5 Peptic Ulcer Disease Nursing Care Plans


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

Risk For Deficient Fluid Volume

Nursing Diagnosis

May be related to

  • Gastrointestinal (GI) bleeding
  • Nausea, vomiting

Possibly evidenced by

  • [not applicable]

Desired Outcomes

  • Client will be normovolemic as evidenced by systolic BP greater than or equal to 90 mm Hg (or client’s baseline), absence of orthostasis, HR 60 to 100 beats/minute, urine output greater than 30 ml/hr, and normal skin turgor.
Nursing Interventions Rationale
Assess for the signs of hematemesis or melena. The client with a bleeding ulcer may vomit bright red blood or coffee grounds emesis. Melena occurs when there is bleeding in the upper GI tract.
Monitor the client’s fluid intake and urine output. The kidney will reabsorb water into circulation to support a decrease in blood volume. This compensatory mechanism results in decreased urine output. A decrease in circulatory blood volume leads to decreased renal perfusion and decreased urine output
Monitor the client’s vital signs, and observes BP and HR for signs of orthostatic changes. The erosion of an ulcer through the gastric or duodenal mucosal layer may cause GI bleeding. The client may develop anemia. If bleeding is brisk, changes in vital signs and physical symptoms of hypovolemia may develop rapidly. A decrease in BP and an increase in HR with changes in position is an early indicator of decreased circulatory volume.
Instruct the client to immediately report symptoms of nausea, vomiting, dizziness, shortness of breath, or dark tarry stools. These assessment findings are signs of GI bleeding and should be reported immediately.
Monitor hemoglobin and hematocrit levels. Erosion of the gastric mucosa by an ulcer results in GI bleeding. A decrease in hemoglobin and hematocrit occurs with bleeding.
Administer IV fluids, volume expanders, and blood products as ordered. Isotonic fluids, volume expanders, and blood products can restore or expand intravascular volume.


See Also

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Gastrointestinal Care Plans

Care plans covering the disorders of the gastrointestinal and digestive system:

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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