CASE STUDY

Nursing Diagnoses and Care Plan for Peptic Ulcer

Student name:
ALjwharah Aqeel
NURSING DIAGNOSIS FOR PEPTIC ULCER
PATIENTS
Based on the clinical manifestations presented in
the scenarios, here are possible nursing
diagnoses for each patient according to NANDA
(North American Nursing Diagnosis Association):
Scenario 1 (55-year-old man)
 Risk for Impaired Skin Integrity related to

malnutrition from nausea and potential

vomiting.
 Pain (chronic) related to peptic ulcer disease

as evidenced by epigastric burning.

 Deficient Knowledge related to peptic ulcer

disease, risk factors, and treatment plan.

Scenario 2 (Amit Hussain)
 Imbalanced Nutrition: Less Than Body

Requirements related to frequent eating out

and unhealthy food choices.
 Pain (acute) related to peptic ulcer disease as

evidenced by nighttime heartburn and

belching.
 Anxiety related to work stress and potential

complications of peptic ulcer disease.

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 II. NURSING CARE PLAN FOR PEPTIC ULCER
Framework:

SCENARIO 1: 55-YEAR-OLD MAN WITH

PEPTIC ULCER
Nursing Planning
Assessment Diagnosi (Goals & Rationales Interventions Evaluation
s Outcomes)

- Administer pain
- Patient
will report medication as
a decrease prescribed by the
in pain - Monitor pain
doctor. - Implement
intensity intensity and
- Pain
to a non- response to
management
manageabl pharmacological interventions
Epigastric medications
Pain e level using a pain
burning can help pain relief methods
(chronic) (e.g., 4/10 scale. -
(describe alleviate
related on a pain (distraction Document
intensity, discomfort. -
to peptic scale) patient's self-
duration), Identifying techniques,
ulcer within 2 reported pain
nausea, stable triggers relaxation therapy)
disease days. - levels and
weight helps tailor
Patient will as tolerated. - effectiveness
interventions
identify of pain
. Encourage patient
factors management
that to report any strategies.
worsen or changes in pain
improve
intensity or
pain.
character.

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 - Collaborate with a

dietitian to develop

a bland, low-acid
- Patient - Monitor
Risk for diet plan that
will weight and
Impaired
maintain considers patient vital signs. -
Skin
adequate Assess for skin
Integrity preferences. - Offer
Risk factors for nutritional - Early integrity,
related frequent small
malnutrition intake (as intervention especially over
to
(e.g., limited determine can prevent meals and snacks pressure
malnutrit
dietary intake d by complication points. -
ion from throughout the day.
due to nausea) dietician) s. Document any
nausea
to prevent - Monitor for signs nutritional
and
skin of nausea and challenges and
potential
breakdow interventions
vomiting vomiting and
n. implemented.
administer

antiemetics as

prescribed.
- Patient
will
- Develop a
demonstra
te teaching plan about
understan peptic ulcer
- Evaluate
ding of
disease, including patient's
peptic
Deficient causes, risk factors understanding
ulcer
Knowled through verbal
disease, (smoking, NSAID
ge - Education explanations
risk
Lack of related empowers use), signs and and
factors,
knowledge to peptic patients to symptoms, and demonstration
and
about peptic ulcer manage their s of self-care
treatment treatment options
ulcer disease disease, condition practices (e.g.,
plan by
and risk and prevent (medication, medication
the end of
management factors, complication administration)
teaching lifestyle changes). -
and s. . - Document
session. - Encourage patient
treatmen teaching
Patient will
t plan to ask questions provided and
ask
patient's
questions and clarify doubts. -
learning.
and clarify Provide written
any
information for
doubts
about their future reference.
condition.

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 SCENARIO 2: AMIT HUSSAIN WITH PEPTIC
ULCER .
Planning
Nursing
Assessment (Goals & Rationales Interventions Evaluation
Diagnosis
Outcomes)

- Administer pain

medication as

prescribed by the

doctor. - Collaborate
- Monitor pain
- Patient will with a dietitian to
intensity and
report a
develop a bland, low- response to
decrease in
interventions
pain intensity - Pain acid diet plan that
using a pain
to a management avoids trigger foods
scale. -
manageable medications
(e.g., spicy, fatty Document
Nighttime level (e.g., 4/10 can help
Pain (acute) patient's self-
heartburn, on a pain alleviate foods). - Encourage
related to reported pain
belching, recent scale) within 2 discomfort. - smaller, more frequent
peptic ulcer levels and
weight changes days. - Patient Lifestyle
disease meals. - Educate effectiveness of
(if any) will identify modifications
pain
strategies to can reduce acid patient on elevating
management
manage reflux and the head of the bed
strategies. -
heartburn and heartburn.
during sleep and Assess for
prevent
heartburn
nighttime avoiding lying down
frequency and
episodes. immediately after severity.
meals. - Recommend

avoiding smoking and

excessive alcohol

consumption.
Frequent eating Imbalanced - Patient will - A balanced - Monitor weight
- Collaborate with a
out, unhealthy Nutrition: Less maintain a diet promotes and vital signs.
dietician to develop a
food choices Than Body balanced diet healing and - Assess dietary
Requirements that meets prevents healthy meal plan that intake and
related to nutritional complications. adherence to
incorporates fruits,
frequent eating needs as the
vegetables, and whole
out and determined by recommended
unhealthy food a dietician. grains. - Educate meal plan.

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 patient on healthy

food choices when

eating out. - Provide

choices
education on portion

control and mindful

eating practices.

- Assess patient's
- Patient will
report a stress level and
decrease in coping mechanisms. -
anxiety level
Anxiety related Educate patient on
(using a - Reducing
Work stress, to work stress
validated stress can relaxation techniques
recent travel, and potential
anxiety scale) improve overall (e.g., deep breathing
potential for complications
within 2 days. - health and aid
complications of peptic ulcer exercises, meditation).
Patient will in ulcer healing.
disease
identify - Encourage time
healthy coping management and
mechanisms to
prioritizing tasks to
manage stress.
reduce

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