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What are causes of Peptic Ulcer Disease (PUD)?
H. Pylori, NSAIDs, stress, alcohol, smoking
Symptoms of a gastric ulcer are what?
Pain 30-60 mins AFTER eating
Eating worsens the pain
N/V
Weight loss
Symptoms of a duodenal ulcer are what?
Pain 1.5-3 hours AFTER meals
Eating relieves the pain
Night-time pain
Melena
Major complications of Ulcers?
Black stools
Vomiting blood
Severe pain
Rigid abdomen (if perforated)
Distension/vomiting (if obstructed)
As a nurse, how do we help the patient with an ulcer?
NPO during active complications
What two medications are given during an active ulcer
flare up?
Proton Pump Inhibitors (PPIs) & H2 blockers
,How do we know when our patient has a bowel
obstruction?
Severe cramping, abdominal distension, vomiting
Absent/high pitched bowel sounds
No flatulence or stool is able to pass
What is considered a mechanical obstruction?
Adhesions & Hernias
What is considered a non-mechanical obstruction?
Ileus, patient recovering from surgery
What are liver disease complications?
Ascites, esophageal varices (GI bleeding), hepatic
encephalopathy and coagulopathy
What labs will be increased in a patient with liver
complications?
AST, ALT, Bilirubin, ammonia, PT, INR
As a nurse, how do we care for our patient with liver
complications?
measure daily abdominal girth
Have patient on bleeding precautions
What medication would we give a patient with ascites,
and what would we avoid?
Give lactulose
Avoid sedatives
What is a normal INR lab value?
0.8-1.2
What should a patients INR be if they are taking
warfarin?
2.0-3.0
What electrolyte needs to be carefully monitored if a
patient is taking a Proton Pump Inhibitor because it
will decrease?
,Calcium
Emergency complications in a patient with peptic
ulcers?
Emesis that looks like coffee grounds
Sharp, sudden abdominal pain (probably perforation)
Tachy & Hypotensive = SHOCK
Symptoms of systemic shock?
Tachycardia and hypotension
What electrolyte imbalance needs to be monitored if a
patient has a bowel obstruction?
Vitamin K
Priority nursing intervention for a patient with a
suspected bowel obstruction?
DO NOT GIVE OPIOIDS BEFORE CONFIRMING CAUSE
This may worsen an ileus
One example of when you would observe Kussmaul
breathing?
Diabetic Ketoacidosis (DKA)
What diet change needs to be implemented on a
patient who has live disease or high ammonia levels?
Decrease of protein
What is one example of a medication that can
decrease portal hypertension in a patient with
esophageal varices?
Propanolol
What always gets addressed first?
ACTUAL PROBLEMS vs Potential
Unstable patient is what?
High priority
*PT PAP HOT*
, ▪ Pituitary
▪ Thyroid
▪ Pancreas
▪ Adrenals
▪ Parathyroid
▪ Hypothalamus
▪ Ovaries
▪ Testes - 100 correct answer as-What are the
glands of the endocrine system? (SATA Q?)
Grave's disease - 100 correct answer as-an
autoimmune disorder that is caused by hyperthyroidism
and is characterized by *goiter and/or exophthalmos*
*Treatments*
▪ Rx: methimazole, atenolol, and *iodine-131*
▪ radiation therapy
*Nursing Interventions*
▪ provide a calm environment
▪ keep patients room cool
▪ assess pain
▪ prepare patient for surgery
▪ post-operative care
▪ maintain a patent airway
-------- same as hypothyroidism ---------
▪ provide periods of rest