
pregnant' stop ACE
in!ibitors
Aive captopril <
!our be"ore #eals
:9 #g'
<tab now
Drug 0a#e Classi"ication Indication Contraindication Adverse E""ect 0sg$
Consideration
Dose' route'
"reuenc%
4etoprolol
Antianginale
.)eta )loc*ersI
4oderate to
serve angina
.beta bloc*ersI
classic' e""ort-
induced angina'
Prin(#etal
angina'
recurrent
angina' acute
angina' unstable
angina
)eta )loc*ers
are
contraindicated
in pt$
!%persensitive
to t!e# and in
pt$ wit!
cardiogenic
s!oc*' sinus
brad%cardia'
!eat bloc*
greater t!an
"irst degree or
bronc!ial
ast!#a
)eta bloc*ers
#a% cause
brad%cardia'
coug!' diarr!ea'
disturbing
drea#s'
di((iness'
d%spnea'
"atigue' "ever'
!eart "ailure'
!%potension'
let!arg%'
nausea'
perip!eral
ede#a' F
w!ee(ing$
Don/t give a beta
bloc*er or calciu#
c!annel bloc*er to
relieve acute angina
@arn pt$ not to
stop drug abruptl%
wit!out prescriber/s
approval
@it!!old t!e dose
F noti"%
prescriber/s i" pt$
!eart rate is slower
t!an G; bp# or
s%stolic )P is slower
t!an =; ##,g
Tell Pt$ to report
pervious7 persistent
adverse reaction
9; #g' < tab now
Drug 0a#e Classi"ication Indication Contraindicatio
n
Adverse E""ect 0sg$
Consideration
Dose' route'
"reuenc%
Ci#etidine ,ista#ine :-
receptor
antagonist
Acute duodenal
or gastric ulcer'
Nollinger-Ellison
s%ndro#e'
gastro
esop!ageal
re"lu-
Contra
indicated in pt$
!%persensitive
to t!ese drugs
,:-receptor
antagonists
rarel% cause
adverse
reactions$
Cardiac
arr!%t!#ias'
di((iness'
"atigue'
g%neco#astia'
!eadac!e' #ild F
transient
diarr!ea F
t!ro#boc%tose#i
a are possible
Ad&ust dosage
"or pt$ wit!
renal disease$
Don/t e-ceed
reco##ended
in"usion rates
w!en giving I6M
doing so
increases ris* o"
adverse C6
e""ects$
Caution pt$ to
avoid s#o*ing
during t!erap%
2;; #g' < tab PC
Drug 0a#e Classi"ication Indication Contraindication Adverse
E""ect
0sg$
Consideration
Dose' route'
"reuenc%
Losartan Anti
!%pertensives
Essential F
secondar% ,P0
Contraindicated
in pt$
!%persensitive to
t!ese drugs F in
t!ose wit!
!%potension
Co##onl%
causes
ort!ostatic
c!anges in ,R'
!eadac!e'
!%potension'
nausea F
vo#iting
Aive drug wit!
"od at bedti#e'
as indicated
@!en #i-ing F
giving parenteral
drugs' 1ollow
#anu"acturer/s
guidelines
To prevent
di((iness' lig!t
!eadedness or
"ainting advice
c!anges in
position$
9; #g' < tab 5D
ever% ? a#
Drug 0a#e Classi"ication Indication Contraindication Adverse E""ect0sg$
Consideration
Dose' route'
"reuenc%
Aspirin Anti Platelet'
antip%retic
1or art!ritis'
#ild pain or
"ever'
prevention o"
t!ro#bosis'
reduction o" 4I
ris* in Pt$ wit!
previous 4I
orun stable
angina' Hawasa*i
s%ndro#eM
prop!%la-is "or
attac*'
r!eu#atic
"ever' peri
ceuditis a"et
acute 4I' F
stent
i#plantation
Contraindicated in
pt$ !%persensitive
to drug F t!ose
wit! bleeding
disorder suc! as
!e#op!ilia' von
@illebrand disease
F telangiectasia' or
0SAID- induced
sensitivit%
reactions
,earing loss'
tinnitus'
d%spepsia' AI
bleeding' AI
distress'
nausea' occult
bleeding'
vo#iting'
transient renal
insu""icienc%'
t!ro#bo
c%topenia'
bruising' ras!'
uticaria'
angioede#a
Re%e s%ndro#e
Aive aspirin
wit! "ood #il*'
antacid or large
glass o" water
to reduce AI
reactions$
I" pt$ !as
trouble
swallowing'
crus! aspirin'
co#bine wit!
