The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse would assess the client for which of the following most frequent symptom(s) of duodenal ulcer?
A. Pain that is relieved by food intake.
B. Pain that radiates down the right arm.
C. N/V
D. Weight loss
Correct Answer: A. Pain that is relieved by food intake.
The most frequent symptom of a duodenal ulcer is pain that is relieved by food intake. These clients generally describe the pain as burning, heavy, sharp, or “hungry” pain that often localizes in the midepigastric area. 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 the first part of the duodenum.
Option B: The degree of disease progression before the initial diagnosis can affect the symptoms with which a patient may present. 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.
Option C: The typical presentation of a patient with gastric ulcers is epigastric pain that is worse with eating. It often correlates with mild nausea and early satiety. They often describe this pain as a sharp or burning type of pain that typically doesn’t radiate. The most common finding on the physical exam is epigastric tenderness.
Option D: The client with a duodenal ulcer usually does not experience weight loss. These symptoms are usually more typical in the client with a gastric ulcer. Patients may present with upper GI bleeding. The clinician should ask if they are having any black tarry stools, hematemesis, coffee-ground emesis, or bright red blood per rectum. It is important to remember that up to 15% of patients who present with bright red rectal bleeding have a brisk upper GI bleed.
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