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Peptic Ulcer Disease Interventions (Picmonic)
Peptic Ulcer Disease Assessment (Picmonic)
Peptic Ulcer Disease Pathochart (Cheat Sheet)
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Example Nursing Diagnosis for Peptic Ulcer Disease (PUD)
- Acute Pain: Peptic ulcers can cause abdominal pain and discomfort. This diagnosis addresses the pain management needs of the patient.
- Risk for Bleeding: Peptic ulcers may bleed, leading to potential hemorrhage. This diagnosis emphasizes the risk of bleeding and the need for monitoring.
- Altered Nutrition: Less than Body Requirements: Peptic ulcers can affect the patient's ability to tolerate and digest food. This diagnosis addresses nutritional deficits.
Transcript
In this care plan, we will discuss peptic ulcer disease. In this care plan on peptic ulcer disease, we will cover the desired outcome, the subjective and objective data and the nursing interventions along with the rationales.
Our medical diagnosis is peptic ulcer disease. Peptic ulcer disease consists of open sores in the protective lining of the stomach and in the upper small intestine. Gastric ulcers occur inside the stomach and duodenal ulcers occur in the duodenum, or the upper small intestine. The primary cause of PUD is H pylori infection. Other diseases are practices that weaken the mucosal lining of the stomach and duodenum may also cause PUD such as chronic NSAID use, alcohol abuse, or smoking gastritis hepatic disease. Crohn's disease or pancreatitis may also cause PUD. Our desired outcome is the relief of pain, the absence of complications, and we want to maintain adequate nutrition.
So let's take a look at our care plan. The subjective data is epigastric pain that might be gnawing or burning after meals. Remember that the disease includes ulcers in the lining of the stomach, which is super painful and uncomfortable. They might get that heartburn from acid, kind of going back up into the esophagus or even tarry stools from bleeding that might occur in the stomach or duodenum. The patient might feel full if they're bleeding. They might have some unexplained weight loss and dysphasia from the ulcers and possibly bleeding. Also, they could experience some constipation, especially if they decrease their activity levels in their fluid intake.
Some objective data that you might see in your patient includes bleeding, shown as tarry stools, anemia from the bleeding, vomiting from the stomach irritation, and hypovolemia especially if they aren't eating or drinking enough and they're bleeding. So, it's important to note that bleeding ulcers are not always painful.
Now let's take a look at our interventions and rationales. You're going to monitor your patient's vital signs and their pain level. Look out for signs of infection like fevers, tachypnea, tachycardia. Also, look out for signs of hypovolemia like hypotension or tachycardia. The most common symptom of peptic ulcers is burning stomach pain that might get worse between meals and at night. Our next nursing intervention is to evaluate the lab tests. You'll test for H pylori per doctor’s order. H pylori is responsible for about 90% of peptic ulcers. Also check the CBC and coagulation panels for signs of bleeding and anemia. If the patient is going to have an upper GI endoscopy procedure, you'll prepare them for that procedure. You're going to keep them NPO prior and after the procedure until their gag reflex comes back because you want to avoid aspiration. You might have to hold anticoagulants for several days prior to the procedure because you want to avoid any excessive bleeding during the procedure. Be sure to monitor their vital signs during and after just to make sure that they remain stable.
You will administer medications as ordered by the doctor. So medications might be given to help reduce the stomach acid, protect the stomach lining and or to treat the H pylori bacteria, If they have that. You will educate your patient on nutrition and let them know to avoid foods that cause excessive acid that irritates the stomach lining. This would be like alcohol, caffeine, carbonated drinks, spicy foods, peppers, dairy products, you’d be surprised, they also can cause that. It's also helpful to include probiotics in their diet, such as yogurt, aded cheese, or even probiotic pills. This kind of just helps to restore that natural bacteria in the GI tract. Eating regular small meals can help to kind of decrease the pressure on the stomach and the acid buildup.
Our last nursing intervention is to encourage lifestyle changes. Try to help them with reducing their stress. I know this is hard, but maybe they can try to find some better coping mechanisms. Encourage them to stop smoking, limit alcohol (avoid it if possible) and these will all help to decrease that stomach irritation from acid.
We love you guys. Now, go out and be your best self today and as always, happy nursing!
Our medical diagnosis is peptic ulcer disease. Peptic ulcer disease consists of open sores in the protective lining of the stomach and in the upper small intestine. Gastric ulcers occur inside the stomach and duodenal ulcers occur in the duodenum, or the upper small intestine. The primary cause of PUD is H pylori infection. Other diseases are practices that weaken the mucosal lining of the stomach and duodenum may also cause PUD such as chronic NSAID use, alcohol abuse, or smoking gastritis hepatic disease. Crohn's disease or pancreatitis may also cause PUD. Our desired outcome is the relief of pain, the absence of complications, and we want to maintain adequate nutrition.
So let's take a look at our care plan. The subjective data is epigastric pain that might be gnawing or burning after meals. Remember that the disease includes ulcers in the lining of the stomach, which is super painful and uncomfortable. They might get that heartburn from acid, kind of going back up into the esophagus or even tarry stools from bleeding that might occur in the stomach or duodenum. The patient might feel full if they're bleeding. They might have some unexplained weight loss and dysphasia from the ulcers and possibly bleeding. Also, they could experience some constipation, especially if they decrease their activity levels in their fluid intake.
Some objective data that you might see in your patient includes bleeding, shown as tarry stools, anemia from the bleeding, vomiting from the stomach irritation, and hypovolemia especially if they aren't eating or drinking enough and they're bleeding. So, it's important to note that bleeding ulcers are not always painful.
Now let's take a look at our interventions and rationales. You're going to monitor your patient's vital signs and their pain level. Look out for signs of infection like fevers, tachypnea, tachycardia. Also, look out for signs of hypovolemia like hypotension or tachycardia. The most common symptom of peptic ulcers is burning stomach pain that might get worse between meals and at night. Our next nursing intervention is to evaluate the lab tests. You'll test for H pylori per doctor’s order. H pylori is responsible for about 90% of peptic ulcers. Also check the CBC and coagulation panels for signs of bleeding and anemia. If the patient is going to have an upper GI endoscopy procedure, you'll prepare them for that procedure. You're going to keep them NPO prior and after the procedure until their gag reflex comes back because you want to avoid aspiration. You might have to hold anticoagulants for several days prior to the procedure because you want to avoid any excessive bleeding during the procedure. Be sure to monitor their vital signs during and after just to make sure that they remain stable.
You will administer medications as ordered by the doctor. So medications might be given to help reduce the stomach acid, protect the stomach lining and or to treat the H pylori bacteria, If they have that. You will educate your patient on nutrition and let them know to avoid foods that cause excessive acid that irritates the stomach lining. This would be like alcohol, caffeine, carbonated drinks, spicy foods, peppers, dairy products, you’d be surprised, they also can cause that. It's also helpful to include probiotics in their diet, such as yogurt, aded cheese, or even probiotic pills. This kind of just helps to restore that natural bacteria in the GI tract. Eating regular small meals can help to kind of decrease the pressure on the stomach and the acid buildup.
Our last nursing intervention is to encourage lifestyle changes. Try to help them with reducing their stress. I know this is hard, but maybe they can try to find some better coping mechanisms. Encourage them to stop smoking, limit alcohol (avoid it if possible) and these will all help to decrease that stomach irritation from acid.
We love you guys. Now, go out and be your best self today and as always, happy nursing!
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