Question

The nurse has established a goal to limit the amount of blood loss in a client with peptic ulcer discase (PUD) and GI bleeding. Which plan best correlates with the accomplishment of the goal? A. Administer blood products as appropriate B. Administer appropriate medications (antacids, histamine blockers) C. Monitor for fluid loss (bleeding, vomiting, and so on) D. Monitor vital signs, as appropriate

Short answer

Answer: Administer appropriate medications (antacids, histamine blockers).

Step-by-step solution

Review the Options

Let's break down the four choices and consider their relevance: A. Administer blood products as appropriate - This can help replace the lost blood, but it does not directly address the cause of the problem, which is GI bleeding. B. Administer appropriate medications (antacids, histamine blockers) - These medications could help reduce gastric acid secretion and promote the healing of peptic ulcers, which eventually may reduce GI bleeding. C. Monitor for fluid loss (bleeding, vomiting, and so on)- This option involves monitoring and keeping track of the symptoms, but it does not provide any intervention to minimize blood loss or treat the underlying issue. D. Monitor vital signs, as appropriate - Monitoring vital signs is important in this situation, but it does not provide a direct intervention to minimize blood loss or treat the underlying issue.

Compare the Options

Comparing the four options, we can see that choice B, administering appropriate medications such as antacids and histamine blockers, is the most effective plan to address the root cause of the issue and limit the amount of blood loss in a client with PUD and GI bleeding.

Select the Best Plan

Therefore, the best plan to limit the amount of blood loss in a client with PUD and GI bleeding is: B. Administer appropriate medications (antacids, histamine blockers)

Key concepts

Peptic Ulcer Disease

Peptic Ulcer Disease (PUD) is a common condition where painful sores, known as ulcers, develop on the lining of the stomach, small intestine, or occasionally the esophagus. These ulcers occur primarily due to an imbalance between the mucosal defenses and aggressive factors such as gastric acid and pepsin. The most common causes include infection with the bacterium Helicobacter pylori and the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Peptic ulcers can cause symptoms such as burning stomach pain, bloating, and nausea. In severe cases, they can lead to complications like bleeding, perforation, and gastric obstruction. Managing peptic ulcer disease often involves lifestyle changes, medication, and sometimes surgery. It is crucial to eradicate Helicobacter pylori and to reduce gastric acid production to allow healing and prevent recurrences.

GI Bleeding Management

Gastrointestinal (GI) bleeding is a serious complication that can occur when a peptic ulcer starts bleeding. Quick and effective management is essential to prevent significant blood loss and further complications. The severity of GI bleeding can vary, ranging from occult bleeding, which results in subtle signs like anemia, to massive hemorrhages.
Initial management includes stabilizing the patient, monitoring vital signs, and confirming the source of bleeding. Fluid resuscitation is often necessary to maintain blood pressure and support circulation.

• Endoscopic examination is typically performed to identify the bleeding site and apply direct treatments.
• Endoscopic techniques may involve cauterizing the ulcer, injecting medications to control bleeding, or applying mechanical measures such as clips.
• In cases where endoscopic therapy fails, interventional radiology or surgery may be required.

Early intervention is key to reducing morbidity and mortality rates associated with GI bleeding.

Nursing Interventions

Nurses play a crucial role in managing patients with peptic ulcer disease and supervising GI bleeding treatment. They monitor patients closely, provide necessary interventions and support throughout the recovery process. Some important nursing interventions include:

• Frequent monitoring of vital signs to detect early signs of deterioration and bleeding.
• Ensuring proper fluid balance by monitoring input and output, and administering IV fluids as necessary.
• Providing education about lifestyle modifications, such as avoiding NSAIDs, reducing alcohol consumption, and quitting smoking to promote healing and prevent recurrence.
• Offering emotional support and reassurance to reduce anxiety levels, which can exacerbate symptoms.
• Coordinating care with other healthcare professionals to ensure comprehensive treatment and follow-up care.

Nurses are instrumental in executing care plans and ensuring that interventions are both timely and effective.

Medication Administration

Administering medication is a critical component in the treatment of peptic ulcer disease. The primary aim is to reduce gastric acidity, promote ulcer healing, and prevent future occurrences. The medications commonly prescribed include:

• Antacids, which help neutralize stomach acid and provide symptomatic relief.
• Histamine-2 (H2) blockers like ranitidine, which reduce acid production by blocking histamine on the stomach's acid-producing cells.
• Proton pump inhibitors (PPIs) such as omeprazole, which block the enzyme responsible for acid secretion, providing a more long-term suppression of stomach acid.
• Antibiotics, particularly when infection with Helicobacter pylori is present, to eradicate the bacteria.
• Cytoprotective agents like sucralfate, which protect the stomach lining and aid in healing the ulcer.

Nurses must ensure proper administration and monitor for side effects or adverse reactions, adjusting treatment plans as necessary to achieve optimal outcomes. Effective medication management can significantly improve patient prognosis and quality of life.