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21 Cards in this Set
- Front
- Back
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PUD
acute v chronic |
Acute:
-superficial -minimal erosion chronic: -muscular wall eroded, fibrous tissue formed -present continuously |
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Gastric ulcers - causes
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-drugs: asprin, NSAIDs, corticosteroids
-stress -cigs, chronic alcohol use |
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duodenal ulcers
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any age, anyone
more often 35-45 y/o |
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Physiologic stress ulcers
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r/t transient ischemia from:
-HTN -severe injury -burns -surgery |
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PUD manifestation
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-N/V
-pyrosis (heartburn) **rule out cardiac problem -intermittent, dull, gnawing, burning pain (usu to BACK) -food sometimes relieves pain -black/tarry stool |
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PUD
3 complications |
hemorrhage
perforation gastric outlet obstruction |
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PUD diagnosis
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-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 |
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PUD - hemorrhage
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**most common**
watch vitals, redness of aspirate (blood in gastric) |
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PUD - perforation
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**most dangerous**
-boardlike abdomen, acute pain -usu duodenal ulcers -restore blood vol (LR, RBCs), stop spillage -NG tube **antibiotic therapy... allergies? |
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PUD - gastric outlet obstruction
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hypertrophy of stomach wall r/t increased needed force
-vomiting, constipation, swelling -decompress stomach, NG tube, electrolytes |
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PUD diet
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sm freq meals
nothing spicy, no caffiene/alcohol less roughage |
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PUD meds
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antacids, H2R blocker, PPIs (prilosec), antibiotics, anticholinergics, cytoprotective therapy
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Maalox
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-often prophylactic in hospitals
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flagyl/amoxicillin
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antibiotics for h pylori
***dont take w/ alcohol*** |
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Pepto
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stools may be black/tarry w/ use
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PUD surgery: complications post op
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<20% pts need it surgery
dumping syndrome postprandial hypoglycemia bile reflux gastritis |
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dumping syndrome
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-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 |
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dumping syndrome s/s
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weakness, diaphoresis, inc HR, syncope, distention/fullness, cramping, nausea
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dumping syndrome teaching
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-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 |
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postprandial hypoglycemia
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r/t dumping syndrome
lots of insulin released @ once |
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PUD - gerontological considerations
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increased rate of dumping syndrome
NSAIDS used more be sure to check sugars |
