Podcast
Questions and Answers
Which of the following is the most common infectious cause of peptic ulcer disease (PUD)?
Which of the following is the most common infectious cause of peptic ulcer disease (PUD)?
- Streptococcus pneumoniae
- Escherichia coli
- Clostridium difficile
- Helicobacter pylori (correct)
Which of the following best explains how NSAIDs contribute to peptic ulcer formation?
Which of the following best explains how NSAIDs contribute to peptic ulcer formation?
- They cause autoimmune destruction of the mucosal lining.
- They increase gastric acid production.
- They inhibit prostaglandin synthesis that protects the mucosa. (correct)
- They directly infect gastric tissues.
Which of the following are risk factors for developing PUD? (Select all that apply)
Which of the following are risk factors for developing PUD? (Select all that apply)
- High-fiber diet
- NSAID use (correct)
- Smoking (correct)
- Crohn’s disease (correct)
- Stress (correct)
A patient with COPD presents with epigastric pain. Which of the following should the nurse consider?
A patient with COPD presents with epigastric pain. Which of the following should the nurse consider?
Which population is more likely to experience gastric ulcers?
Which population is more likely to experience gastric ulcers?
What is the route of transmission for H. pylori?
What is the route of transmission for H. pylori?
A nurse is assessing a patient who smokes, takes ibuprofen daily, and has a history of Crohn’s disease. Which factor is least modifiable in preventing PUD?
A nurse is assessing a patient who smokes, takes ibuprofen daily, and has a history of Crohn’s disease. Which factor is least modifiable in preventing PUD?
Which conditions can increase the risk of PUD by altering gastric secretion? (Select all that apply)
Which conditions can increase the risk of PUD by altering gastric secretion? (Select all that apply)
Which of the following symptoms is most commonly associated with a duodenal ulcer?
Which of the following symptoms is most commonly associated with a duodenal ulcer?
Which of the following descriptions best characterizes the pain of a gastric ulcer?
Which of the following descriptions best characterizes the pain of a gastric ulcer?
A nurse is assessing a patient with suspected PUD. Which of the following symptoms would support this diagnosis? (Select all that apply)
A nurse is assessing a patient with suspected PUD. Which of the following symptoms would support this diagnosis? (Select all that apply)
A patient with PUD reports black, tarry stools. What is the most appropriate nursing action?
A patient with PUD reports black, tarry stools. What is the most appropriate nursing action?
Which of the following terms refers to black, tarry stools seen in patients with GI bleeding?
Which of the following terms refers to black, tarry stools seen in patients with GI bleeding?
During morning rounds, a nurse finds a patient with PUD pale and fatigued. Vital signs show BP 90/60, HR 110. What is the priority concern?
During morning rounds, a nurse finds a patient with PUD pale and fatigued. Vital signs show BP 90/60, HR 110. What is the priority concern?
Which symptoms help differentiate duodenal ulcers from gastric ulcers? (Select all that apply)
Which symptoms help differentiate duodenal ulcers from gastric ulcers? (Select all that apply)
A patient presents with fatigue, bloating, and a positive fecal occult blood test. Which of the following is the most likely explanation?
A patient presents with fatigue, bloating, and a positive fecal occult blood test. Which of the following is the most likely explanation?
The nurse reviews a client’s lab results and finds low hemoglobin and hematocrit levels. The client also reports mild abdominal discomfort. What should the nurse suspect?
The nurse reviews a client’s lab results and finds low hemoglobin and hematocrit levels. The client also reports mild abdominal discomfort. What should the nurse suspect?
Which class of drugs is commonly used to reduce gastric acid secretion in PUD?
Which class of drugs is commonly used to reduce gastric acid secretion in PUD?
What is the primary purpose of using a proton pump inhibitor in a patient with PUD?
What is the primary purpose of using a proton pump inhibitor in a patient with PUD?
A nurse is teaching a patient newly diagnosed with H. pylori–associated PUD. Which medications would likely be included in their regimen? (Select all that apply)
A nurse is teaching a patient newly diagnosed with H. pylori–associated PUD. Which medications would likely be included in their regimen? (Select all that apply)
Which of the following medications is used to coat and protect the ulcer site?
Which of the following medications is used to coat and protect the ulcer site?
A patient with PUD is prescribed sucralfate. What is the most appropriate instruction regarding its administration?
A patient with PUD is prescribed sucralfate. What is the most appropriate instruction regarding its administration?
What is the action of H2 receptor antagonists like famotidine in treating PUD?
What is the action of H2 receptor antagonists like famotidine in treating PUD?
A nurse is reviewing a patient’s medication list. Which of the following drugs should be avoided in a patient with a history of PUD?
A nurse is reviewing a patient’s medication list. Which of the following drugs should be avoided in a patient with a history of PUD?
A patient has been treated for H. pylori with triple therapy for two weeks. They now report continued pain. What is the nurse’s priority action?
A patient has been treated for H. pylori with triple therapy for two weeks. They now report continued pain. What is the nurse’s priority action?
