I. Introduction
a 54 years of age, married, from  Genetics
Peptic ulcer disease (PUD) is a common
disorder that affects thousands of individuals in the
Philippines each year. In the last two decades,
major advances have been made in the
understanding of the pathophysiology of PUD,
particularly regarding the role of Helicobacter
pylori infection and nonsteroidal anti-inflammatory
drugs (NSAIDs). Peptic ulcers are defects in the
gastric or duodenal mucosa that extend through
the muscularis mucosa. Under normal conditions, a
physiologic balance exists between peptic ulcer
occur when the balance between the aggressive
factors and the defensive mechanisms is disrupted.
II. Discussion
A peptic ulcer is an excavation formed in
the mucosal wall of the stomach, pylorus,
duodenum, or esophagus. It is frequently referred
to as a gastric, duodenal or esophageal ulcer,
depending on its location. The erosion of a
circumscribed area of mucous membrane causes it.
Peptic ulcers are more likely to be in the duodenum
than in the stomach. Peptic ulcer disease occurs
when stomach acid such as HCl penetrates the
stomach and/or duodenal lining and causes sores
or erosions that may bleed, lead to anemia and/or
cause abdominal pain. Moreover, one of the major
causes of peptic ulcer is Helicobacter pylori
infection. Helicobacter pylori infection is usually
due to eating raw or improperly cooked meat. The
second major cause is prolonged use of
nonsteroidal anti-inflammatory drugs (NSAIDs).
Untreated, the ulcer can literally eat a hole in the
stomach lining, requiring surgery. Chronic
inflammation from an ulcer can cause swelling and
scarring which may obstruct the outlet of the
stomach, preventing the passage of food and
causing vomiting and weight loss. In severe cases,
ulcer complications can lead to death.
III. History of the Patient
Mr. X.
Mapolo-polo, Basista, Pangasinan was admitted on
February 15, 2010 at Pangasinan Provincial V. Clinical Manifestations
Hospital. Mr. X is a smoker and alcoholic. He eats  Dull, gnawing pain or burning sensation in the
three times a day excluding snacks but, sometime midepigastrium area
he eats not on proper time because he does not  Bloating
want to leave what he’s working on.  Diarrhea
Mr. X has been having an on and off
epigastric pain for about a year which was not
 Loss of appetite
associated with food intake. Mr. X took  Melena
esomeprazole (Nexium) to relief pain. One and a
half month prior to admission, Mr. X had VI. Pathophysiology
recurrence of epigastric pain, 6-7/10 in severity,
relieved by esomeprazole. He experienced loss of HCl+Pepsin Mucous
appetite, diarrhea, a feeling of fullness in upper (Aggressor) Secretion
abdomen or bloating after eating. He then sought (Protector)
consent with a private medical doctor and was
advised gastroscopy.
On his early childhood, he sometimes had Damage of
headache and diarrhea but he will just take a
↑Secretion: mucous
-stress membrane
medicine for it. At the age of ten, he had felt pain
-stimulants
at his epigastric area and his parents brought him
to the hospital for a checkup. His diagnosis was an ↓Secretion
acute gastritis. He received a complete -blood flow
immunization. He does not have any allergies to -irritants
foods or drugs. In 1979, he was hospitalized due to
malaria at the Region I Medical Center. At the age
of 40, he was diagnosed as hypertensive. Patient
states that in his father’s side, there is no illness PUD
inherited. In contrary, hypertension is in the
bloodline of his mother’s side. VII. Nursing Intervention
a. Relieve pain by administering antacid
IV. Etiology/Cause as prescribed.
The predisposing factors for PUD are as b. Encourage patient to promote a healthy
follows: lifestyle:
 Stress  The client may eat anything that he can
 Cigarette smoking tolerate when he is asymptomatic.
 Alcohol  Liberal bland diet is recommended during
exacerbation.
 Caffeine
 Advise client to eat slowly and to chew food
 Drugs
properly.
 Gastritis
 Small, frequent feedings during exacerbation.
 Zollinger-Ellison Syndrome
 Encourage the client to quit smoking
 Irregular, hurried meals
 Fatty, spicy, highly acidic-foods  Enhance coping through stress therapy
 Type A personality  The client should avoid the ff:
 Type O Blood
 -fatty foods, coffee, tea, chocolate, cola Internet: http://www.google.com
cringes, spices, red/black pepper, alcohol
- bed time snacks Presented by:
-binge eating
-large quantities of milk
GROUP 3 COLLEGE OF NURSING
VIII. Recommendation (MTW 4PM-6Pm) DEPARTMENT OF NATURAL
As future nurses, we should acquire the SCIENCE
three important aspects of being a good nurse: ABAD, MICHAEL
knowledge, skills, and attitude. These will help us
to become effective and efficient nurses who know AMBROSIO, ALPHA
how to deal with patients with different disease BAROMA, DANNY
conditions in different situations. A lack of even
one of these will be very difficult to a nurse and it BARTOLOME, ARLENE
is expected that he/she will not be able to provide BARTOLOME, DEXTER
the care needed by the patient. We also
recommend, especially to student nurses to voice CRUZ, GLAIZA
MARCH 2010
out/express their concerns and ask if they are DELA CRUZ, DIANNE
curious and or unsure about doing procedures for
them not to commit mistakes. Besides, there is TAMAYO, RENDA
nothing wrong in asking. Not asking will only DE GUZMAN, JHOELYN
endanger your patient and yourself.
ETRATA, JENNIFER
IX. References NERO, JOHNSON
Saxton, Dolores B. et. Al. 1996, MOSBY’s PACIS, GLADYS
Comprehensive Review of Nursing,
15th edition, Mosby-Year Book,
Inc.

Smeltzer, Suzanne C. et. Al, 2008, Brunner

& Suddarthis Textbook of Medical-
Surgical Nursing, 11th edition, MRS. MARICRIS SERQUILLOS
Lippincott Williams & Wilkins.

Udan, Josie Q. et. Al. 2009, NCLEX-RN (BIOCHEM INSTRUCTOR)

Test-PREP for International Nurses
Series 11, 2009-edition,
Educational Publishing House.

Udan, Josie Q. et. Al. 2002, Medical-

Surgical Nursing: Concepts &
Clinical Application, 1st edition,
Educational Publishing house.