Thank you Marianne! The most common complication of peptic ulcer disease that occurs in 10% to 20% of patients is: A. Hemorrhage. Individual cultural or religious restrictions and personal preferences. F A Davis Company. Elsevier, Inc. Absence of complications. Ileus is self-limiting and is usually resolved within 1 to 3 days. Restrict intake of caffeine, milk, and dairy products. Thanks for the questions I have learned something. For more information, check out our privacy policy. However, common signs and symptoms include severe abdominal pain, bloating, nausea and vomiting, fever, chills, and a rapid heartbeat. 11th Edition, Mariann M. Harding, RN, Ph.D., FAADN, CNE. Submit the clients stool for culture.A culture is a test to detect which causative organisms causean infection. NURSING | Free NURSING.com Courses She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. 2. Nursing diagnoses handbook: An evidence-based guide to planning care. 2. D. 60 and 80 years. To minimize the occurrence of signs and symptoms of GERD and avoid exacerbation of the condition. In: StatPearls [Internet]. Peritonitis, inflammation of the inner abdominal wall lining. Nursing interventions for the patient may include: If perforation and penetration are concerns: The patient should be taught self-care before discharge. B. Knowledge about the management and prevention of ulcer recurrence. 3. 2. Peritonitis is the inflammation of the peritoneal cavity. (2020). Hinkle, J. L., & Cheever, K. H. (2018). We may earn a small commission from your purchase. These are warning signs of septic shock. 3. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. This exposes the structures within the peritoneal cavity to gastrointestinal contents. Patient will be free from any signs of infection or further complications. Assist the healthcare provider in treating underlying issues.Collaboration with the healthcare provider is necessary to determine the root cause of decreased fluid volume and bleeding. It is important to provide proper patient education about the condition, prognosis, treatment options, and complications to ensure adherence with the treatment regimen. Encourage the client to eat foods rich in potassium.When a client experience diarrhea, the stomach contents which are high in potassium get flushed out of the gastrointestinal tract into the stool and out of the body,resulting in hypokalemia. Assess for abdominal pain, abdominal cramping, hyperactive bowel sounds, frequency, urgency, and loose stools.These assessment findings are commonly connected with diarrhea. Acute Peritonitis Nursing Care Plan & Management - RNpedia This results in loose, watery stools that can lead to dehydration if not treated promptly. Administer prescribed medications.Give prescribed prophylactic medications, such as antiemetics, anticholinergics, proton pump inhibitors, antihistamines, and antibiotics. 1.The client diagnosed with a gastric ulcer, pain usually occurs 30 to 60 minutes after eating, but not at night. This lessens abdominal tension and/or diaphragmatic irritation, which in turn lessens pain by facilitating fluid or wound drainage by gravity. When the patient develops cyanotic, cold, and clammy skin, this can indicate septic shock from peritoneal infection. Teach the patient how to change the dressing aseptically and wound care. Likewise, the continuous release of fluids may cause dehydration. Symptoms of this disease include fever, anorexia, nausea, vomiting, diarrhea, and abdominal discomfort. The nurse can monitor the vital signs of the patient, especially alterations in the blood pressure and pulse rate which may indicate the presence of bleeding. 1. St. Louis, MO: Elsevier. Continuously monitor ECG fir dysrhythmias resulting from electrolyte disturbances. 5 Peptic Ulcer Disease Nursing Care Plans, Peptic ulcer disease occurs with the greatest frequency in people between. Evaluate the patients vital signs and take note of any patterns that indicate sepsis (increased heart rate, progressing decreased blood pressure, fever, tachypnea, reduced pulse pressure). Peptic ulcers are more likely to occur in the duodenum. Nursing Care Plan for Bowel Perforation 1 Risk for Infection Nursing Diagnosis: Risk for Infection related to inadequate primary defenses invasive procedures, and immunosuppression secondary to bowel perforation Desired Outcomes : The patient will achieve timely healing and be free of fever and purulent drainage or erythema It is easy for edematous tissue with poor circulation to break down. The leaked bowel contents may also cause abscess formation leading to an excruciating infection called peritonitis. The patient will identify the relationship of signs/symptoms to the disease process and associate these symptoms with causative factors. Assess laboratory values.Alterations in laboratory values like white blood count can indicate infection. Assess the clients pain characteristics.The assessment of pain includes the location, characteristics, severity, palliative, and precipitating factors of the pain. As directed, administer total parenteral nutrition (TPN) or tube feeds. Assess and monitor the patients NG tube output. 