Peptic Ulcer Disease: Nursing Interventions and Medications

Introduction

• Presenter: SAR from Register Nurse RN.com
• Focus: Nursing interventions and medications for Peptic Ulcer Disease (PUD)
• Part 1: Covers pathophysiology, complications, and signs/symptoms
• Quiz: Available online to test knowledge on PUD

Nursing Interventions

Assessing the Patient

• Vital Signs: Ensure they are within normal range
• Bowel System:
  • Monitor bowel sounds: Hyperactive, hypoactive, absent
  • Palpate abdomen for tenderness
  • Inspect for masses or lumps
  • Assess pain location and intensity
• Stool and Vomit:
  • Inspect for bright blood or coffee ground appearance (indicates GI bleed)
• Patient Questions:
  • Onset and timing of pain: Gastric ulcers worsen with food; duodenal ulcers improve
  • Night pain: Indicator of duodenal ulcers
  • Medication use history: NSAIDs, corticosteroids, anticoagulants
  • Family history of ulcers or H. pylori
  • Lifestyle habits: Alcohol, smoking, caffeine

Monitoring Complications

• GI Bleeding:
  • Signs: Increased heart rate, low blood pressure, weakness, low H&H, pallor, bloating, mass
  • Stool: Dark, tarry or coffee ground emesis
• Perforation and Peritonitis:
  • Severe abdominal pain, bloating, vomiting, increased heart rate, fever
• Pyloric Obstruction:
  • Vomiting, abdominal pain, bloating
• Dumping Syndrome:
  • Early Dumping: 15-30 mins post-eating; symptoms include bloating, diarrhea, hypotension
  • Late Dumping: 3 hours post-eating; hypoglycemia symptoms

Patient Education

Diet for Dumping Syndrome

• Eat small, frequent meals: Avoid large meals
• Lie down post-meal: Helps slow emptying
• Fluid Intake: Separate from meals
• Avoid Sugary Foods/Drinks: Prevent hypertonic fluid
• Avoid Hot/Cold Foods
• Diet Composition: High protein, high fiber, low carbs

Diet for Ulcers

• Avoid: Spicy, acidic foods, caffeine, chocolate, alcohol, fried foods
• Consume: Low fiber, bland foods (e.g., white rice, bananas)

Medications for Peptic Ulcer Disease

Categories of Drugs

• Mnemonic: Ant acid medications help basic peptic elements

Antacids

• Examples: Magnesium hydroxide, calcium carbonate
• Function: Neutralize stomach acid
• Administration: Alone, 1-2 hours before other meds

Mucosal Healing Drugs

• Example: Sucralfate (Carafate)
• Function: Lines stomach, protects ulcer
• Administration: On empty stomach, 1-2 hours before meals

H2 Receptor Blockers

• Examples: Ranitidine (Zantac), Famotidine (Pepcid)
• Note: Names often end in "tidine"

Bismuth Subsalicylate

• Example: Pepto-Bismol
• Use: In H. pylori infection treatment

Proton Pump Inhibitors (PPIs)

• Examples: Omeprazole (Prilosec), Pantoprazole (Protonix)
• Note: Names often end in "prazole"

Antibiotics

• Use: To treat H. pylori
• Examples: Clarithromycin, Metronidazole, Tetracycline, Amoxicillin

Conclusion

• Video Series: Part 1 is crucial for understanding the full scope of PUD
• Next Steps: Take the free quiz, subscribe for more content