The client with a duodenal ulcer may exhibit which of the following findings during an assessment?
A. Hematemesis
B. Malnourishment
C. Melena
D. Pain with eating
Correct Answer: C. Melena
The client with a duodenal ulcer may have bleeding at the ulcer site, which shows up as melena (black tarry stool). Duodenal ulcers occur when there is a disruption to the surface of the mucosa of the duodenum. These ulcers are part of peptic ulcer disease, which involves the stomach and first part of the duodenum. The other findings are consistent with a gastric ulcer.
Option A: Patients who initially present with ulcer-related complications may present with symptoms suggestive of upper GI bleed, including melena, hematemesis, elevated BUN, and anemia of varying degrees in severity with associated fatigue. Patients who present with more alarming symptoms such as anemia, melena, or hematemesis, which may represent perforation or bleeding, will likely require more invasive forms of evaluation.
Option B: The presentation of patients with symptoms consistent with dyspepsia or peptic ulcer disease, and most specifically, duodenal ulcers, can vary highly depending on the degree of disease progression and time when a patient seeks treatment. Other common signs and symptoms include epigastric abdominal pain, bloating, nausea and vomiting, and weight gain due to improved symptoms post meals.
Option D: Overall, dyspepsia is the most common symptom for patients who do experience symptoms. The location of the disease can also be differentiated based on symptoms. The pain associated with duodenal ulcers improves after meals, while the pain associated with gastric ulcers generally intensifies after meals.
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