Question

1. Using the nursing process as a framework for care of the patient receiving enteral or parenteral nutrition support, identify the key assessment considerations.

2. Using the nursing process as a framework for care of patient with peptic ulcer, summarize the assessment, pharmacologic, dietary, and surgical treatment.

Answer 1

1. Assessment consideration for the patients receiving parenteral or enteral nutrition support are :-

- Monitoring weight of the patient , allowed weight gain is 1- 2 pounds.

- Serum electrolytes should be within normal range.

- Serum glucose levels should be less than 200 mg/100 mL.

2. Assessment for peptic ulcer :-

- Physical examination ( epigastric tenderness , abdominal distension )

- Endoscopy

- Diagnostic test include analysis of stool specimens for occult blood , gastric secretory , biopsy and histology

#. Pharmacologic therapy :-

- Antibiotics

- H2 -receptor antagonist

- Cytoprotective agents

- Antacids

#. Dietary modification :-

- Advise to take small , frequent meals

- Alcohol and caffeinated beveragea should be avoided

- Diet rich in milk , cream should be avoided because they are acid stimulator

- Avoid oversecretion and hypermotility of the GI tract.

#. Surgical management :-

Surgery is usually for intractable ulcers , life threatening hemorrhage , perforation , or obstruction . Surgical procedures includes vagotomy , vagotomy with pyloroplasty or Billroth I and II.