Ch. 42 - Upper GI Problems (PUD) Quiz

Questions and Answers

What intervention should the nurse anticipate for a patient with a perforated ulcer?

Performing a fecal occult blood test and administering IV calcium gluconate

Starting parenteral nutrition and placing the patient in a high-Fowler's position

Administering oral bicarbonate and testing the patient's gastric pH level

Providing intravenous (IV) fluids and inserting a nasogastric (NG) tube (correct)

What is the priority nursing intervention if the nasogastric tube is suspected to be repositioned?

Monitoring for symptoms of edema and inflammation

Inserting a new nasogastric tube

Irrigating the nasogastric tube with normal saline solution

Notifying the primary health care provider immediately (correct)

Which therapy should be maintained for a patient connecting a nasogastric tube (NG) to suction after abdominal surgery?

Triple-drug therapy

Intravenous therapy (correct)

Adjuvant therapy

Cobalamin replacement therapy

Which teaching point should the nurse provide to a patient diagnosed with peptic ulcer disease?

It would likely be beneficial for you to eliminate drinking alcohol. Signup and view all the answers

Which medication is anticipated to be prescribed to help reduce hydrochloric acid secretion in a peptic ulcer patient?

Ranitidine Signup and view all the answers

What surgical procedure should the nurse expect when the vagus nerve is severed for a peptic ulcer patient?

Vagotomy Signup and view all the answers

Which type of vomitus would concern the nurse for a patient with peptic ulcer who begins vomiting?

Coffee ground Signup and view all the answers

What complication may occur due to loss of intrinsic factor in a patient who underwent surgical therapy for peptic ulcer disease?

Pernicious anemia Signup and view all the answers

Which patient assessment warrants an urgent change in the nursing plan of care for an elderly patient with epigastric pain from a gastric ulcer?

Rigid abdomen and vomiting following indigestion Signup and view all the answers

What symptom is expected for a patient with suspected gastric ulcer perforation?

Rigid abdomen Signup and view all the answers

What beneficial therapy is recommended for a patient suspected of having pernicious anemia after gastrectomy?

Cobalamin replacement therapy Signup and view all the answers

What is the most immediate intervention for a patient with a suspected perforated duodenal ulcer?

Insert a nasogastric (NG) tube into the stomach Signup and view all the answers

Which statement by a patient indicates the need for further teaching about managing peptic ulcer disease?

I should take medications that include only antisecretory class of drugs. Signup and view all the answers

What instructions should the nurse give to a patient regarding the prevention of peptic ulcers?

Report symptoms of gastric irritation, such as nausea and epigastric pain, to the health care provider. Signup and view all the answers

Study Notes

Peptic Ulcer Disease (PUD) Interventions

A perforated peptic ulcer requires immediate intravenous (IV) fluid replacement and nasogastric (NG) tube placement to manage fluid loss and gastric contents.
Suspected repositioning of an NG tube necessitates notifying the primary health care provider immediately to prevent complications such as perforation or suture line disruption.
IV therapy is maintained for patients with NG tubes post-abdominal surgery for adequate hydration.

Patient Education for PUD

Alcohol should be eliminated as it increases stomach acid production and exacerbates symptoms.
Milk consumption may worsen PUD symptoms and should not be recommended as a treatment.
Nutritional changes are often necessary, but there is no need for an exclusively minced or pureed diet for symptom management.

Pharmacological Therapies

Ranitidine, a histamine-receptor blocker, is commonly used to reduce hydrochloric acid secretion in the stomach.
Cobalamin replacement therapy is mandated for patients experiencing pernicious anemia after gastrectomy due to loss of intrinsic factor necessary for vitamin B12 absorption.

Surgical Interventions

A vagotomy is performed to sever the vagus nerve, reducing gastric acid secretion in severe PUD cases unresponsive to medication.
Complications like bile reflux gastritis and dumping syndrome can arise from surgery, with vomiting of "coffee ground" consistency indicating bleeding.

Assessment and Symptoms

Rigid abdomen with vomiting in gastric ulcer patients signals perforation, requiring urgent assessment.
The presence of a rigid abdomen and severe pain suggests perforation of a gastric or duodenal ulcer.
Patients may experience symptoms like burning epigastric pain or back pain that necessitate monitoring but are not as urgent as a rigid abdomen.

Management of PUD

Encourage patients to avoid smoking, as it may delay ulcer healing and contribute to further gastric irritation.
Patients must wash hands thoroughly to prevent H. pylori infection, a common cause of peptic ulcers.
Avoid over-the-counter medications like aspirin that can damage gastric mucosa and increase ulcer risks.
Report any symptoms of gastric irritation, including nausea and epigastric pain, promptly to seek timely medical intervention.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on upper gastrointestinal problems related to peptic ulcer disease (PUD) through this quiz. Focused on patient management and nursing interventions, it includes scenarios and multiple-choice questions. Enhance your understanding of gastrointestinal emergencies and nursing responses.