PUD - Peptic Ulcer Disease
Pathophysiology
Complication
Dyspepsia: Burning Pain
“Epigastric” “Back”
Gastric Ulcer (stomach)
Duodenal Ulcer (intestine)
● PAIN Increased with food
● 30 - 60 min. after meals
● Weight LOSS
● Vomits blood “Hematemesis”
● PAIN Decreased with food
● 2 - 3 hours after meals
● Worse at NIGHT
● Weight Gain
● Blood in stool “melena” (dark tarry stool)
NCLEX TIP
NCLEX TIP
GGastric Ulcer
GGut Paint with food
DDuodenal Ulcer
DDon’t have pain with food
PUD (Peptic Ulcer Disease) happens when gastric acids erode
the gastric lining creating open
sores / holes in the esophagus,
stomach, or duodenum.
Peptic Ulcer Disease
Perforation = Peritonitis & Sepsis
Report to HCP!
● Fever (over 100.3F)
● Rebound tenderness
● “Rigid” or “board-like abdomen”
● Increasing Pain, tenderness
● Restless
● Fast HR & RR
(tachycardia / tachypnea)
Saunder’s
Client with ... a peptic ulcer. Which
assessment finding would most likely
indicate perforation of the ulcer?
● A rigid, board-like abdomen
Hemorrhage (bleeding)
Gastric outlet obstruction
● Melena (black tarry stools)
● Hematemesis (vomiting of blood)
HESI
Which complications does the nurse monitor
for while assessing a patient with peptic ulcer
disease (PUD)?
Select all that apply.
● Perforation
● Hemorrhage
● Gastric outlet obstruction
● Hematemesis and melena
Signs & Symptoms
Pharmacology
Antibiotics: H. Pylori bacteria
● Amoxicillin
● Clarithromycin
● Tetracycline
● Metronidazole
● Bismuth (brand: Pepto-Bismol)
Acid reducers
● Antacids
● Histamine receptor blockers
Ranitidine
● PPIs: Proton pump inhibitors
Omeprazole
Mucosal protectants
● Sucralfate
● Misoprostol
HESI
A patient … is diagnosed with Helicobacter
pylori (H. pylori) peptic ulcer disease. The
nurse anticipates administering which drugs?
Select all that apply.
● Bismuth
● Tetracycline
● Metronidazole
HESI
Which classes of drugs are used to reduce
the symptoms of peptic ulcers?
Select all that apply.
● Antacids
● Mucosal healing agents
● Proton pump inhibitors
● Histamine receptor blockers
Patient Education
Diet
● Avoid Spicy, Fatty, Fried, Acidic foods
● NO Caffeine (coffee, Soda, tea)
● NO Alcohol
● NO Cigarettes (tobacco)
Avoid NSAIDs
● Naproxen
● Indomethacin
● Ibuprofen
Decrease Stress
Report black tarry stools to HCP!
Common NCLEX Question
The nurse is educating the client
on peptic ulcer prevention.
Which statement by the client
shows correct understanding?
Select all that apply.
“I will not drink beer at the
party this weekend”
1.
“I will avoid using naproxen”2.
“I should avoid drinking excess
coffee or soda”
3.
“I will start smoking cessation”4.
“I will avoid spicy foods but
fried chicken is ok”
5.
Diagnostics
Perforation = Peritonitis & Sepsis
Upper GI Series with barium contrast
● PRIORITY - Report to HCP!
Fever (over 100.3F)
Esophagogastroduodenoscopy (EGD) Client Education:
● NPO (no eating or drinking)
No smoking
8 hours BEFORE the procedure
● Expected:
During: Abdominal cramping
After: Chalky white stool
● Flush the Contrast
Increase fluid intake
Take Laxatives
Kaplan
Causes & Risk
1. H. Pylori bacteria
2. NSAIDs
Naproxen
Indomethacin
Ibuprofen
3. Stress (prolongs the ulcer)
- Nursing school / NCLEX
NCLEX TIP 1HCP
> 100.3 oF
NAPROXEN
Indomethacin
H.Pylori
Med Surg: GI - Gastrointestinal
