Pathophysiology
What is a peptic ulcer?
A loss of tissue from the lining of the digestive tract.
List 3 causes of peptic ulcers.
Drugs
Infections
Stress
Stressful events
H. pylori
How is hemorrhage managed?
NG tube to suction and measure blood in the stomach.
Name three diagnostic measures.
barium swallow examination
gastroscopy
esophagogastroduodenoscopy
H. Pylori can also be detected in blood, stool, or breath tests.
Nursing diagnoses mostly differ from medical diagnoses, in that they are:
dependent upon medical diagnoses for the direction of appropriate interventions.
primarily concerned with caring, while medical diagnoses are primarily concerned with curing.
primarily concerned with human response, while medical diagnoses are primarily concerned with pathology.
primarily concerned with psychosocial parameters, while medical diagnoses are primarily concerned with physiologic parameters.
primarily concerned with human response, while medical diagnoses are primarily concerned with pathology.
What protects the stomach lining?
A mucous barrier protects the lining from digestive fluids
What is often blamed for peptic ulcers, but is not proven?
spicy foods
Name two ways perforation is initially managed.
Initially with gastric decompression and IV fluids and antibiotics.
Describe a gastroscopy.
a thin, flexible tube called an endoscope is used to look inside the stomach
Which statement by a patient with diabetes mellitus indicates an understanding of the medication insulin glargine (Lantus)?
"Lantus causes weight loss."
"Lantus is used only at night."
"The duration of Lantus is six hours."
"There is no peak time for Lantus."
"There is no peak time for Lantus."
What is the difference between acute & chronic ulcers?
Acute ulcers only affect the superficial layers of the digestive lining, but chronic ulcers extend into the muscle layer.
What is the microorganism that often causes peptic ulcers? FULL NAME ONLY.
Helicobacter pylori
How is an obstruction managed?
NG suction
Name two goals of drug therapy for peptic ulcers.
relieve symptoms
heal the ulcer
cure H. pylori infections
prevent recurrence.
Which action occurs primarily during the evaluation phase of the nursing process?
Data collection.
Decision-making and judgment.
Priority-setting and expected outcomes.
Reassessment and audit.
Reassessment and audit.
What percentage of peptic ulcers occur in the duodenum?
80%
True or False. Gastric acid production is elevated when a peptic ulcer is present.
FALSE. Gastric acid production is usually normal or decreased.
What is intractability?
The term used to describe symptomatic peptic ulcer disease that does not respond to treatment.
Why would antibiotics be used for peptic ulcers?
If it is caused by bacteria.
Which statement by a patient demonstrates an accurate understanding about herbal supplements?
"Herbs may interact with prescribed medications but not other herbs."
"Most herbs have been tested and found to be safe and therapeutic."
"The Food and Drug Administration regulates herbs and allows advertising."
"There is no standardization among the manufacturers of herbs in this country."
"There is no standardization among the manufacturers of herbs in this country."
What causes irritation of the peptic ulcer?
Pepsin and hydrochloric acid injure the unprotected tissue.
Name the drug class that can lead to peptic ulcers, and give three examples.
NSAIDS (ibuprofen, naproxen, celecoxib, aspirin, indomethacin).
Using nursing judgment, what is the most serious complication?
hemmorhage
True or False. The patient should skip breakfast to prevent discomfort early in the morning.
What is this?
pH- 7.29
PaCO2- 50
HCO3- 25
Respiratory Acidosis