d. Nursing implications.
(1)
Stop all P.O. intakes until symptoms subside.
(2) Assess the patient's symptoms and administer the prescribed
symptomatic relief medications such as antacids and antiemetics.
(3) Monitor intake and output closely. Excessive vomiting or diarrhea may
result in severe electrolyte depletion that will require replacement therapy.
(4)
Administer and monitor IV therapy when ordered to replace lost fluids.
(5)
Weigh daily to monitor weight loss.
(6)
Encourage the prescribed diet to maintain nutrition.
1-50. GASTROINTESTINAL ULCERS
a. A gastrointestinal ulcer is a break in the continuity of the mucous lining.
Ulcers may occur in any part of the GI tract that comes in contact with the gastric juices.
Ulcers commonly occur in the lower esophagus, the stomach, and the duodenum.
b. In addition to mucosal deterioration by hydrochloric acid and pepsin secretion,
other factors may be implicated in the development of ulcers.
(1)
Emotional stress.
(2)
Prolonged physical stress associated with trauma, surgery, burns, and
so forth.
(3)
Hereditary factors.
(4) Certain drugs and medications. For example: alcohol, caffeine, aspirin,
corticosteroids, and chemotherapeutic agents.
c. The primary symptom of ulcers is pain. It is described as a burning,
cramping, aching, or gnawing pain in the stomach area between the xiphoid process
and the umbilicus. The severity of the pain is generally an indication of the extent of the
ulceration. Likewise, ulcer pain is normally localized, the patient being able to indicate
the area of the pain by pointing one finger. Radiating pain indicates a severe or
perforated (ruptured) ulcer.
d. Nursing implications are usually twofold. The focus of treatment and nursing
care for the patient with ulcers is twofold. The first objective is to promote gastric rest.
The second objective is prevention of further ulceration. Both of these objectives may
be accomplished by utilizing the following measures:
MD0918
1-49
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