Peptic Ulcer
A nurse is proving community education about peptic ulcer disease, its causes, treatment, and symptoms. Which statement by the nurse is incorrect? "The most common form of chronic gastritis is caused by Helicobacter pylori infection." "The incidence of H pylori infection increases in patients who are older than 60." "H pylori infection is more prevalent in industrialized countries than in developing countries." "Urea breath testing can be used to detect active infection with H pylori."
"H pylori infection is more prevalent in industrialized countries than in developing countries." Rationale: H pylori infection is more prevalent in developing countries than in industrialized countries.
The nurse is discussing dietary considerations with a patient diagnosed with peptic ulcer disease. Which responses made by the patient indicate the need for further discussion? "I must refrain from drinking coffee." "I should consume six small meals a day." "I must limit my alcohol consumption." "I must restrict my intake of fluids."
"I must restrict my intake of fluids." Rationale: There are no fluid restrictions for the patient. The patient should drink adequate amounts of fluids, which can be helpful in neutralizing the acidity of the stomach.
The nurse is creating a plan of care for a patient with peptic ulcer disease. What is important to include? Select all that apply. Advise the patient to refrain from caffeine intake. Advise the patient to limit the use of aspirin. Advise the patient to limit bedtime snacks. Administer antacids 1 hour before meals. Administer proton pump inhibitors (PPIs) before breakfast.
Advise the patient to refrain from caffeine intake. Rationale: The nurse should advise patients to eliminate risk factors such as caffeine in the diet. Intake of caffeine elevates gastric acid secretion. Administer proton pump inhibitors (PPIs) before breakfast. Rationale: PPIs should be administered before breakfast to be helpful in reducing the gastric pain
A patient is diagnosed with medication-induced nonsteroidal anti-inflammatory drug (NSAID) peptic ulcer disease. Which clinical finding is the nurse most likely to find in the patient? Decrease in pepsin secretion Increase in bicarbonate levels Decrease in mucus production Increase in gastric mucosal blood flow
Decrease in mucus production Rationale: Because of the reduced blood flow to the mucosal membrane, there will be a decrease in mucus production.
A patient with peptic ulcer disease is being discharged on several new medications. When performing medication education, which medication should the nurse say helps block gastric secretions? Antacids H2-receptor antagonists Metoclopramide Sucralfate
H2-receptor antagonists Rationale: H2-receptor antagonists help in blocking gastric secretions.
When caring for a patient with peptic ulcer disease (PUD), he mentions that "something feels different, it's like I have a fullness or heaviness above my stomach after eat." What complication should the nurse consider is occurring? Penetration Perforation Obstruction Gastrointestinal (GI) bleeding
Obstruction Rationale: An obstruction is a complication of peptic ulcer disease that has characteristics such as epigastric fullness and heaviness after meals.
A patient is hospitalized to rule out peptic ulcer disease (PUD). He asks the nurse what types of noninvasive tests the provider will perform. Which test should the nurse say is most commonly performed? Upper-endoscopy test Liver function test Esophagogastroduodenoscopy (EGD) A stool antigen test.
Rationale: A stool antigen test is an example of a noninvasive test for detecting PUD because it does not involve the introduction of devices in the body. Test Taking Tips:"Noninvasive" is the key word.
A patient reports nausea, vomiting, and epigastric pain, and is diagnosed with acute gastritis. Which medications are appropriate for symptomatic relief of the patient? Select all that apply. Sucralfate Diclofenac Pantoprazole Vitamin B12 Magnesium sulfate
Sucralfate Rationale: Sucralfate forms a protective lining in the stomach, which prevents irritation of the gastric mucosa. Pantoprazole Rationale: Pantoprazole is a proton pump inhibitor that reduces gastric ulcers and may provide symptomatic relief to the patient. Magnesium sulfate Rationale: Magnesium sulfate is an antacid used in gastritis that may provide the patient symptomatic relief. Test Taking Tips:Differentiate between gastritis and peptic ulcer disease.
Which diagnostic tests are used to detect an active infection with Helicobacter pylori? Select all that apply. Radiological test Urea breath test Barium x-ray test Serological test Fecal antigen test
Urea breath test Rationale: A urea breath test helps in detecting active infection with H pylori. Serological test Rationale: A serological test helps in detecting active infection with H pylori. Fecal antigen test Rationale: A fecal antigen test helps in detecting active infection with H pylori.
Which nursing actions should a nurse perform when caring for a patient with peptic ulcer disease? Select all that apply.
*Document and notify the primary health-care provider about S/S of dumping syndrome *Administer antacids 1 - 3 hours after meals *Prepare the PT for an Upper Endo or surgery per order *Administer PPIs before breakfast *Eliminate bedtime snacks - may stimulate gastric acid and pepsin production
A patient reports tarry stools and emesis with a "coffee grounds" appearance. They have a history of peptic ulcer disease. Which complication is the patient likely experiencing? Perforation Penetration Obstruction Gastrointestinal (GI) bleeding
Gastrointestinal (GI) bleeding Rationale: Gastrointestinal bleeding is one of the complications of peptic ulcer disease and is characterized by tarry stools and emesis with a coffee-grounds appearance. Test Taking Tips:Consider complications.
After receiving hand-off report, the nurse begins reflecting on the possible complications that can occur in the patient with peptic ulcer disease. Which considerations should the nurse make? Select all that apply. Ulcer crater penetrating through adjacent organs Gastrointestinal (GI) contents entering the peritoneum Edema, spasm, or contraction of scar tissue Abdominal distention and third spacing Abdomen tender when palpating
Gastrointestinal (GI) contents entering the peritoneum Rationale: Gastrointestinal contents entering the peritoneum is a characteristic of peptic ulcer disease with perforation. Abdominal distention and third spacing Rationale: Abdominal distention and third spacing is a characteristic of peptic ulcer disease with perforation. Abdomen tender when palpating Rationale: In peptic ulcer disease with perforation, the abdomen may be tender when palpated. Test Taking Tips:Consider the complication of perforation.
As the nurse is getting a patient with peptic ulcer disease out of bed, he vomits, has severe epigastric pain, and states he is feeling dizzy. Which priority nursing actions should the nurse take? Select all that apply. Return the patient to bed. Assess the bowel sounds. Lower the head of the bed. Obtain a blood pressure reading. Call for help.
Return the patient to bed. Rationale: The patient may be experiencing a complication and needs to be returned to bed for safety reasons. Lower the head of the bed. Rationale: The dizziness may be from a lack of perfusion and lowering the head of the bed is appropriate. Obtain a blood pressure reading. Rationale: This is a priority to determine stability. Call for help. Rationale: This is important since the event is sudden and the patient is unstable. Test Taking Tips:Consider immediate needs based on safety.
The nurse is caring for a patient with a peptic ulcer. Which symptom would suggest that it is in the duodenum? The patient is dizzy, sweating, and has palpations. The patient has ulcer-like pain that cannot be relieved by antacids. The patient has burning epigastric pain, which can be relieved after taking antacids. The patient feels stomach fullness.
The patient has burning epigastric pain, which can be relieved after taking antacids. Rationale: A patient with a duodenal ulcer may complain of burning epigastric pain, which can be relieved after taking antacids.
A patient reports epigastric pain, blood in stools, and a loss of appetite. Which initial diagnostic test is the primary health-care provider most likely to order to determine if the client has Helicobacter pylori infection? Endoscopy Urea breath test Complete blood count Upper gastrointestinal (GI) x-ray
Urea breath test Rationale: A urea breath test is appropriate to confirm the presence of an H pylori infection.