A client with peptic ulcer disease tells the nurse that he has black stools, which he has not reported to his physician. Based on this information, which nursing diagnosis would be appropriate for this client?
A. Ineffective coping related to fear of diagnosis of chronic illness.
B. Deficient knowledge related to unfamiliarity with significant signs and symptoms.
C. Constipation related to decreased gastric motility.
D. Imbalanced nutrition: Less than body requirements due to gastric bleeding.
Correct Answer: B. Deficient knowledge related to unfamiliarity with significant signs and symptoms.
Black, tarry stools are an important warning sign of bleeding in peptic ulcer disease. Digested blood in the stomach causes it to be black. The odor of the stool is very stinky. Clients with peptic ulcer disease should be instructed to report the incidence of black stools promptly to their physician. Assess the client’s knowledge and misconceptions regarding peptic ulcer disease, lifestyle behaviors, and the treatment regimen.
Option A: Provide emotional support to the client. Providing emotional support will give a client a calming and relaxing mood that will lower anxiety and stress related to the condition. Assist the client in developing anxiety-reducing measures such as biofeedback, positive imagery, and behavior modification.
Option C: Teach about the importance of eating a balanced diet with meals at regular intervals. Specific dietary restrictions are no longer part of the treatment for PUD. During the symptomatic phase of an ulcer, the client may find benefit from eating small meals at more frequent intervals.
Option D: Assist the client with identifying foods that cause gastric irritation. Clients need to learn what foods they can tolerate without gastric pain. Soft, bland, non-acidic foods cause less gastric irritation. The client is more likely to increase food intake if the foods are not associated with pain. Foods that may contribute to mucosal irritation include spicy foods, pepper, aNd raw fruits and vegetables.
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