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NR 499 Week 6 Discussion: Diagnosis – Peptic Ulcer (GRADED A)
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NR 499 Week 6 Discussion: Diagnosis – Peptic Ulcer (GRADED A)
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Discussion #6Diagnosis: Peptic Ulcer
Physical
Signs and
Assessment
Pathophysiology Symptoms Pharmacologic
Findings
Summary Recommendations
(subjective)
(objective)
Peptic ulcer is an erosion
Diagnosis that occurs in the mucosa Patient Review prior When it comes to healing a
#1: lining as a single, small, complaining of: history to compare peptic ulcer, it can be
round cavity with smooth with current difficult because the ulcer
Peptic margins that penetrate the Epigastric findings. can not be isolated from the
Ulcer submucosa. (Hubert & burning irritants in the environment.
VanMeter, 2018). The most Epigastric Upon physical During treatment, it is
common peptic ulcer is pain especially assessment the important to instruct the
found in the upper portion when eating following was patient to reduce the
of the small intestines the spicy food observed: exacerbating factors like
duodenum referred as Pain alleviates weight loss due stress, coffee, alcohol,
duodenal peptic ulcer. It can with food to decreased NSAID’s, etc., to help the
also be found in the mucosal intake or appetite healing process. It is
lining of the antrum portion antacid weight gain due recommended to use a
of the stomach referred as Heartburn to hunger-like combination of drugs to help
gastric ulcer and the less Wakes up in sensation and/or target multiple areas of the
common is found in the the middle of increase food healing process.
lower part of the esophagus. the night due intake to alleviate
Under normal circumstances to burning pain The following medications
there is a physiologic stomach pain iron-deficiency are recommended:
balance in the Nausea/ anemia (results
gastrointestinal mucosa vomiting from blood work) Over the counter medication
between the gastric acid especially with occult blood in to alleviate the pain: (avoid
secretions and particular food stool (results or minimize using NSAID’s
gastroduodenal mucosal Constant from stool test) and aspirin)
defenses. When this balance hunger-like 1) Acetaminophen:
is affected then it makes it a sensation Diagnostic testing analgesic/ antipyretic
perfect environment to Bloating CBC with (Tylenol)
develop a peptic ulcer. Burping differential Mechanism of action:
When the ulcer is formed it Decreased indicator for “primarily inhibit the
exposes the underlying appetite anemia cyclooxygenase (COX)
tissue to digestive acid and enzyme, decreasing the
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, pepsin. The size of the ulcer occasional BMP synthesis of prostaglandins,
varies, it does not have a dizziness Stool: fecal and modulating pain and
specific size range. occult blood test temperature”. (Candidio,
There are different factors Stool culture: Perozo & Knezevic, 2017)
that contribute to a indicator for
development of a peptic Helicobacter 2) Drug Classification:
ulcers: Antacid
pylori gram
Helicobacter pylori (H. (aluminum carbonate,
negative bacteria
Pyloric) infection aluminum hydroxide,
promotes development of Upper calcium carbonate,
peptic ulcer by activating gastrointestinal magaldrate, magnesium
inflammatory response, endoscopy: carbonate, hydroxide,
increasing gastric acid -examines oxide, sodium carbonate)
secretion and weakening mucosal lining of Mechanism of action:
the mucosal defense the stomach works locally in the stomach
system. (Schub & Smith, -help diagnose to dissolve stomach acid
2019???) ulcers, neutralize gastric acid,
Chronic use of ulcerogenic hemorrhage, reducing the total acid in the
substances which will perforation or GI tract and allowing ulcers
breakdown the mucous to heal
obstruction
layer like aspirin, Side effects:
-may be used to
nonsteroidal anti- aluminum: constipation,
inflammatory drugs obtain biopsy of fecal impaction,
(NSAID) or alcohol gastric mucosal hemorrhoids, rectal fissures
Inadequate blood supply tissue from hard stools,
due to vasoconstriction -may be used to hyperaluminemia and
caused by stress, smoking, help stop possible osteomalacia,
shock, circulatory hemorrhage dementia in patients in renal
impairment on elderly Upper failure, hypophosphatemia
people, scar tissue or gastrointestinal (anorexia, malaise, muscle
severe anemia. This would series, X-rays, weakness)
interfere with regeneration Abdominal CT magnesium: diarrhea,
of epithelium cells, scan or MRI scan electrolyte abnormalities,
production of sufficient hypermagnesemia
to help diagnose
mucus, reduces secretion (hypotension, nausea,
obstruction or
of alkaline bicarbonate vomiting, ECG changes,
ions in productive mucus perforation respiratory or mental
and reduce secretion of depression, coma) in patients
protective prostaglandin. with renal failure
(Hubert & VanMeter, calcium: acid rebound, milk-
2018) alkali syndrome
Excessive glucocorticoid (hypercalcemia, metabolic
secretion and medications alkalosis, renal impairment)
Atrophy of gastric mucosa
(chronic gastritis) 3) Drug Classification:
Increased stimulation of Proton pump inhibitors
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