Peptic ulcer is an ulceration in the mucosal wall of the lower esophagus, stomach, pylorus, or duodenum. The ulcer may be referred to as duodenal, gastric, or esophageal, depending on its location. The most common symptom of both gastric and duodenal ulcers is epigastric pain. It is characterized by a burning sensation and usually occurs shortly after meals with gastric ulcer and 2-3 hours afterward with duodenal ulcer.
Predisposing factors of peptic ulcer includes infection with the gram-negative bacteria Helicobacter pylori which may be acquired through the ingestion of food and water, excessive HCL secretion in the stomach, chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) which weakens the lining of the GI tract by reducing the protective function of the mucosal layer, increased stress associated with illness and surgery, alcohol ingestion and excessive cigarette smoking.
Nursing Care Plans
The nursing goals of a client with a peptic ulcer disease include reducing or eliminating contributing factors, promoting comfort measures, promoting optimal nutrition, decreasing anxiety with increased knowledge of disease, management, and prevention of ulcer recurrence and preventing complications
- Acute Pain
- Imbalanced Nutrition: Less Than Body Requirements
- Deficient Knowledge
- Risk For Deficient Fluid Volume
May be related to
- Abdominal distention
- Abdominal muscle spasm
- Recent nonsteroidal anti-inflammatory drug (NSAID) or acetylsalicylic acid (ASA) use
Possibly evidenced by
- Client will report satisfactory pain control at a level less than 2 to 4 on a scale of 0 to 10.
- Client uses pharmacological and nonpharmacological pain relief measures.
- Client will exhibit increased comfort such as baseline levels for HR, BP, and respirations and relaxed muscle tone for body posture.
|Assess the client’s pain, including the location, characteristics, precipitating factors, onset, duration, frequency, quality, intensity, and severity.||Clients with gastric ulcer typically demonstrate pain 1 to 2 hours after eating. The client with duodenal ulcers demonstrate pain 2 to 4 hours after eating or in the middle of the night. With both gastric and duodenal ulcers, the pain is located in the upper abdomen and is intermittent. Client may report relief after eating or taking an antacid.|
|Encourage the use of nonpharmacological pain relief measures:
|Nonpharmacological relaxation techniques will decrease the production of gastric acid, which in turn will reduce pain.|
|Instruct the client to avoid NSAIDs such as aspirin.||These medications may cause irritation of the gastric mucosa.|
|Instruct the client that meals should be eaten ar regularly paced intervals in a relaxed setting.||An irregular schedule of meals may interfere with the regular administration of medications.|
|Encourage the importance of smoking cessation.||Smoking decreases the secretion of bicarbonate from the pancreas into the duodenum, resulting in increased acidity of the duodenum.|
|Administer the prescribed drug therapy:
|Antacids buffer gastric acid and prevent the 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. H2 receptor antagonists block the secretion of gastric acid. Prostaglandin analogue reduces acid secretion and enhance the integrity of the gastric mucosa to resist injury. Proton pump inhibitors block the production and secretion of gastric acid and thereby reduce gastric pain. Sucralfate forms a barrier at the base of the ulcer crater to protect the healing ulcer from gastric acid.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans