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Ch. 42 Nursing Management: Upper Gastrointestinal Problems practice questions

Key Concepts:

Terms in this set (26)

Correct answer: d
Rationale: Peptic ulcers develop only in the presence of an acidic environment. However, an excess of hydrochloric acid (HCl) may not be necessary for ulcer development. The back diffusion of HCl into the gastric mucosa results in cellular destruction and inflammation. Histamine is released from the damaged mucosa, which results in vasodilation and increased capillary permeability and further secretion of acid and pepsin. A variety of agents (certain infections, medications, and lifestyle factors) can damage the mucosal barrier. Helicobacter pylori can alter gastric secretion and produce tissue damage, which leads to peptic ulcer disease. The response to H. pylori is probably influenced by a variety of factors, including genetics, environment, and diet. Ulcerogenic drugs, such as aspirin and NSAIDs, inhibit synthesis of prostaglandins, increase gastric acid secretion, and reduce the integrity of the mucosal barrier. Patients taking corticosteroids, anticoagulants, and selective serotonin reuptake inhibitors (e.g., fluoxetine [Prozac]) are also at increased risk for ulcers. High alcohol intake stimulates acid secretion and is associated with acute mucosal lesions. Coffee (caffeinated and uncaffeinated) is a strong stimulant of gastric acid secretion. Psychologic distress, including stress and depression, can hamper the healing of ulcers after they have developed. Smoking also delays ulcer healing. In addition, infection with herpes and cytomegalovirus (CMV) in immunocompromised patients may lead to gastric ulcers