1. The nurse is conducting a community education program on peptic ulcer disease prevention. Recommend resuming regular activities gradually as tolerated, allowing for enough rest. Common causes of this disorder are recent abdominal surgeries and/or drugs that interfere with intestinal motility. From: Gastrointestinal Perforation. McGraw Hill Education. St. Louis, MO: Elsevier. Patients presenting with abdominal pain and . Patient will be able to demonstrate efficient fluid volume as evidenced by stable hemoglobin and hematocrit. Buy on Amazon, Gulanick, M., & Myers, J. L. (2022). Note and report symptoms of penetration (back and epigastric pain not relieved by medications that wereeffective in the past). The nurse can assess by asking the patient to rate their pain with the use of pain assessment tools applicable to the patient and determine whether the pain is constant, aching, stabbing, or burning. Gastrointestinal Care Plans Care plans covering the disorders of the gastrointestinal and digestive system. Surgery may be necessary if bleeding is severe and tests cant visualize the source. Desired Outcome: The patient will pass formed stool no more than thrice per day. 1. Complications of bowel perforation may include: Diagnostic tests for bowel perforation should usually include: Treatment for bowel perforation should usually include the following: Nursing Diagnosis: Risk for Infection related to inadequate primary defenses invasive procedures, and immunosuppression secondary to bowel perforation. Monitoring the clearance of the infection and the return to regular activities is essential. Irregular mealtimes may cause constipation. Thirty minutes later, the JP [Jackson 1. The management of the patient with a peptic ulcer is as follows:. Maintenance of nutritional requirements. Due to the regurgitation of food, a common complication is aspiration pneumonia. The PEG site was leaking gastric contents. Use the appropriate solution to clean these sites. To neutralize stomach acids and relieve pain.To help hasten gastric emptying time and reduce the occurrence of nausea and vomiting. This means that while pain may come on suddenly or gradually, its severity typically increases. List of Sample Nursing Diagnosis for Gastrointestinal (GI) Disorders (3 Based on the assessment data, the patients nursing diagnoses may include the following: Main Article: 5 Peptic Ulcer Disease Nursing Care Plans. Patient will verbalize understanding of the condition and its complications and alert the nurse or provider to signs of infection such as fever or wound drainage. Reduced renal perfusion, circulating toxins, and the effects of antibiotics all contribute to the development of oliguria. Includes: appendectomy, gastroenteritis, inflammatory bowel disease, live cirrhosis, and more. Nursing Diagnosis: Acute Pain related to tissue trauma, chemical irritation of the parietal peritoneum, and abdominal distension secondary to bowel perforation as evidenced by muscle guarding, rebound tenderness, verbalization of pain, distraction behavior, facial mask of pain, and autonomic or emotional responses (anxiety). Invasive procedure or surgical intervention, Leakage of bowel contents into the peritoneum. Patient will be able to verbalize relief or control of pain. It is either caused by bacteria or chemicals, can either be primary or secondary, and acute or chronic. Kathleen Salvador is a registered nurse and a nurse educator holding a Masters degree. 2023 Nurseslabs | Ut in Omnibus Glorificetur Deus! This leads to various occurrences that cause discomfort and pain to the patient. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. She has worked in Medical-Surgical, Telemetry, ICU and the ER. As tolerated, advance the patients diet. 3. 3. To help in the excretion of toxins and to improve renal function, diuretics may be taken. consistent with gastric perforation. Assess dietary habits, intake, and activity level. Patients with achalasia are advised to eat slowly and to drink fluids with meals. Ileus is the term for the absence of peristaltic activity in the lower gastrointestinal tract. 3rd Edition. She has worked in Medical-Surgical, Telemetry, ICU and the ER. B. Clostridium difficile She received her RN license in 1997. Major Nursing Issues and Interventions . Buy on Amazon. 2. The nurse anticipates that the assessment will reveal which finding? Meals should be regularly spaced in a relaxed environment. Administer antiemetics or antipyretics as indicated. Additionally, patients may also experience signs of sepsis, such as confusion, dizziness, and low blood pressure. Auscultate the bowels for irregular, absent, or hyperactive bowel sounds. Learning style, identified needs, presence of learning blocks. 3. 3. Encourage the patient to use abdominal splints.Splinting the abdomen can help reduce abdominal pressure before and after surgery when moving. What are the common causes of bowel perforation? Learn more about the nursing care management of patients with peptic ulcer disease in this study guide. Administer medications for pain control.Providing analgesics once the diagnosis has been established can help reduce metabolic rate, minimize peritoneal irritation, and promote comfort in patients with bowel perforation. Explain that smoking may interfere with ulcer healing;refer patient to programs to assist with smokingcessation. Food is commonly regurgitated as it does not pass to the stomach, leading to chest pain, heartburn, nausea, and vomiting. [Updated 2022 Aug 14]. Surgery for intestinal perforation is contraindicated in the presence of general contraindications to anesthesia and major surgery, such as severe heart failure, respiratory failure, or. 2. Gastrointestinal Care Plans, Nursing Care Plans 7 Gastroesophageal Reflux Disease (GERD) Nursing Care Plans Peptic Ulcer Disease Nursing Diagnosis - NurseStudy.Net The reported rates of complications following percutaneous endoscopic gastrostomy (PEG) tube placement vary from 16 to 70 percent [ 1-5 ]. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Gastric Perforation - StatPearls - NCBI Bookshelf Intestinal Perforation Treatment & Management - Medscape Nursing Diagnosis & Care Plan Acute Pain r/t Chemical burn of Gastric Mucosa Nursing Interventions - Record reports of pain including severity, location and duration. Our website services and content are for informational purposes only. To make up for blood and fluid loss and to keep GI circulation and cellular function intact, IV fluids, blood products, and electrolytes are often required. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. Hemoglobin is the oxygen-carrying component of blood while hematocrit reflects blood volume. Recommended nursing diagnosis and nursing care plan books and resources. The ligament of Treitz sometimes referred to as the suspensory ligament of the duodenum, is the anatomical marker that delineates the upper and lower bleeding.