Welcome to another round of nursing lectures, featuring the gastrointestinal system. Right now, we will be focusing on peptic ulcer disease (PUD).
So, what is peptic ulcer disease and what does it do to the body? To adequately explain what PUD is, we’ll review its pathophysiology then delve into the nursing process of the disease.
An effective method when studying any subject, especially those that are within the scope of Medical-Surgical Nursing subject, is that, aside from knowing the keywords, you should also summarize the condition by following the nursing process. In this way, you will be able to gather the necessary keywords just by taking note of the D-A-R, which means:
- Data – signs and symptoms, laboratory results, vital signs, and any form of physical assessment findings.
- Action – drugs and client education (two most common nursing interventions)
- Response – how the client reacts or feels after the interventions were given
Peptic Ulcer Disease: An Overview
A peptic ulcer is an ulcer inside the gastrointestinal tract. It is named as such because of the presence of an acid known as pepsin lingering inside the stomach. An overproduction of pepsin will result in deterioration of the gastrointestinal lining. Ulcers can happen either inside the stomach or in the duodenum.
Aside from that, we’ll also talk about how the bacteria, Helicobacter pylori (H. pylori), contributes to the occurrence of peptic ulcer disease.
Inside the Stomach
The stomach has a mucosal lining that protects itself from hydrochloric acid, pepsin, and other enzymes that can break down food into chyme. After food is converted into chyme, it will pass the duodenum (the first portion of the small intestine), then go into the jejunum, ileum, and large intestine. And finally, once chyme is transformed into feces, it will be excreted by defecation through the anus. So, this is what happens typically inside the gastrointestinal tract.
How Peptic Ulcer Occurs
The moment the mucosal membranes become eroded to the point wherein the epithelial cells are exposed, that’s the time the gastric juices start to “eat up” the epithelial cells. The epithelial cells are considered as the stomach’s skin. Continuous “eating up” of the epithelial cells will result in peptic ulcer and can lead to a perforated bowel.
Perforation of bowel means that there is a gaping hole or an opening where the nutrients and toxic wastes can leak and go into the peritoneal cavity. The peritoneal cavity is the space inside the abdomen that keeps the liver, stomach, and intestines intact.
The Peritoneal Cavity
In general, all the organs inside the body are covered with thin membranes that compartmentalize them and keep them safe within their specified location. The heart has a pericardium that protects it from trauma caused by collision against the ribcage or any event similar to that.
The peritoneum or peritoneal cavity is the stomach’s protective covering just in case there will be direct blows or trauma happening around that area. The peritoneal cavity will prevent the bursting of bowels and other forms of internal conditions.
If there’s bowel perforation, it can lead to infection. However, the entire body will not get infected immediately because the peritoneal cavity prevents it from spreading. On the other hand, since the infection is confined within the peritoneal cavity, a condition known as peritonitis will occur. Infection of the peritoneum is called peritonitis.
What happens when there’s peritonitis? The peritoneum is filled up and will manifest as distention. Peritonitis is just one of the primary complications of peptic ulcer.
Now that we’ve appropriately discussed what peptic ulcer disease is and its pathophysiology, we’ll proceed to the assessment findings regarding the data collection, whether the peptic ulcer occurs in the stomach or duodenum. Check it out on our succeeding videos via our SimpleNursing YouTube channel.
For more nursing-related topics that will surely come out of major school exams and the NCLEX®, drop by our SimpleNursing website.
Until next time!