A client with a peptic ulcer reports epigastric pain that frequently awakens her at night, a feeling of fullness in the abdomen, and a feeling of anxiety about her health. Based on this information, which nursing diagnosis would be most appropriate?
A. Imbalanced Nutrition: Less than Body Requirements related to anorexia.
B. Disturbed Sleep Pattern related to epigastric pain.
C. Ineffective Coping related to exacerbation of duodenal ulcer.
D. Activity Intolerance related to abdominal pain.
Correct Answer: B. Disturbed Sleep Pattern related to epigastric pain.
Based on the data provided, the most appropriate nursing diagnosis would be Disturbed Sleep pattern. A client with a duodenal ulcer commonly awakens at night with pain. Clients with a gastric ulcer typically demonstrate pain 1 to 2 hours after eating. The client with duodenal ulcers demonstrates pain 2 to 4 hours after eating or in the middle of the night. With both gastric and duodenal ulcers, the pain is located in the upper abdomen and is intermittent. The client may report relief after eating or taking an antacid.
Option A: 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.
Option C: The client’s feelings of anxiety do not necessarily indicate that she is coping ineffectively. 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.
Option D: Encourage the use of nonpharmacological pain relief measures. Non Pharmacological relaxation techniques will decrease the production of gastric acid, which in turn will reduce pain.
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