General Nursing©

ULCERS

In patients with ulcers, nurses should accurately record intake and output, particularly frequency and volume of stools. Signs of dehydration and electrolyte imbalances should be watched. Complications such as perforated colon and peritonitis (fever severe abdominal pain, abdominal rigidity and tenderness, cool, clammy skin), and toxic mega colon (abdominal) distention (decreased bowel sounds) should be observed.

After a pouch ileostomy, the catheter is uncorked every hour to allow contents to drain. After 10 to 14 days, gradually increase the length of time the catheter is left corked until it can be opened every three hours. Then remove the catheter and reinsert it every three to four hours.

Excess stomach acid or other irritants in the stomach or intestine can result in formation of erosions and ulcer craters; often these are large enough to hold a good part of the surgeon's thumb. A breakdown of the protective mucous barrier of the stomach accelerates the damage. We all form small ulcers every now and again, but severe progressive one can lead to pain and major hemorrhage (bleeding). Severe ulcers can even perforate (make holes) all the way through the wall of the stomach or small intestine.

Prevention:

· Stress, in all it's forms, is a frequent contributing factor. Avoidance of physical activity decreases gastric secretions and peristalsis. Thus our goal is to promote recovery by helping the person achieve total rest-physically and mentally. Be alert for factors that interfere with person's rest. Arrange the environment to encourage relaxation.

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