WESLEY BALA

NURSING CARE PLAN

Nursing Diagnosis

Imbalanced nutrition :Less than body requirements related to abdominal distention as

evidenced by nausea ,vomiting and weight loss.

Nursing Inference

The patient is suffering from Peptic ulcer disease. Peptic ulcer is an ulceration in the mucosal wall of
the lower esophagus , the stomach and pylorus. This ulceration in the stomach then either propagate or
produce scarring in the lining of the digestive tract. Either the ulcers or the scars may be an obstruction
to the passage way of the food , which then leads to distention , hence the vomiting and eventually
weight loss.

Nursing Goal

After the 1-2 weeks of rendering nursing intervention , the client will demonstrate progressive
weight gain toward the initial weight before the noticeable changes due to the disease.

Intervention
Assess base line information from the client such
as vital signs as well as initial weight.
Determine the clients ability to chew and swallow
food .
Asses the lifestyle and habits of the client that
might affect and aggravate symptoms such as
alcohol intake and tobacco use.
Encourage non pharmacologic relaxation
techniques such as guided imagery , distraction
and music therapy.
Instruct the client that meals should be eaten ar
regularly paced intervals in a relaxed settin
Rationale
For the Healthcare provider to keep track of the
development of the client’s condition
These factors are closely related to ingestion and
digestion of nutrients.
Lifestyle habits such as excess intake of alcohol
containing drinks and tobacco use may aggravate
symptoms of PUD which then leads to
obstruction in the GIT , then cause distention and
vomiting .
Non pharmacologic relaxation will decrease the
production of gastric acid , which in turn will
reduce irritation in the mucosa .
An irregular schedule of meals may interfere with
the regular administration of medications

Administer antacids and antibiotics as prescribed. Antacids buffer gastric acid and prevent the
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formation of peptin. This mechanism of action

promotes of healing of the ulcer. Antibiotics treat
the Helicobacter pylori infection and promote
healing of the ulcer. As the ulcer heals, the client
experience less pain. 

Collaborate with other healthcare team such as To provide a diet that will suffice the needs of the
client while considering the foods that will not
the nutritionist to make a meal plan .
aggravate symptoms of the disease.

Nursing Evaluation

After the 1 week of rendering nursing intervention , the client demonstrated progressive weight
gain towards the set goal.

DRUG STUDY
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Rebamipide 1 tab TID pc

Generic Name: Rebamipide

Brand Name: Mucosta

Classification: Antacids

Dosage, route & frequency: 500mg TID PO

Mechanism of Action: Rebamipide is a mucosal protective agent and is postulated to increase gastric
blood flow, prostaglandin biosynthesis and decrease free oxygen radicals

Desired Effect: helps in mucosal and healing of gastroduedenal ulcers

Nursing Responsibilities

Check and verify doctor’s order. To prevent medication error.

Observe the 12 Rights in medication
administration.
Explain the drug to the patient and
significant other.
Assess allergy to any component of the drug.
Take BP before administering the drug
Advise the patient to watch out for adverse
reactions including rash, constipation, bloating,
difficulty breathing, etc.
To ensure safety and prevent medication
error.
To gain cooperation and promote
compliance.
To prevent hypersensitivity reactions.
To prevent further increase in blood pressure
To prevent complications

Clarithromycin 500mg PO BID

Generic Name: Clarithromycin

Brand Name: Clariget

Classification: Macrolide Antibiotic

Dosage, route & frequency: 500mg PO BID

Mechanism of Action: Binds to ribosomal receptor sites of susceptible organisms, inhibiting protein
synthesis of bacterial cell wall

Desired Effect: Prophylaxis

Nursing Responsibilities

Check and verify doctor’s order. To prevent medication error.

Observe the 12 Rights in medication To ensure safety and prevent medication
administration. error.
Explain the drug to the patient and To gain cooperation and promote
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significant other. compliance.

Assess allergy to any component of the drug. To prevent hypersensitivity reactions.
Educate the client not to chew/break when To retain the extended-release function of
taking the drug the drug
Take drug with food if GI effects occur To prevent complication
Advise client not to drink grapefruit juice To prevent increased side effects of the drug
Advise patient to anticipate side effects including To educate the client
stomach cramping
Educate the client to report immediately if water To prevent complications
diarrhea, n/v, rash or itching occurs

Omeprazole 40mg IV OD
Generic Name: Omeprazole

Brand Name: Omepron

Classification: Proton Pump Inhibitor

Dosage, route & frequency: 40 mg IV OD

Mechanism of Action: Binds to the activated proton pump on the apical membrane of parietal cells.
Inhibits acid secretion into the gastric lumen.

Desired Effect: Reduces gastric acid secretion

Nursing responsibilities

Nursing Responsibilities Rationale

1. Check and verify doctor’s order.
2. Observe the 12 Rights in medication
administration.
3. Explain the drug to the patient and
significant other.
4. Assess allergy to any component of
the drug.
5. Monitor improvements in GI symptoms
(gastritis, heartburn, and so forth) to help
determine if drug therapy is successful.
6. Assess dizziness that might affect gait,
balance, and other functional activities
7. Advise patient to avoid alcohol and foods
that may cause an increase in GI
irritation.
To prevent medication error.
To ensure safety and prevent medication
error.
To gain cooperation and promote
compliance.
To prevent hypersensitivity reactions.
To determine medication efficacy
To prevent injury from fall
To avoid increase in gastric acid secretion
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8. Instruct patient to report bothersome or To prevent drug complications

prolonged side effects, including skin
problems (itching, rash) or GI effects
(nausea, diarrhea, vomiting, constipation,
heartburn, flatulence, abdominal pain).