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21 Cards in this Set

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PUD
acute v chronic
Acute:
-superficial
-minimal erosion
chronic:
-muscular wall eroded, fibrous tissue formed
-present continuously
Gastric ulcers - causes
-drugs: asprin, NSAIDs, corticosteroids
-stress
-cigs, chronic alcohol use
duodenal ulcers
any age, anyone
more often 35-45 y/o
Physiologic stress ulcers
r/t transient ischemia from:
-HTN
-severe injury
-burns
-surgery
PUD manifestation
-N/V
-pyrosis (heartburn) **rule out cardiac problem
-intermittent, dull, gnawing, burning pain (usu to BACK)
-food sometimes relieves pain
-black/tarry stool
PUD
3 complications
hemorrhage
perforation
gastric outlet obstruction
PUD diagnosis
-stool: do occult blood. iron can skew heme test
-endoscopy **check gag reflex after**. may do bx to (cancer)... degree of healing seen
-blood tests
-breath test
-barium contrast: push fluids after
PUD - hemorrhage
**most common**
watch vitals, redness of aspirate (blood in gastric)
PUD - perforation
**most dangerous**
-boardlike abdomen, acute pain
-usu duodenal ulcers
-restore blood vol (LR, RBCs), stop spillage
-NG tube
**antibiotic therapy... allergies?
PUD - gastric outlet obstruction
hypertrophy of stomach wall r/t increased needed force
-vomiting, constipation, swelling
-decompress stomach, NG tube, electrolytes
PUD diet
sm freq meals
nothing spicy, no caffiene/alcohol
less roughage
PUD meds
antacids, H2R blocker, PPIs (prilosec), antibiotics, anticholinergics, cytoprotective therapy
Maalox
-often prophylactic in hospitals
flagyl/amoxicillin
antibiotics for h pylori
***dont take w/ alcohol***
Pepto
stools may be black/tarry w/ use
PUD surgery: complications post op
<20% pts need it surgery
dumping syndrome
postprandial hypoglycemia
bile reflux gastritis
dumping syndrome
-r/t surgical removal of part of stomach & pyloric sphincter
-decreased stomach capacity... rapid emptying of stomach into sm intestine
-meals are hyperosmolar
1/3-1/2 of pts get it
w/ tx it can be stopped
dumping syndrome s/s
weakness, diaphoresis, inc HR, syncope, distention/fullness, cramping, nausea
dumping syndrome teaching
-drink fluids between (not with) meals & avoid 1 hr before and 2 hr after meal
-dont have big meals
-dont lie down after eating
-low carb, high protein, avoid sweets... take blood sugars
postprandial hypoglycemia
r/t dumping syndrome
lots of insulin released @ once
PUD - gerontological considerations
increased rate of dumping syndrome
NSAIDS used more
be sure to check sugars