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NCP: Patient with Peptic Ulcer Disease

Acute pain related to increased gastric secretion, decreased mucosal protection, and ingestion of gastric irritants as evidenced by
Nursing diagnosis burning cramplike pain in epigastrium and abdomen ; pain onset 1-2 hr after meals with gastric ulcer ; pain onset 2-4 hr after meals
(midmorning, mid efternoon) and middle night with duodenal ulcer

Patient goal Reports pain controlled without the use of analgesics

Intervention (NIC) Outcome (NOC)

Pain Management Outcomes (NOC)
 Perform a comprehensive assessment of pain to include Pain Control
location, characteristics, onset/duration, frequency, quality,  Describes causal factors.............
intensity or severity of pain, and precipitating factors to  Uses Preventive measures.....
determine appropriate intervention  Uses nonanalgesic relief measures......
 Provide the person optimal pain relief with prescribed  Uses analgesics appropriately....
analgesics to provide comfort  Reports chane in pain symptoms or sites to health care professional.......
 Select and implement a variety of measures (e.g  Reports pain controlled.......
pharmacologic, nonpharmacologic, interpersonal) to Measurement Scale
facilitate pain relief 1= never demonstrated
 Teach the use of nonpharmacologic techniques (e.g 2= rarely demonstrated
relaxation, guided imagery, music therapy, distraction, 3= sometimes demonstrated
acupressure, massage) before, after, and if possible, during 4= often demonstrated
painful activities ; before pain occurs of increases ; and 5= consistently demonstrated
along with other pain relief measures because relaxation
results in decreased acid production and reduction in pain
 Institute and modify pain control measures of the basis of the
patient’s response so that management can be individualized

NCP: Peptic Ulcer

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Ineffective self- health management related to lack of knowledge of long term management of peptic ulcer disease and
Nursing diagnosis consequences of not following treatmen plan ; unwillingness to modify lifestyle as evidence of exacerbation of symptoms

Patient goal 1. Verbalizes understanding of the therapeutik regimen, including knowledge of disease , rationale for treatment plan, and
benefits for disease management
2. Verbalize as commitment to self-care and management of the disease
Intervention (NIC) Outcome (NOC)
Teaching : Disease Process Outcomes (NOC)
 Review the patient’s knowledge about condition to Knowledge : Treatment regimen
determine if ineffective management is a knowledge problem  Spesific disease process.......
 Explain the pathophysiology of the disease and how it relates  Rationale for treatment........
to anatomy and physiologi to foster understanding  Self-care responsibilities for ongoing treatment.......
 Dicuss therapy/treatment options  Prescribed medication regimen......
 Describe rationale behind management/therapy/treatment Measurement Scale
recommendations to faster understanding of the therapy 1= no knowledge
 Discuss lifestyle changes that may be required to prevent 2= limited knowledge
future complications and /or control the disease process 3= moderate knowledge
 Explore with patient what she or he has already done to 4= substansial knowledge
manage the symptoms to confirm the patient has the ability 5= Extensive knowledge
to manage the disease
 Instruct patient on which signs and symptoms to report to Compliace Behavior
health care provider to ensure early the initiation of  Performs treatment regimen as prescribed.....
treatment  Modifies treatment regimen as directed by health professional......
Measurement Scale
Decision Making Support 1= never demonstrated
 Determine whether there are differences between the 2= rarely demonstrated
patient’s view of own condition and the view of health care 3= sometimes demonstrated
providers to be able to establish common ground for disease 4= often demonstrated
management 5= consistently demonstrated
 Help patient identify the advantages and disadvantages of
each alternative to promote decision making

NCP: Peptic Ulcer

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Nausea related to acute exacerbaton of disease process as evidenced by episodes of nausea and/or vomiting (see NCP Nausea and
Nursing diagnosis vomiting )

Collaborative Problems
Potential Complications : hemorrhage secondary to eroded mucosal tissue
Nursing diagnosis

Patient goal hemorrhage secondary to eroded mucosal tissue

Intervention (NIC) Outcome (NOC)

Nursing Interventions and Rationales Nursing Goals
 Assess for evidence of hematemesis, bright red or melena stool,  Monitor for signs of hemorrhage
abdominal pain or discomfort symptoms of shock (e.g decreased  Carry out appropriate medical and nursing interventions if hemorrhage
blood pressure, cool, clammy skin, dyspnea, tachycardia, occurs
decreased urine output) to plan appropriate interventions
 If ulcer is actively bleeding, observe NG tube aspirate or emesis
for amount and color to assess degree of bleeding
 Take vital sign every 15-30 min to determine patient’s
hemodynamic status and as indicators of shock
 Maintain IV infusion line to provide ready access for blood and
fluid replacement
 If RBC transfusion is given, observe for transfusion reaction so
appropriate actions can be taken immediately
 Monitor hematocrit and hemoglobin every 4-6 hr during active
bleeding as indicators of severity of hemorrhage and need for
fluid and blood replacement (in early phase of bleeding,
hematocrit may be falsely high or low)
 Record intake and output to monitor fluid balance
 Reassure patient and family to decrease their anxiety
 Remain calm and confident in plan of care to foster calm and
confidence in patient and family
 Prepare patient for possible endoscopy or surgery

NCP: Peptic Ulcer