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A nurse is reinforcing discharge instructions to a client who has a peptic ulcer. Which of the following information should the nurse reinforce to the client prior to discharge?

A.

"Monitor for any changes in the color of your urine such as maroon or red-colored urine."

B.

"Monitor for the appearance of ecchymosis on the sides of your abdomen/pelvic areas."

C.

"Monitor for any increase or unintentional weight gain."

D.

"Monitor for any changes in the color of your stool such as dark or black-colored stool."

Answer and Explanation

The Correct Answer is D

A. "Monitor for any changes in the color of your urine such as maroon or red-colored urine.": Hematuria (red urine) is unrelated to upper GI bleeding from peptic ulcers; this is not the correct sign to monitor for GI bleeding.

B. "Monitor for the appearance of ecchymosis on the sides of your abdomen/pelvic areas.": Ecchymosis on the flanks (Grey Turner sign) can indicate severe retroperitoneal hemorrhage but is uncommon and not a routine discharge teaching point; also ecchymosis on sides of abdomen is nonspecific.

C. "Monitor for any increase or unintentional weight gain.": Weight gain is not a primary concern for peptic ulcer complications; unintentional weight loss would be more relevant.

D. "Monitor for any changes in the color of your stool such as dark or black-colored stool.": Dark, tarry stools (melena) indicate upper GI bleeding (digested blood) and should prompt immediate contact with a provider - this is the correct discharge warning sign.


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Related Questions

Correct Answer is A

Explanation

A. Use of NSAIDs for arthritic pain: NSAIDs inhibit prostaglandin synthesis, which reduces the protective mucus layer of the stomach and increases the risk of PUD. Clients with chronic NSAID use are at significantly higher risk for gastric ulcers.

B. Smoking history for 10 years: Smoking can delay healing of ulcers and contribute to recurrence, but it is not as direct a risk factor for developing PUD as NSAID use.

C. History of rheumatoid arthritis:RA itself does not directly cause PUD. However, clients with RA may take NSAIDs, which increases risk; the condition alone is not a primary risk factor.

D. Family history of peptic ulcer disease:While genetic predisposition may play a minor role, family history alone is not as significant as active NSAID use or other direct risk factors in increasing suspicion for PUD.

Correct Answer is C

Explanation

A. Decreased body temperature: Peritonitis typically causes fever (elevated temperature) due to infection/inflammation, not a decreased temperature.

B. Increased bowel sounds: Peritonitis usually leads to hypoactive or absent bowel sounds because inflammation causes intestinal ileus, not increased sounds.

C. Rigidity of the abdomen upon palpation: Rigid, board-like abdominal muscles (guarding/rigidity) with rebound tenderness are classic signs of peritoneal irritation/inflammation.

D. Decreased pain intensity with palpation: Pain typically increases with palpation and rebound in peritonitis; decreased pain with palpation would not support peritonitis.

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