Flashcards in Peptic Ulcers FE Deck (16):
What are peptic ulcers?
Excavation that forms into mucosal wall of stomach or duodenum as a result of imbalanced protective/aggressive mechanisms. (i.e pepsin, acids, H. pylori and less mucus, bicarbonate, gastric mucosal blood flow.)
What are five types of peptic ulcers?
1. Erosion of mucosal layer.
2. Acute (erosion into submucosa/musclaris)
3. Chronic (deep into muscularis)
4. Scarring (caused by repeated episodes)
Could be located in stomach or duodenum (80% near pyloric sphincter in duodenum)
What are four Diagnostic tests for Peptic Ulcers?
1. Upper GI endoscopy with biopsy
2. Barium test
3. Labs (like H+H)
4. H. Pylori tests
What are four risk factors for peptic ulcers?
1. NSAIDS and H. pylori together = high risk
3. H. Pylori
8. Genetic predisposition
What are some clinical manifestations (s/sx) of peptic ulcers?
1. Pain: burning/gnawing
2. Pain in stomach shortly after meals
3. Pain in duodenum 2-3 hours after eating; nocturnal pain
4. Dyspepsia (indigestion/discomfort)
6. Melena (dark, tarry stool when blood is coming from upper GI)
What is the plan of care for Ulcers?
3. NG tube for bowel rest
4. Pt education
5. Possible blood transfusion
What are some things we can educate its on about Peptic Ulcers?
1. ID cause and eliminate
2. Avoid foods that irritate (caffeine)
5. Stress, etc
(Ask nutrition/dietary consult--they can teach these.)
What are three complications for Peptic Ulcers?
1. Hemorrhage (n, v, hematemesis, coffee ground emesis, pale, low BP, melena)
2. Perforation (severe unrelenting sudden onset pain. Rigid, hard, boardlike abdomen. Fever, tachypnea, tachycardia.)
3. Gastric outlet obstruction
What is a gastric outlet obstruction?
An ulcer, gastritis, edema or tumor (a blockage) near pyloric sphincter that can occlude exit of stomach.
What are some ways to stop bleeding for hemorrhage?
Surgical consult or upper endoscopy exam; cauterization
What can Antacids do for Peptic Ulcers?
Neutralize stomach acid
What can Sucralfate do for Ulcers?
Viscous substance augments stomach's protective lining
What can H2 receptor blockers do for ulcers?
(Ranitidine) blocks histamine receptors on the cells of the stomach lining, decreasing stomach acid production.
What can PPI do for ulcers?
(Pantoprazole) decreases stomach acid production by inhibiting active enzymes (a building block for H+ ions) in some parietal cells.
What can Prokinetic agents do for ulcers?
(Metoclopramide) increase gastric emptying