Page 1493 - Saunders Comprehensive Review For NCLEX-RN

return.

h. Monitor for postoperative

complications of hemorrhage,
dumping syndrome, diarrhea,
hypoglycemia, and vitamin B 12
deficiency.

Following gastric surgery, do not irrigate or

remove the NG tube unless specifically prescribed
because of the risk for disruption of the gastric
sutures. Monitor closely to ensure proper functioning
of the NG tube to prevent strain on the anastomosis
site. Contact the surgeon if the tube is not
functioning properly.
C. Duodenal ulcers
1. Description
a. A duodenal ulcer is a break in the
mucosa of the duodenum.
b. Risk factors and causes include
infection with H. pylori; alcohol intake;
smoking; stress; caffeine; and the use
of aspirin, corticosteroids, and
NSAIDs.
c. Complications include bleeding,
perforation, gastric outlet obstruction,
and intractable disease.

2. Assessment (see Box 48-5)

3. Interventions

a. Monitor vital signs.
b. Instruct the client about a bland diet,
with small, frequent meals.
c. Provide for adequate rest.
d. Encourage the cessation of smoking.
e. Instruct the client to avoid alcohol
intake; caffeine; and the use of aspirin,
corticosteroids, and NSAIDs.
f. Administer medications to treat H.
pylori and antacids to neutralize acid
secretions as prescribed.
g. Administer H -receptor antagonists or
2
proton pump inhibitors as prescribed
to block the secretion of acid.
4. Surgical interventions: Surgery is performed only if

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