Medical-surgical Nursing Demystified

(^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