Nurse study guides Medical surgical nursing

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peptic ulcer n g 1
Nursing case i
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study

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Presented by Prashant Rawal
PEPTIC ULCER

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•Defination

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• peptic ulcer refers to painful sores or

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ulcers in the lining of the stomach or first part of

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the small intestine example > Duodenum

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•Types of peptic ulcer
1. gastric ulcer
2. deodenum ulcer
3. oesophagus ulcer
Etiology ( causes) & Risk factor

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•H.pylori (Helicobacter pylori)

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• stress & anxietys
•Caused by NSAID'S : paracetamol

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N factors such as spicy food
•Dietary

•Tobaco smoking
CONTINUE........

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•Zolinger elison syndrome

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•: it is excessive secreation of gastric juice due to high

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level of circulation gastrin which is produced by

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pancreas

N u
Risk factor :
•alcohol consumption
•tobaco
•anemia
•steroids
Patho physiology

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Due to etiological factor

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s i
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damage mucosa layer

N u
Break down of gastric mucosal barrier
CONTINUE........

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Alteration in acid secreation

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in
Decreased resistance to bacteria

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N u
mocosal infection
CONTINUE........

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distruction of blood vessels and

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bleeding

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Ulceration >>>>>>>>> Clinical

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manifestion
Complications

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a. Gstro interstinal bleeding

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b.

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Peritonitis

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c. bowel blokage

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d. hemorrhage

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e. perforation and penetration
f. pyloric obstruction
CLinical manifestion

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•Pain in the epigastric region

burn)i
•Pyrosis(heart s
n
•Nausea & Vomiting

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•N
Bowel blockage ( constipation)

•Gastric bleeding
CLinical manifestion

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•Bloating & abdominal fullness

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•Hematemesis [s
•Loss of appetite

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N [ foul smelling faecus]
vomiting of blood ]

•Malena

•Gastric & duodenal perforation

CLinical manifestion

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•Gastroesophageal reflux disease{GERD}

in
s
•Burning near the sturnum

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N
DIAGNOSTIC FINDING

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•History collection :> Episode of vomiting, any

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burning sensation

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•Physical examination :> Inspection of right

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epigastric region & umblical region

•Esophagogastroduodenoscopy {EGD}
DIAGNOSTIC FINDING

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•Urea breath test:> {used to detect the presence

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of H. Pylori}

in
s
•Endoscopy

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N
•Biopsy

•Stool examination

•Barium Enema X RAY

MANAGEMENT

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n
•Srgical Management

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1. vagotomy

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NAnarectomy
2. Pyloroplasty

3.
4. Gastrojejunostomy
Nursing management

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•Asess the location , duration & intensity

in
bof pain & bleeding

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•Asess for blood in stools

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•assess vital signs for indication of
anemia

•assess for malnutrition & weight loss

Nursing management

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•Rlieving pain & maintain nutrition diet

i n
r s
NURSING DIAGNOSIS

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i. Acute pain related to effect of gastric
acid secreation
ii. Imbalanced nutritional status. related
to change in diet
NURSING DIAGNOSIS

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i. acute pain................

in
ii. imbalance nutritional status.........

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iii. fear and anxiety related to

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hospitalization
iv. Deficient knowledge about prevention
of symptoms and management of the
condition.
Difference between gastric

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& duodenal ulcer

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GASTRIC ULCER DUODENAL ULCER

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• Gastric ulcer occurs in • duodenal ulcer occurs in

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stomach duodenum

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•pain occurs with in

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• pain occurs with in 2 ,3

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one hours after meal
hours after meal

•in gastric ulcers • duodenal ulcers no

special diet is need for special diet needed
example.>> spicy food
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•blood in vomiting seen •blood come with stool

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in gastric ulcer

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•it is greater in men

N u
•it is greater in women
• occurs b/w age of 35
•above 50 yrs of age to 50
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in
rs
Nu
THANK U FOR WATCHING
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THANK YOU FOR WATCHING

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