Podcast
Questions and Answers
What is the incidence range of peptic ulcer bleeding in the pediatric population?
What is the incidence range of peptic ulcer bleeding in the pediatric population?
- 1–3%
- 2–8% (correct)
- 0.5–4.4% (correct)
- 5–10%
In treating peptic ulcer disease (PUD) during pregnancy, which is the appropriate management for H. pylori infection?
In treating peptic ulcer disease (PUD) during pregnancy, which is the appropriate management for H. pylori infection?
- Prescribe antibiotics during pregnancy
- Use over-the-counter antacids
- Begin treatment immediately
- Wait until after delivery if possible (correct)
Which medication is commonly used in co-therapy to lower the risk of PUD in older adults taking NSAIDs?
Which medication is commonly used in co-therapy to lower the risk of PUD in older adults taking NSAIDs?
- Proton Pump Inhibitors
- Laxatives
- Antibiotics
- H2-receptor antagonists (correct)
What is a concerning symptom that may indicate the need for further assessment in pregnant women with PUD?
What is a concerning symptom that may indicate the need for further assessment in pregnant women with PUD?
What is the effectiveness comparison between high-dose and low-dose H2RA in the prophylaxis of PUD?
What is the effectiveness comparison between high-dose and low-dose H2RA in the prophylaxis of PUD?
Which of the following is NOT a recommended action for nurses to promote health in patients at risk for peptic ulcer disease (PUD)?
Which of the following is NOT a recommended action for nurses to promote health in patients at risk for peptic ulcer disease (PUD)?
What is a common complaint that nurses should assess for when evaluating a patient with PUD?
What is a common complaint that nurses should assess for when evaluating a patient with PUD?
Which vital sign measurement is important during the assessment of a patient suspected of having PUD?
Which vital sign measurement is important during the assessment of a patient suspected of having PUD?
Which of the following goals is appropriate for the treatment plan of patients with PUD?
Which of the following goals is appropriate for the treatment plan of patients with PUD?
Which of the following factors is linked to an increased risk of exacerbation and recurrence of PUD?
Which of the following factors is linked to an increased risk of exacerbation and recurrence of PUD?
Which assessment finding might indicate potential bleeding in a patient with PUD?
Which assessment finding might indicate potential bleeding in a patient with PUD?
Which of the following is a potential nursing diagnosis for a patient with PUD?
Which of the following is a potential nursing diagnosis for a patient with PUD?
What type of symptoms should a patient with PUD be encouraged to discuss regarding possible infection?
What type of symptoms should a patient with PUD be encouraged to discuss regarding possible infection?
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Study Notes
PUD in Children and Adolescents
- PUD incidence in children internationally is 2 - 8%
- Bleeding occurs in 0.5 to 4.4/100,000 children
- Complex chronic disease in pediatric intensive care unit patients should be reviewed for PUD if they experience life-threatening GI bleeding
- PUD should be assessed in acutely ill children
PUD in Pregnant Women
- Nausea and vomiting are common in pregnancy; however, epigastric discomfort, hematemesis, and weight loss require further assessment
- While historically rare, routine endoscopy now provides data on the occurrence of PUD in pregnant women
- PPIs may be used to treat PUD; treatment for H pylori (if present) should be delayed until after delivery, if possible
PUD in Older Adults
- PUD in patients over 65 years old is associated with NSAID use
- H2 receptor antagonists (H2RA) are often co-administered with NSAIDs to reduce the risk of PUD
- High-dose H2RA shows greater effectiveness than low-dose H2RA in preventing PUD with NSAID use in adults
- Nurses should remind patients to discuss co-therapy with their primary care providers
Risk Factors for PUD
- Excessive aspirin or NSAID use
- Cigarette smoking
Nursing Interventions for PUD
- Advise patients to avoid risk factors
- Encourage patients to seek treatment for GERD and chronic gastritis
- Assess for epigastric or left upper quadrant pain, heartburn, or discomfort
- Assess for nausea or vomiting
- Assess for blood in vomitus
- Assess for current medications, including aspirin or other NSAIDs
- Assess for cigarette smoking and use of alcohol or other drugs
- Assess for general appearance, including height and weight relationship
- Assess for vital signs, including orthostatic measurements
- Assess for abdominal examination, including shape and contour, bowel sounds, and tenderness to palpation
- Assess for presence of obvious or occult blood in vomitus and stool
Nursing Diagnoses for PUD
- Potential for bleeding
- Risk for fluid volume deficit
- Weight loss
- Chronic pain
- Sleep disturbance
Goals of Treatment for PUD
- No complications related to bleeding
- No signs or symptoms of infection
- Maintain fluid volume balance
- Adequate dietary intake to meet nutritional and caloric needs
- Understand the risk factors related to PUD exacerbation and recurrence
- Maintain pain at a tolerable level
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