PUD in Children, Pregnant Women, and Older Adults
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Questions and Answers

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?

  • 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?

  • 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?

    <p>Hematemesis</p> Signup and view all the answers

    What is the effectiveness comparison between high-dose and low-dose H2RA in the prophylaxis of PUD?

    <p>High-dose shows greater effectiveness</p> Signup and view all the answers

    Which of the following is NOT a recommended action for nurses to promote health in patients at risk for peptic ulcer disease (PUD)?

    <p>Promote frequent alcohol consumption</p> Signup and view all the answers

    What is a common complaint that nurses should assess for when evaluating a patient with PUD?

    <p>Epigastric pain</p> Signup and view all the answers

    Which vital sign measurement is important during the assessment of a patient suspected of having PUD?

    <p>Orthostatic measurements</p> Signup and view all the answers

    Which of the following goals is appropriate for the treatment plan of patients with PUD?

    <p>The patient will maintain urine output of at least 0.5 mL/kg/hr.</p> Signup and view all the answers

    Which of the following factors is linked to an increased risk of exacerbation and recurrence of PUD?

    <p>Nonsteroidal anti-inflammatory drug (NSAID) use</p> Signup and view all the answers

    Which assessment finding might indicate potential bleeding in a patient with PUD?

    <p>Bright blood in vomitus</p> Signup and view all the answers

    Which of the following is a potential nursing diagnosis for a patient with PUD?

    <p>Risk for fluid volume deficit</p> Signup and view all the answers

    What type of symptoms should a patient with PUD be encouraged to discuss regarding possible infection?

    <p>Nausea or vomiting</p> Signup and view all the answers

    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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    Description

    This quiz explores the incidence and treatment of Peptic Ulcer Disease (PUD) across different age groups, including children, pregnant women, and older adults. Key factors such as the implications of chronic illness, medication use, and assessment requirements for each group will be discussed in detail.

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