Duodenal And Gastric Ulcers Discussion Paper
Question
History: 60-year old female complains of epigastric pain that occurs about 2 hours after meals. She states it is a burning sensation, sometimes relieved with antacids. She also complains of bloating and fullness, has smoked one pack of cigarettes/day for 20 years. She does have a glass of wine with her evening meal. She has taken ibuprofen for arthritis pain in her left knee for about 4 years. She thinks her father had an ulcer. She is currently taking lisinipril 10 mg po daily for hypertension and Unidur 400 mg for mild COPD.
1. What is her pack year history?
2. What factors can you identify that help in making a differential diagnosis?
3. Following endoscopy, your patient is diagnosed with a duodenal ulcer. Discuss the advantages and disadvantages of the following drug therapy.
ORDER YOUR PAPER NOW
|
|
Advantage |
Disadvantage |
|
Maalox 30 mL after meals and at bedtime
|
|
|
|
Cimetidine 200 mg 4 times a day
|
|
|
|
Sucralfate 1 gram four times a day 30 minutes before meals and at bedtime
|
|
|
4. The nurse completes a nursing care plan. What would your priority nursing diagnosis be?
5. Analyze the following teaching plan. Identify appropriate nursing interventions and rationales. Make appropriate corrections and additions where needed.
a. Instruct the patient to eat six small feedings because research shows that a full stomach decreases acid production and mucosal irritation. Encourage her to eat a snack before bedtime. Duodenal And Gastric Ulcers Discussion Paper
b. Explain why alcohol is harmful to patients with ulcers. Encourage the patient to continue drinking wine with her meals because it increases appetite.
c. Discuss implications of smoking on ulcer development. Begin discussion regarding possible plan to diminish or quit smoking.
d. Incorporate discussions of decreasing smoking with relaxation and stress reduction techniques. Stress measures will be important because smoking is often a coping mechanism in times of stress.
e. Instruct patient to keep antacids available and to take bicarbonate of soda at frequent intervals to enhance the antacid effects of Maalox. If discomfort increases, instruct the patient to take aspirin four times a day.
History: A 55 year-old man is hospitalized with GI bleeding. He has a history of peptic ulcer disease. He states he has had tarry stools and coffee ground emesis with abdominal cramping throughout the day. He begins to vomit bright red emesis, BP falls to 80/56, pulse increases to 120 and he is very restless.
1. What is the first nursing action to be taken? Why?
2. What important nursing interventions should the nurse take during this crucial period of bleeding?
3. Why is iced saline not used for gastric lavage?
Complete the following table. Duodenal And Gastric Ulcers Discussion Paper
|
|
Gastric Ulcer |
Duodenal Ulcer |
|
Acid secretion
|
|
|
|
Connection with NSAID use
|
|
|
|
H. pylori as etiology
|
|
|
|
Age incidence
|
|
|
|
Mortality
|
|
|
|
Symptoms
|
|
|
|
Relief measures
|
|
|
|
Complications
|
|
|
Expert Answer
This solution was written by a subject matter expert. It’s designed to help students like you learn core concepts.
Step-by-step
1st step
All steps
Answer only
Step 1/2
.1. What is the first nursing action to be taken? Why? To prevent GI bleeding treat hypovolemic shock and prevent dehydration, electrolytes imbalance.
2. What important nursing interventions should the nurse take during this crucial period of bleeding? . .Avoidance of gastric irritants. …
- Take only prescribed medications.
- Methods of testing vomitus/stools for occult blood.
- Potential need for prophylactic PPI.
- Prompt treatment of upper respiratory infection in patient with esophageal varices.
3. Why is iced saline not used for gastric lavage?
Warm water or saline is infused into the tube, with approximately 5 to 10 ml/kg per cycle to moderately distend the stomach. The fluid is then allowed to drain from the tube via gravity flow. The procedure is repeated until clear fluid is returned. Activated charcoal may then be administered through the
Complete the following table. .Gastric Ulcer
.
Acid secretion-normal tSymptomsseceration o stomach acid
Connection with NSAID use-pain occurs half to 1hr after meal
H. pylori as etiology-no
Age incidentally-ually 50 and ove
Symptoms-vomiting ,heartburn etc.
Relief measures-no pain at sleep
Complications-occanaliy occur malignancy. Duodenal And Gastric Ulcers Discussion Paper
Step 2/2
Duodenal Ulcer
Acid secretion-increase stomach acid secretions
Connection with NSAID use-relived
H. pylori as etiology-yes
Age incidence-moe than 50
Mortality-severe cases
Symptoms-bleeding ,melena
Relief measures-antacids ;
Complications-bleeding
Final answer
This all about deodinal and gastric ulcers
Duodenal And Gastric Ulcers Discussion Paper