Page 1491 - Saunders Comprehensive Review For NCLEX-RN

b. Predisposing factors include stress,
smoking, the use of corticosteroids,
NSAIDs, alcohol, history of gastritis,
family history of gastric ulcers, or
infection with H. pylori.
c. Complications include hemorrhage,
perforation, and pyloric obstruction.

2. Assessment (Box 48-5)

3. Interventions

a. Monitor vital signs and for signs of
bleeding.
b. Administer small, frequent bland
feedings during the active phase.
c. Administer H -receptor antagonists or
2
proton pump inhibitors as prescribed
to decrease the secretion of gastric
acid.
d. Administer antacids as prescribed to
neutralize gastric secretions.
e. Administer anticholinergics as
prescribed to reduce gastric motility.
f. Administer mucosal barrier protectants
as prescribed 1 hour before each meal.
g. Administer prostaglandins as
prescribed for their protective and
antisecretory actions.

4. Client education

a. Avoid consuming alcohol and
substances that contain caffeine or
chocolate.
b. Avoid smoking.
c. Avoid aspirin or NSAIDs.
d. Obtain adequate rest and reduce stress.

5. Interventions during active bleeding

a. Monitor vital signs closely.
b. Assess for signs of dehydration,
hypovolemic shock, sepsis, and
respiratory insufficiency.
c. Maintain NPO status and administer
intravenous (IV) fluid replacement as
prescribed; monitor intake and output.
d. Monitor hemoglobin and hematocrit.

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