A nurse is teaching a patient taking omeprazole. Which of the following should the nurse include in the teaching?
A nurse is teaching a patient taking omeprazole. Which of the following should the nurse include in the teaching?
A nurse is monitoring a patient taking long-term PPIs. Which complications or side effects should be considered? (Select all that apply)
A nurse is monitoring a patient taking long-term PPIs. Which complications or side effects should be considered? (Select all that apply)
What is the most common complication of peptic ulcer disease?
What is the most common complication of peptic ulcer disease?
Which symptoms are most indicative of a bleeding peptic ulcer?
Which symptoms are most indicative of a bleeding peptic ulcer?
A nurse suspects a patient is experiencing a GI hemorrhage from a peptic ulcer. Which assessment findings would support this? (Select all that apply)
A nurse suspects a patient is experiencing a GI hemorrhage from a peptic ulcer. Which assessment findings would support this? (Select all that apply)
A patient with known PUD suddenly reports intense abdominal pain, a rigid abdomen, and absent bowel sounds. What is the nurse’s priority action?
A patient with known PUD suddenly reports intense abdominal pain, a rigid abdomen, and absent bowel sounds. What is the nurse’s priority action?
Which patient statement best indicates understanding of hemorrhage risk from PUD?
Which patient statement best indicates understanding of hemorrhage risk from PUD?
Which lab result supports the diagnosis of an active GI bleed in a patient with PUD?
Which lab result supports the diagnosis of an active GI bleed in a patient with PUD?
What is the most lethal complication of peptic ulcer disease?
What is the most lethal complication of peptic ulcer disease?
A nurse is assessing a patient for a possible gastric outlet obstruction due to PUD. Which symptoms would support this complication? (Select all that apply)
A nurse is assessing a patient for a possible gastric outlet obstruction due to PUD. Which symptoms would support this complication? (Select all that apply)
A patient with PUD has a distended abdomen, absent bowel sounds, and low blood pressure. What is the likely complication?
A patient with PUD has a distended abdomen, absent bowel sounds, and low blood pressure. What is the likely complication?
Which of the following are peritoneal signs indicating ulcer perforation?
Which of the following are peritoneal signs indicating ulcer perforation?
Which of the following is a classic sign of peritonitis from ulcer perforation?
Which of the following is a classic sign of peritonitis from ulcer perforation?
A nurse is assessing a patient with suspected ulcer perforation. Which signs support the presence of peritoneal irritation?
A nurse is assessing a patient with suspected ulcer perforation. Which signs support the presence of peritoneal irritation?
Which clinical signs would indicate a progression from PUD to peritonitis? (Select all that apply)
Which clinical signs would indicate a progression from PUD to peritonitis? (Select all that apply)
A client with suspected perforation is awaiting surgery. What is the nurse’s priority intervention?
A client with suspected perforation is awaiting surgery. What is the nurse’s priority intervention?
A patient with suspected PUD undergoes an EGD (esophagogastroduodenoscopy). What is the nurse's priority post-procedure assessment?
A patient with suspected PUD undergoes an EGD (esophagogastroduodenoscopy). What is the nurse's priority post-procedure assessment?
Which diagnostic test confirms H. pylori infection by detecting its byproducts in exhaled air?
Which diagnostic test confirms H. pylori infection by detecting its byproducts in exhaled air?
A patient with PUD asks how to prevent future complications. Which statement indicates a need for further education?
A patient with PUD asks how to prevent future complications. Which statement indicates a need for further education?
Which nursing interventions help prevent peptic ulcer recurrence? (Select all that apply)
Which nursing interventions help prevent peptic ulcer recurrence? (Select all that apply)
Flashcards
Common cause of PUD
Common cause of PUD
H. pylori is the most common infectious cause of PUD, responsible for 80–90% of cases. It damages the mucosal barrier through enzymatic action.
NSAIDs contribution to PUD
NSAIDs contribution to PUD
NSAIDs inhibit prostaglandins that maintain mucosal integrity, increasing the risk for ulcers.
Risk factors for PUD
Risk factors for PUD
Smoking, stress, NSAID use, and diseases altering gastric secretions like Crohn's are all risk factors.
COPD and PUD
COPD and PUD
Signup and view all the flashcards
Older adults and gastric ulcers
Older adults and gastric ulcers
Signup and view all the flashcards
H. pylori transmission
H. pylori transmission
Signup and view all the flashcards
Duodenal ulcer symptom
Duodenal ulcer symptom
Signup and view all the flashcards
Gastric ulcer symptom
Gastric ulcer symptom
Signup and view all the flashcards
Melena indicates...
Melena indicates...
Signup and view all the flashcards
What is melena?
What is melena?
Signup and view all the flashcards
PUD bleeding signs
PUD bleeding signs
Signup and view all the flashcards
Difference in ulcer pain
Difference in ulcer pain
Signup and view all the flashcards
PPIs reduce...
PPIs reduce...
