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