Question

When the nurse is gathering information for the assessment, the patient states, "My stomach hurts about 2 hours after I eat." Based upon this information, the nurse knows the patient likely has a: A. Gastric ulcer B. Duodenal ulcer C. Peptic ulcer D. Curling's ulcer

Short answer

A. Gastric Ulcer B. Duodenal Ulcer C. Peptic Ulcer D. Curling's Ulcer Answer: B. Duodenal Ulcer Explanation: The most probable cause of the patient's stomach pain occurring 2 hours after eating is a duodenal ulcer, as pain from duodenal ulcers typically occurs 2-3 hours after a meal when the stomach is emptying its contents into the duodenum. Gastric ulcers are less likely, as they cause pain during or immediately after eating, while Curling's ulcers are related to severe stress or trauma and are not typically related to meal timing. Peptic ulcers include both gastric and duodenal ulcers, making the term not specific enough to pinpoint the location of the patient's pain.

Step-by-step solution

Analyze the information given by the patient

The patient's main complaint is stomach pain that occurs about 2 hours after eating. This information will be essential in determining the most probable type of ulcer the patient may have.

Evaluate Answer Choice A: Gastric Ulcer

Gastric ulcers are located in the stomach lining. They are often characterized by pain that occurs during or immediately after eating, not 2 hours after. Therefore, this is most likely not the cause of the patient's pain.

Evaluate Answer Choice B: Duodenal Ulcer

Duodenal ulcers are located in the upper portion of the small intestine (duodenum). Pain from duodenal ulcers typically occurs 2-3 hours after a meal, when the stomach is emptying its contents into the duodenum. This is a likely match for the patient's reported pain.

Evaluate Answer Choice C: Peptic Ulcer

Peptic ulcers refer to both gastric and duodenal ulcers, as they involve erosion of the gastrointestinal tract lining due to acid and pepsin. The term peptic ulcer is not specific enough to pinpoint the location of the patient's pain.

Evaluate Answer Choice D: Curling's Ulcer

Curling's ulcers occur due to severe stress or trauma, such as burns or major surgery, and are not typically related to meal timing. The patient's information does not indicate any recent stress or trauma, so this option is less likely.

Choose the correct answer

Based on the analysis of each answer choice, the most probable cause of the patient's stomach pain occurring 2 hours after eating is a duodenal ulcer. Therefore, the correct answer is B. Duodenal Ulcer.

Key concepts

Nursing Assessment

Nursing assessments are a vital part of patient care. They involve collecting, interpreting, and documenting information about a patient's overall health status.

In the given exercise, the nurse begins by engaging with the patient to understand their symptoms. This is a classic example of a subjective nursing assessment, where the patient's experience, such as pain 2 hours after eating, provides clues to their condition.

A thorough nursing assessment includes both subjective data, like the patient's reported symptoms, and objective data, which can be measured or observed, such as vital signs, lab results, and physical examination findings.

The nurse's ability to correlate symptoms with potential conditions is essential, and effective communication skills play a key role in obtaining accurate patient information. Assessments are continuous, not just a one-time task at admittance, and the information gathered can lead to a prompt and accurate diagnosis.

Duodenal Ulcer Diagnosis

A duodenal ulcer is a type of peptic ulcer that occurs in the duodenum. This ulcer is typically diagnosed based on the patient's history, symptom presentation, and often confirmed with endoscopy, an imaging study, or lab tests.

Symptoms of a duodenal ulcer can include epigastric pain that is relieved by eating, but resumes after a couple of hours, which the patient in our exercise reported. Nausea, bloating, and sometimes even night pain are also associated with it.

Differential Diagnosis

It's important to distinguish duodenal ulcers from gastric ulcers based on symptom timing and triggers. Gastric ulcers usually cause pain during or right after eating, while duodenal ulcer pain typically occurs when the stomach is empty.

Moreover, testing for Helicobacter pylori, a bacterium often responsible for peptic ulcers, is a critical part of diagnosis and treatment planning. Personal lifestyle factors, such as use of nonsteroidal anti-inflammatory drugs (NSAIDs) or smoking, which can exacerbate ulcers, should also be assessed.

Medical-Surgical Nursing

Medical-surgical nursing is a specialty area that focuses on the care of adults with a variety of medical issues or who are preparing for/recovering from surgery.

Nurses in this field require broad knowledge and skills to manage patients with complex conditions and to support them through their recovery. The principles of medical-surgical nursing apply in the assessment of a patient with potential duodenal ulcers, as seen in the exercise.

These nurses need to be proficient in conducting thorough assessments, developing patient-centered care plans, monitoring for complications, providing education, and coordinating with other healthcare professionals for optimal patient outcomes.

In the context of a duodenal ulcer, a medical-surgical nurse would be responsible for administering medications such as antacids or proton-pump inhibitors, monitoring for potential complications like bleeding, and educating the patient on lifestyle modifications to prevent ulcer recurrence.