5 Peptic Ulcer Disease Nursing Care Plans

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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

Here are five (5) nursing care plans (NCP) and nursing diagnosis for patients with peptic ulcer disease:

  1. Acute Pain
  2. Imbalanced Nutrition: Less Than Body Requirements
  3. Anxiety
  4. Deficient Knowledge
  5. Risk For Deficient Fluid Volume
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Imbalanced Nutrition: Less Than Body Requirements

Nursing Diagnosis

May be related to

Possibly evidenced by

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  • Inadequate dietary intake
  • Malabsorption of irons, minerals, and vitamins
  • Weight loss

Desired Outcomes

  • Client will verbalize and demonstrate selection of foods or meals that will achieve a cessation of weight loss.
  • Client will weigh within 10% of ideal body weight.
Nursing Interventions Rationale
Obtain a nutritional history. Clients may often overestimate the amount of food eaten. The client may not eat sufficient calories or essential nutrients as a way to reduce pain episodes with peptic ulcer disease. Because of this, clients are at high risk for malnutrition.
Assess for body weight changes. Weight loss is an indication of inadequate nutritional intake. Gastric ulcers are more likely to be associated with vomiting, loss of appetite and weight loss than duodenal ulcers.
Assist the client with identifying foods hat cause gastric irritation. Clients need to learn what foods they can tolerate without gastric pain. Soft, bland, non acidic foods cause less gastric irritation. The client is more likely to increase food intake if the foods are not associated with pain. Foods that may contribute to mucosal irritation include spicy foods, pepper, aNd raw fruits and vegetables.
Monitor laboratory values for serum albumin. This test indicates the degree of protein depletion (2.5 g/dL indicates severe depletion; 3.8 to 4.5 g/dL is normal).
Instruct in the importance of abstaining from excessive alcohol. Alcohol causes gastric irritation and increases gastric pain.
Encourage the client to limit the intake of caffeinated beverages such as tea and coffee. Caffeine stimulates the secretion of gastric acid. Coffee, even if decaffeinated, contains a peptide that stimulates the release of gastrin and increases acid production.
Teach about the importance of eating a balanced diet with meals at regular intervals. Specific dietary restrictions are no longer part of the treatment for PUD. During the symptomatic phase of an ulcer the client may find benefit from eating small meals at more frequent intervals.
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See Also

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Gastrointestinal Care Plans

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Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.

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