Nursing Care Plan for Peptic Ulcers
Peptic ulcer is a condition in which the unbroken continuity of the gastric mucosa and extends below the epithelium. Mucosal damage does not extend all the way down
epithelial erosion, although often considered as well as ulcers. (eg ulcers due to stress).
Chronic peptic ulcer is different premises acute, because it has a scarring of the ulcer base. By definition, peptic ulcer can be found on any part of the gastrointestinal tract that is exposed to stomach acid sap, namely the esophagus, stomach, duodenum, and after gastroduodenal, too jejunum. Although the activity of peptic digestion by gastric an important aetiological factor, there is evidence that this is only one factor of many factors that play a role in the pathogenesis of peptic ulcer.
Ulcer symptoms can disappear for days, weeks, or months and can even disappear only to look back, often with no identifiable cause. Many individuals have symptoms of ulcer, and 20-30% had perforation or haemorrhage which precedes manifestation absence.
1. Pain: usually patients with ulcers complain of dull pain, like stabbing or burning sensation in the epigastric middle or at the back. It is believed that the pain occurs when the acidic contents of the stomach and duodenum increased erosion and stimulates nerve endings exposed. Another theory suggests that the lesion contact with acids stimulate the local reflex mechanism mamulai surrounding smooth muscle contraction.
The pain is usually relieved by eating, because eating neutralize acid or by using alkali, but when the stomach is empty or unused alkali back pain arises. Sharp local tenderness can be removed by gentle pressure on the epigastric or slightly to the right of the center line. Some symptoms decreased with the local pressure on the epigastrium.
2. Pyrosis (heartburn): some patients experience a burning sensation in the esophagus and stomach, which rose to mouth, sometimes accompanied eruktasi acid. Eructation or belching is common when the patient's stomach is empty.
3. Vomiting: although rarely in uncomplicated duodenal ulcer, vomiting can be a symptom of peptic ulcer. This is attributed to the formation of scar tissue or acute swelling of the inflamed mucous membrane surrounding the acute ulcer. Vomiting may occur or without preceded by nausea, severe pain are usually removed after the ejection of gastric acid content.
4. Constipation and bleeding: constipation may occur in patients with ulcers, possibly as a result of diet and medication. Patients may also come with a small portion of gastrointestinal bleeding due to ulcer patients who have previously experienced acute complaints, but they show symptoms afterwards.
Acute pain related to irritation of the mucosa and muscle spasm.
Goal: The client expresses pain diminished or disappeared.
1. Give drug therapy in accordance with the program:
2. Instruct to avoid drugs are sold freely especially those containing salicylates.
R /: Medicines containing salicylates may irritate the gastric mucosa.
3. Instruct the client to avoid foods / drinks that irritate the gastric mucosa: caffeine and alcohol.
R /: to stimulate the secretion of hydrochloric acid.
4. Encourage clients to use food and snacks at regular intervals.
R /: Schedule regular meals helps retain food particles in
which helps neutralize stomach acidity of gastric secretion.
5. Instruct the patient to stop smoking.
R /: Smoking can stimulate ulcer recurrence.