so"t "ood or
dissolve it in
liuid$ Don/t
crus! enteric-
coated aspirin$
Aive PR a"ter a
bowel #ove#ent
or at nig!t to
#a-i#i(e
absorption
Stop aspirin 9->
da%s be"ore
elective surger%
<;; #g < tab
5D P$C$
0ursing Care Plan
Cues F Evidence+ 0sg$ Diagnosis 5b&ective Intervention Rationale Evaluation
SO P Sa*it a*ong
Huto*utoQ as
verbali(ed b% t!e pt$
5O Seen l%ing on bed
wit! gri#aced "ace
and pressing !er
epigastric area
@ea*
Restless
Unable to response
well
Loss o" appetite
Pain scale+ G
Acute7 c!ronic
pain related to
lesions secondar%
to increased
gastric secretions
A"ter ? !ours o"
nsg$ F #edical #gt$
pt$ will+
a$ verbali(e relie" o"
pain
b$ able to sleep well
Independent+
<$ E-plain t!e relations!ip
between !%dro c!ronic acid
secretion and onset o" pain
:$ E-plain t!e ris*s o"
nonsteroidal anti-
in"la##ator% drugs
.0SAIDsI
.e$g$ 4otrin' Aleve' Rela"enI
3$ ,elp t!e pt$ to identi"%
irritating substances. E$g$
1ried "ood' spic% "oods'
co""eeI
2$ Encourage t!e pt$ to avoid
s#o*ing and alco!ol use$
9$ Encourage t!e pt$ to
reduce inta*e o" ca""eine-
containing and alco!olic
beverages' i" indicated
G$ Teac! Pt$ t!e i#portance
o" continuing treat#ent even
in t!e absence o" pain$
Dependent+
<$ ad#inister drug t!erap% as
prescribed
a$ antacids
b$ !ista#ine
c$ !: bloc*er
d$ antic!olinergics
<$ ,%droc!loric
acid.,CLI presu#abl%
is an i#portant
variable in t!e
appearance o" peptic
ulcer dse' because o"
t!is relations!ip'
control o" ,CL
secretion is
considered an
essential ai# o"
treat#ent$
:$ 0SAIDs cause
super"icial irritation
o" t!e gastric #ucosa
and in!ibit t!e
production o"
prostaglandins t!at
protect gastric
#ucosa
3$ Avoidance o"
irritating substances
can !elp to prevent
t!e pain response$
2$ S#o*ing decreases
pancreatic secretion
o" bicarbonateM t!is
increase duodenal
acidit%$ Tobacco
dela%s t!e !ealing o"
gastric duodenal ulcer
and increases t!eir
"reuenc%
9$ Aastric acid
secretion #a% be
sti#ulated b% ca""eine
ingestion$ Alco!ol can
cause gastritis
G$ Dietar% restrictions
and #edications #ust
be continued "or t!e
prescribed duration$
Pain #a% be relieved
long be"ore !ealing is
co#plete$
Aoal #et as evidence
b% PTM
<$verbali(ed relie" o"
pain
:$able to sleep
Cues F Evidence 0sg$ Diagnosis 5b&ective Intervention Rationale
Evaluation
SO Pwala a*ong
ganang *u#ainQ as
verbali(ed b% t!e
pt$
5O "acial Ari#ace
Restlessness
Anore-ia+ pt$ not
able to consu#e
"oods serve
67S+
TO3>$9 C
PROG9 )P4
RRO<2 CP4
)PO<<;7?; ##,g
0utrition I#balace
less t!an bod%
weig!t related to
loss o" appetite
A"ter ? !ours o" nsg$ F
#edical #gt$ pt$ will+
a$ @ill be able to
consu#e served "ood
Independent+
<$ 4onitor 67S as
ordered$
:$ Instruct pt$ to
increase t!e inta*e
o" water
3$ Identi"% and li#it
"oods t!at create
disco#"ort
2$ Encourage s#all'
"reuent #eals$
9$ Provide prescribed
diet$
Dependent+
Ad#inister drug
t!erap%+
a$Antacid
b$,ista#ine-:
Antagonist
<$ As baseline data
in cases o"
alterations "ro#
t!e nor#al$
:$ @ater is
considered as a
good antacid$
3$ 1ood !as acid
neutrali(ing
e""ects F dilutes$
2$ S#all #eals
prevent distention
F t!e release o"
gastrin$
9$ To avoid gastric
irritation
Patient will be able
to consu#e served
"ood$
Prognosis
@!en t!e underl%ing cause "or peptic ulcer disease is success"ull%
treated' t!e prognosis .e-pected outco#eI "or patients wit! t!e
condition is e-cellent$To !elp prevent peptic ulcers' avoi" t!e
"ollowing+
Alco!ol
Co##on sources o" ,elicobacter p%lori bacteria .e$g$'
conta#inated "ood and water' "loodwater' raw sewageI
Long-ter# use o" nonsteroidal anti-in"la##ator% drugs .0SAIDsI
S#o*ing
Goo" ,#!iene can !elp reduce t!e ris* "or peptic ulcer disease
caused b% ,elicobacter p%lori in"ection$ 5as,in! t,e ,an"s
t!oroug!l% wit! war# soap% water a"ter using t!e restroo# and
be"ore eating and avoiding s!aring eating utensils and drin*ing
glasses also can reduce t!e spread o" bacteria t!at can cause PUD$
Prepared b%+
Li#pango' 8oan
0udalo' Rai(a
Paradero' Desiree
Pison' @ilsan
Puno' Rebe*a! Ann
Tan' Cristali
Tina#isan' 8o!nn%
Santillan' 8uliet
Su#ile' Dais% 4ae
Sawit' 8o!nderic*
Res#a' Rosalie
Rudie' Aldin
Urian' Pedro