sherpath: PUD nad meds

Which ulcer occurs after an acute medical crisis such as sepsis, head injury, or critical illness?

stress

Which symptom is a feature of an upper gastrointestinal (GI) bleed?

1. coffee ground emesis 

2. melena 

3. inc heart rate 

Which medication may contribute to the development of peptic ulcer disease (PUD)?

Ibuprofen

Which feature is indicative of gastric ulcers?

commonly affects patient between 50 and 70 years old 

Proton Pump Inhibitor-Based (PPI) Triple Therapy

• Common regimen for H. pylori

• Includes a PPI, plus two antibiotics for 10–14 days

Quadruple Therapy

• Combines a PPI, any two commonly used antibiotics, and bismuth

Bismuth Therapy

• Used in patients who are allergic to penicillin-based medications

• Inhibits H. pylori from binding to the mucosal lining and stimulates mucosal protection and prostaglandin production

• avd Aspirin → an overdose of salicylates

• cause harmless black discoloration of stools and tongue

Hyposecretory Drugs

• Reduce gastric acid secretions

• Used for both PUD and gastritis management 

• Include PPIs and H₂-receptor antagonists

PPI Omeprazole, lansoprazole, dexlansoprazole, and esomeprazole

• Delayed-release PPIs: omeprazole, lansoprazole, dexlansoprazole, esomeprazole.

• Feeding tube options:

  • Omeprazole, lansoprazole, dexlansoprazole → dissolve in sodium bicarbonate.

  • Capsules can be opened; enteric-coated granules may go in apple/orange juice for large-bore tubes.

  • Esomeprazole, omeprazole, pantoprazole → oral suspension available.

• Do NOT crush: rabeprazole and pantoprazole tablets (enteric-coated).

• IV forms: esomeprazole and pantoprazole for NPO patients.

Safety & Monitoring

• Long-term risks: possible increased osteoporotic fractures.

• Reassess periodically to confirm continued need.

• Taper over several days when discontinuing to prevent rebound acid secretion.

Which drug therapy would be contraindicated for a patient on aspirin therapy? 

quadruple therapy

bismuth therapy 

Which nutrition therapy would the nurse include when educating a patient with peptic ulcer disease (PUD)?

eat a bland diet during the acute symptomatic phase

Which solution would be used for immediate volume replacement in a patient with an upper gastrointestinal (GI) bleed?

.9% normal saline

Which intervention would the nurse expect to provide for a patient with a pyloric obstruction?

correct metabolic alkalosis

Which complication of a gastric ulcer presents with a tender, rigid, and boardlike abdomen?

Peritonitis

Which diagnostic test is the treatment of choice for diagnosing peptic ulcer disease (PUD) because of its accuracy?

Esophagogastroduodenoscopy (EGD)

Which manifestation is associated with blood loss of greater than 1 L over a 24-hour period in a patient with an active bleeding peptic ulcer?

Hypotension 

Diaphoresis 

Weak, thready pulse

Which complication of peptic ulcer disease (PUD) is the most serious?

hemorrhage 

Which action would the nurse complete prior to sending a patient for an esophagogastroduodenoscopy (EGD) for treatment of a bleeding ulcer? 

insert two large-bore IV catheters