PEPTIC ULCER

PREDISPOSING MAIN IDEA

CONTRIBUTING MAIN IDEA
PRECIPITATING
FACTORS FACTORS FACTORS
Age: 61 years old History of chronic gastritis with Helicobacter pylori (H. pylori) infection.
Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) for Weight loss, Bloating and Fullness, Stomach
Gender: Female
Family history of gastric cancer (mother) and duodenal
osteoarthritis. Ache, Nausea, Vomiting
Recent increase in NSAID intake due to knee pain.
ulcers (brother). History of smoking for 30 years.

MAIN IDEA
CHIEF
COMPLAINT
2-month history of burning pain in the epigastric
abdomen and chest, which radiates toward her
back

LABORATORY/DIAGNOSIS
TEST

LIVER UPPER ENDOSCOPY ABDOMINAL

CBC (ESOPHAGOGASTROD FECAL OCCULT
FUNCTION ULTRASOUND COLONOSCOPY
UODENOSCOPY OR BLOOD TEST
TESTS EGD) OR CT SCAN

Hemoglobin (Hb): Decreased Alanine Aminotransferase

(indicating anemia due to
chronic blood loss).
Hematocrit (Hct): Decreased
(consistent with anemia).
Mean Corpuscular Volume
(MCV): May be normal or
decreased.
White Blood Cell Count (WBC):
May be normal or elevated
(indicating inflammation or
infection).
(ALT) and Aspartate
Aminotransferase (AST): May
Findings may include:
be elevated (suggestive of
liver inflammation or injury).
Alkaline Phosphatase (ALP):
May be elevated (indicative of
biliary obstruction or liver
involvement).
Bilirubin: Elevated levels may
suggest liver dysfunction or
obstruction.
finding may include:
Positive result (indicating Pancreatic inflammation or
Gastritis: Inflammation of the stomach Inflammation, polyps, or
the presence of blood in changes consistent with
lining, possibly with erosions or ulcers.
pancreatitis. tumors in the colon or
Peptic Ulcers: Ulcerations in the the stool, suggestive of
stomach or duodenum. Liver abnormalities such as rectum, depending on the
Esophagitis: Inflammation of the gastrointestinal bleeding). fatty liver disease or liver
esophagus, often due to
extent of examination.
metastases.
gastroesophageal reflux disease
(GERD). Abdominal masses or
Possible presence of Helicobacter lymphadenopathy suggestive
pylori infection. of malignancy.

DISEASE
PROCESS

Acquisition of H pylori

Chronic H pylori infection in stomach

cagA+ tox+ cagA-tox -

Intense gastritis (Increase IL-8, nreutophil

infiltration), epithelial damage

Peptic Ulcer

CLINICAL
MANIFESTATIONS

Proton Pump Inhibitors

Epigastric pain Proton Pump Inhibitors (Omeprazole)
suppress gastric acid production,
promoting ulcer healing and symptom
relief.
Nausea and vomiting Antiemetics (Ondansetron)
help control nausea and vomiting by Bloating and fullness
Hyoscyamine Gastrointestinal (Pantoprazole)
Alleviate abdominal discomfort and
blocking neurotransmitter receptors or bloating by reducing smooth bleeding inhibit gastric acid secretion,
inhibiting gastric motility and sensitivity. promoting hemostasis and
muscle spasms in the
preventing rebleeding from ulcer
gastrointestinal tract.
sites.

Acute Pain related to gastric Nausea and Vomiting related to gastric Impaired Comfort related to abdominal Risk for Deficient Fluid Volume related to actual or
mucosal irritation and ulceration as irritation, inflammation, or bleeding distention, bloating, and early satiety as potential gastrointestinal bleeding secondary to
evidenced by patient reports of secondary to peptic ulcer disease, as evidenced by patient reports of peptic ulcer disease, as evidenced by patient
evidenced by patient reports of nausea reports of hematemesis (vomiting blood), melena
burning or gnawing sensation in the discomfort and fullness in the upper (black, tarry stools), or hematochezia (bright red
and episodes of vomiting.
upper abdomen. abdomen. blood in stools).

1. Assess patient’s vital sign. 1. Assess patient’s vital sign. 1. Assess the patient’s vital sign.,
1. Monitor vital signs and oxygen
2. Assess the severity and 2. Assess the frequency, severity, 2. Assess the patient's abdominal
discomfort, bloating, and fullness, saturation.
characteristics of pain, including and duration of nausea and
location, intensity, and including any associated factors or 2. Administer oxygen, blood
vomiting episodes.
exacerbating factors. 3. Administer antiemetic exacerbating triggers. transfusions, and medications
3. Administer prescribed pain relief medications, such as
3. Encourage the patient to maintain a as prescribed.
low-fat, low-fiber diet to reduce 3. Insert an IV catheter for fluid
medications, such as antacids, ondansetron or metoclopramide, bloating and discomfort.
H2 receptor antagonists, or as prescribed to alleviate nausea resuscitation.
4. Administer prescribed medications,
proton pump inhibitors, as and prevent vomiting. such as prokinetic agents or 4. Prepare the client for
scheduled. 4. Encourage the patient to antispasmodics, to improve endoscopy or surgery, if
4. Encourage relaxation consume small, frequent meals gastrointestinal motility and reduce necessary.
techniques, positioning for and avoid triggers that may bloating. 5. Educate the client on dietary
comfort, and distraction methods exacerbate nausea, such as 5. Encourage the patient to avoid
modifications and medication
to help alleviate pain. strong odors or spicy foods. carbonated beverages and gas-
producing foods that may management post-discharge.
5. Educate the patient on the 5. Offer oral hygiene measures,
importance of adhering to exacerbate bloating.
such as mouth rinses or chewing
medication regimens to control 6. Provide education on relaxation
gum, to help alleviate the
techniques and stress management
pain and promote ulcer healing. sensation of nausea. strategies to help alleviate
6. Monitor the patient's response to 6. Monitor fluid intake and output, abdominal discomfort.
pain management interventions as persistent vomiting can lead
and adjust as needed based on to dehydration and electrolyte
effectiveness and side effects. imbalances.

References
https://nursinganswers.net/case-studies/study-of-a-patient-with-shortness-of-breath-nursing-essay.php
https://www.sciencedirect.com/science/article/abs/pii/S0002934396002732

LEGEND
DISEASE CHIEF COMPLAINT
PHARMARCOLOGICAL
LAB TEST TEST RESULT DISEASE PROCESS CLINICAL MANIFESTATION NURSING DIAGNOSIS NURSING MANAGEMENT
MANAGEMENT