This document outlines the learning objectives and case of a 79-year-old male patient admitted with abdominal pain and distension. The objectives are to understand peptic gastric ulcer (PGU), including its definition, causes, symptoms, complications, treatments, and appropriate nursing care. The patient's history of BPH and current condition of perforated peptic ulcer disease are also summarized.

2. At the end of this session, you will be
able to :
 State the definition of PGU.
 List the etiology of PGU.
 Identify the pathophysiology of
PGU.
 State the sign & symptom of PGU.

3. LEARNING OBJECTIVES cont.
 Identify the complication of PGU.
 Understand regarding treatment of
PGU.
 Identify the nursing intervention &
appreciate the nursing care for PGU
patient.

5. PATIENT’S PROFILE
 MR. A
 MALE
 79 YEARS OLD
 FARMER

6. PATIENT’S PROFILE
 WHEEL CHAIR
 CALM
 MEDICAL HISTORY – BPH since August 2013
 ALLERGICS - UNKNOWN
 D.O.A 24/9/13 @ 1220 Hrs

7. CURRENT MEDICATION
 QUERY MEDICATION FROM GH FOR
BPH

8. Mr A was admitted to 5XX-1
by wheel chair with
complaint of abdomen pain
& distended with LOA for
few months, unable to pass
motion X 3/7 and nauseated
& vomited coffee ground 4
times since last night.

9. Seen by MO at A&E :
- IV drip dextrose saline
- Blood taken

10. Doctor = Dr DA
Diagnosis
Perforated Peptic Ulcer
Disease

11. Seen by Dr DA at A&E :
- IV drip 3 pint

1 pint Normal saline

1 pint Dextrose saline

1 pint D5%
- Pre OT screening

12. Seen by Dr DA at A&E :
- For OGDS & colonoscopy
CM
- Fleet 45ml at 0600hrs CM
- Normal diet
- Breakfast CM (only fluid)

14. VITAL SIGN






TEMPERATURE
BLOOD PRESSURE
PULSE
RESPIRATION
PAIN SCORE
Weight
:
:
:
:
:
37.2˚C
110/70mmHg
112 bpm
20 bpm
3
: 49 kg

15. ACTIVITY DAILY LIVING
 Loss of appetite, nauseated and vomiting
 Forgetful & weakness
 Smoking
 Ambulate using cane & need assistance in ADL
 On pampers
 Nocturia but now less only 3-4 times per night

16. PHYSICAL EXAMINATION

28. WHAT CAUSES
Helicobacteria pyloriIT?
 Aspirin
 Ibuprofen
 NSAIDs
 Stress
 Aging
 Alcohol & smoking


37. COMPLICATION
• Peritonitis
• Gastrointestinal bleeding
• Gastric outlet obstruction
• Cancer
• Death

39. PRE OT SCREENING
• Haemoglobin
- 8.4 (13.0 – 18.0 g/dL)
• Glucose
- 5.5 (3.9 – 6.1 mmol/L)
• HIV 1/11 antibodies
- Non reactive
• HBs antigen
- Non reactive

40. TUMOR MARKER
• Alpha-feto protein
- 3 ug/L (<11)
• Serum CA 19.9
- 4 U/ml (<32)
• CEA
- 0.9 (<5.1)
• PSA
- 0.5 ug/L (<6.6)

42. DRUGS
IN WARD
DATE
ORDERED
DATE
OFF
IV Controloc 40mg OD
24/9/13
27/9/13
IV Maxalon 10mg TDS
24/9/13
27/9/13
Tab Sangobion 1 OD
24/9/13
27/9/13
Tab Flagyl 400mg TDS
25/9/13
27/9/13

44. OGDS
• Atropic chronic gastritis with tiny
perforation

45. Colonoscopy
• Query CA terminal ileum – small
polyp 5cm

48. NURSING DIAGNOSIS
 Potential fall related to
weakness.

54. NURSING DIAGNOSIS
 Alteration in nutritional
status less than body
requirement related to
nausea, vomiting and loss
of appetite.

57. NURSING DIAGNOSIS
 Potential infection
related to intravenous
cannulation.