Evidence Based Nursing Care Plan For Gastric & Peptic Ulcers

Nursing
Care Plan
for Peptic
Ulcer Dis-
What is Peptic Ulcer?
A peptic ulcer is ulceration in the mu-
cosal wall of the lower esophagus,
stomach, pylorus, or duodenum. The
ulcer may be referred to as duodenal,
gastric, or esophageal, depending on
its location. The most common symp-
tom of both gastric and duodenal ul-
cers is epigastric pain. It is character-
ized by a burning sensation and usually
Pathophysiology
Predisposing factors of peptic ulcer
include infection with the gram-negative bac-
teria Helicobacter pylori which may be ac-
quired through the ingestion of food and wa-
ter, excessive HCL secretion in the stomach,
chronic use of non-steroidal anti-inflamma-
tory drugs (NSAIDs) which weakens the lining
of the GI tract by reducing the protective
function of the mucosal layer, increased
stress associated with illness and surgery,
alcohol ingestion and excessive cigarette
Nursing Care Plans and Man-
agement
Nursing Assessment
Assess for the following subjective
and objective data:
 Early satiety
 Nausea and vomiting
 Pain relieved by food or antacid
 Weight loss
Nursing Diagnosis
Following a thorough assessment, a nursing diagno-
sis is formulated to specifically address the chal-
lenges associated with peptic ulcer disease based on
the nurse’s clinical judgement and understanding of
the patient’s unique health condition. While nursing
diagnoses serve as a framework for organizing care,
their usefulness may vary in different clinical situa-
tions. In real-life clinical settings, it is important to
note that the use of specific nursing diagnostic la-
bels may not be as prominent or commonly utilized
as other components of the care plan. It is ultimately
the nurse’s clinical expertise and judgment that
shape the care plan to meet the unique needs of
each patient, prioritizing their health concerns and
Nursing Goals
Goals and expected outcomes may
include
 The patient will report
satisfactory pain control at a level of less
than 2 to 4 on a scale of 0 to 10.
 The patient uses pharmacological and
nonpharmacological pain relief measures.
 The patient will exhibit
increased comfort such as baseline levels
for HR, BP, and respirations, and
relaxed muscle tone for body posture.
 The patient will be normovolemic as evi-
denced by systolic BP greater than or
equal to 90 mm Hg (or patients baseline),
Nursing Interventions and Actions
Therapeutic interventions and nursing actions
for patients with peptic ulcer disease may in-
clude:
1. Providing Pain Relief and Comfort
 Encourage the use of nonpharmacological pain re-
lief measures such as acupressure, biofeedback, dis-
traction, guided imagery, massage, and music ther-
apy
 Instruct the paient to avoid NSAIDs such as aspirin.
 Instruct the patient that meals should be eaten at
regularly paced intervals in a relaxed setting.
 Encourage the importance of smoking cessation.
Pharmacological Therapy
Administer the prescribed drug
therapy:
 Antacids
 Antibiotics such
as amoxicillin, clarithromycin, metronidaz
ole, tetracycline
 Histamine receptor antagonists
 Proton pump inhibitor
 Proton pump inhibitors block the produc-
tion and secretion of gastric acid
 Sucralfate
 Sucralfate forms a barrier at the base of
2. Improving Nutritional and Fluid Balance
 Obtain a nutritional history..
 Assess for body weight changes.
 Assist the client with identifying foods that cause gastric irrita-
tion.
 Instruct on the importance of abstaining from excessive alcohol.
 Encourage the patient to limit the intake of caffeinated beverages
such as tea & coffee.
 Teach about the importance of eating a balanced diet with meals
at regular intervals.
 Monitor the patients fluid intake and urine output.
 Monitor the patients vital signs, and observes BP &HR for signs of
orthostatic changes.
 Monitor hemoglobin and hematocrit levels.
 These assessment findings are signs of GI bleeding & should be
3. Reducing Anxiety
Learning these methods provides the Paient with a variety
of ways to manage anxiety.
 Assess the patients level of anxiety.
 Acknowledge awareness of the patients anxiety.
 Encourage to express fears openly
 Decrease sensory stimuli by maintaining a quiet en-
vironment.
 Provide emotional support to the patient.
 Assist the client in developing anxiety-reducing
measures such as biofeedback, positive imagery,
and behavior modification.
4. Initiating Patient Education and
Health Teachings
 Assess the patients knowledge and misconceptions
regarding peptic ulcer disease, lifestyle behaviors,
and the treatment regimen.
 Explain the pathophysiology of the disease and how
it relates to the functioning of the body.
 Instruct Patient on what signs & symptoms to report
to health care provider.
 Discuss the therapy options & the rationales for us-
ing these options.
 Discuss the lifestyle changes required to prevent
further complications or episodes of
peptic ulcer disease.
 The modifications of lifestyle behaviors such as alco-
hol use, coffee, and other caffeinated beverages, and
the overuse of aspirin or other nonsteroidal anti-in-
flammatory drugs is necessary to prevent re-
current ulcer development and prevent complica-
Thank
you
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