Medical-surgical Nursing Demystified

(Sean Pound) #1

(^320) Medical-Surgical Nursing Demystified
HALLMARK SIGNS AND SYMPTOMS



  • Epigastric area pain:

    • Worse just after eating as acid increases with gastric ulcer

    • Worse when stomach is empty (with duodenal ulcer); may awaken during
      the night due to pain

    • Weight changes

      • Loss with gastric ulcer

      • Gain with duodenal ulcer





  • Bleeding from ulcer causes:

    • Hematemesis (vomiting bloody fluid—red, maroon); more likely with gas-
      triculcer

    • Coffee-ground emesis (partially digested blood)

    • Melena (tarry stool) more likely with duodenal ulcer



  • Perforation of ulcer causes:

    • Sudden, sharp pain

    • Tender, rigid, board-like abdomen

    • Knee-chest position reduces pain

    • Hypovolemic shock




INTERPRETING TEST RESULTS



  • Anemia due to bleeding.

  • Stool for occult blood positive due to bleeding.

  • H. pyloritesting positive.

  • Upper GI or barium swallow shows areas of ulceration—not done if perfo-
    ration suspected.

  • Upper endoscopy shows ulcer.

  • Abdominal x-rays show free air in perforation.


TREATMENT



  • Administer antacids

Free download pdf