Signup and view all the flashcards
PPIs treat PUD
PPIs treat PUD
Signup and view all the flashcards
H. pylori treatment
H. pylori treatment
Signup and view all the flashcards
Sucralfate action
Sucralfate action
Signup and view all the flashcards
When to take sucralfate
When to take sucralfate
Signup and view all the flashcards
How H2 blockers treat PUD
How H2 blockers treat PUD
Signup and view all the flashcards
Avoid which med?
Avoid which med?
Signup and view all the flashcards
Pain after treatment
Pain after treatment
Signup and view all the flashcards
PPI timing
PPI timing
Signup and view all the flashcards
Long term PPI risks
Long term PPI risks
Signup and view all the flashcards
PUD Complications
PUD Complications
Signup and view all the flashcards
Suspect bleeding
Suspect bleeding
Signup and view all the flashcards
Perforation causes...
Perforation causes...
Signup and view all the flashcards
Study Notes
Risk Factors for Peptic Ulcer Disease (PUD)
- Helicobacter pylori (H. pylori) is the main infectious cause of PUD, responsible for 80-90% of cases
- H. pylori damages the mucosal barrier through enzymatic action.
- NSAIDs contributes to peptic ulcer formation by inhibiting prostaglandin synthesis, which protects the mucosa.
- Risk factors for developing PUD include:
- Smoking
- Stress
- NSAID use
- Crohn's disease.
- COPD alters gastric secretion and is a risk factor for PUD.
- Older adults are more likely to experience gastric ulcers due to increased NSAID use and reduced mucosal protection.
- H. pylori spreads via oral-oral or fecal-oral routes, practicing proper hygiene is important for prevention.
- When assessing a patient at risk of PUD, Crohn's disease is the least modifiable factor in preventing the disease.
- Conditions that can increase the risk of PUD by altering gastric secretion:
- Crohn's disease
- Cancer
- COPD
Signs and Symptoms of Peptic Ulcer Disease (PUD)
- Pain relieved by eating is commonly associated with a duodenal ulcer
- Duodenal ulcer pain typically occurs 2-4 hours after eating
- Gastric ulcer pain starts 1-2 hours after meals and is not relieved by eating, unlike duodenal ulcers.
- The following symptoms support a PUD diagnosis:
- Bloating
- Belching
- Melena (black tarry stools)
- Anemia
- Melena indicates GI bleeding, which is a potential complication; immediate notification is necessary.
- Melena is the term for black, tarry stools caused by digested blood in the GI tract.
- Hypotension and tachycardia, along with pallor and fatigue signals GI bleeding
- Duodenal ulcers are more painful at night, gastric ulcers have pain shortly after eating, additionally duodenal ulcers is relieved by food
- Fatigue, bloating, and a positive fecal occult blood test are most likely due to a peptic ulcer with bleeding.
- Low hemoglobin and hematocrit levels with abdominal discomfort suggest chronic blood loss likely from PUD.
- Hemorrhage is the most frequent complication of PUD and is life-threatening if not addressed promptly.
- Tachycardia and melena suggest GI bleeding, especially in patients with known PUD.
- Assessment findings for GI hemorrhage from a peptic ulcer:
- Hypotension
- Decreased hemoglobin
- Coffee ground emesis
- Intense abdominal pain, a rigid abdomen, and absent bowel sounds indicates perforation/peritonitis, a surgical emergency where immediate intervention is required.
- A patient's understanding of hemorrhage risk from PUD: "Black stools can mean bleeding, and I should call my doctor."
- A hemoglobin level of 7.9 suggests significant blood loss, possibly due to ulcer hemorrhage.
- Perforation can lead to peritonitis and sepsis, making it the highest threatening PUD complication.
- Symptoms of gastric outlet obstruction due to PUD:
- Nausea and vomiting
- Sensation of epigastric fullness
- Electrolyte imbalances
- Distension, absent bowel sounds, hypotension, and pain suggest perforation with peritonitis
- Classic signs of peritoneal irritation that indicate ulcer perforation include rebound tenderness, muscle rigidity, and guarding.
- Perforation causes peritoneal inflammation, resulting in sudden pain, board-like abdomen, and rigidity.
- Hallmark signs of peritoneal inflammation include:
- Rebound tenderness
- Guarding
- Rigidity.
Progression from PUD to Peritonitis
- Clinical signs are:
- Shallow, rapid respirations
- Rapid and weak pulse
- Abdominal distension
- Hypotension
- In suspected perforation, the nurse must maintain NPO, support circulation with IV fluids, and prepare for emergency surgery.
- After EGD, the gag reflex must return before oral oral intake to prevent aspiration.
- The C-urea breath test detects urease enzyme produced by H. pylori in exhaled carbon dioxide.
- Ignoring symptoms like bloating/fullness may delay diagnosis of obstruction or bleeding.
- Nursing interventions to help prevent peptic ulcer recurrence:
- Encouraging smoking cessation
- Education to avoid aspirin/NSAIDs
- Promoting stress reduction strategies
- Instructing adherence to prescribed medications
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.