2. At the end of this session, you will be
able to :
 State the definition of PGU.
 List the etiology of PGU.
 Identify the pathophysiology of
PGU.
 State the sign & symptom of PGU.

3. LEARNING OBJECTIVES cont.
 Identify the complication of PGU.
 Understand regarding treatment of
PGU.
 Identify the nursing intervention &
appreciate the nursing care for PGU
patient.

5. PATIENT’S PROFILE
 MR. A
 MALE
 79 YEARS OLD
 FARMER

6. PATIENT’S PROFILE
 WHEEL CHAIR
 CALM
 MEDICAL HISTORY – BPH since August 2013
 ALLERGICS - UNKNOWN
 D.O.A 24/9/13 @ 1220 Hrs

7. CURRENT MEDICATION
 QUERY MEDICATION FROM GH FOR
BPH

8. Mr A was admitted to 5XX-1
by wheel chair with
complaint of abdomen pain
& distended with LOA for
few months, unable to pass
motion X 3/7 and nauseated
& vomited coffee ground 4
times since last night.

9. Seen by MO at A&E :
- IV drip dextrose saline
- Blood taken

10. Doctor = Dr DA
Diagnosis
Perforated Peptic Ulcer
Disease

11. Seen by Dr DA at A&E :
- IV drip 3 pint

1 pint Normal saline

1 pint Dextrose saline

1 pint D5%
- Pre OT screening

12. Seen by Dr DA at A&E :
- For OGDS & colonoscopy
CM
- Fleet 45ml at 0600hrs CM
- Normal diet
- Breakfast CM (only fluid)

14. VITAL SIGN






TEMPERATURE
BLOOD PRESSURE
PULSE
RESPIRATION
PAIN SCORE
Weight
:
:
:
:
:
37.2˚C
110/70mmHg
112 bpm
20 bpm
3
: 49 kg

15. ACTIVITY DAILY LIVING
 Loss of appetite, nauseated and vomiting
 Forgetful & weakness
 Smoking
 Ambulate using cane & need assistance in ADL
 On pampers
 Nocturia but now less only 3-4 times per night

16. PHYSICAL EXAMINATION

28. WHAT CAUSES
Helicobacteria pyloriIT?
 Aspirin
 Ibuprofen
 NSAIDs
 Stress
 Aging
 Alcohol & smoking


37. COMPLICATION
• Peritonitis
• Gastrointestinal bleeding
• Gastric outlet obstruction
• Cancer
• Death

39. PRE OT SCREENING
• Haemoglobin
- 8.4 (13.0 – 18.0 g/dL)
• Glucose
- 5.5 (3.9 – 6.1 mmol/L)
• HIV 1/11 antibodies
- Non reactive
• HBs antigen
- Non reactive

40. TUMOR MARKER
• Alpha-feto protein
- 3 ug/L (<11)
• Serum CA 19.9
- 4 U/ml (<32)
• CEA
- 0.9 (<5.1)
• PSA
- 0.5 ug/L (<6.6)

42. DRUGS
IN WARD
DATE
ORDERED
DATE
OFF
IV Controloc 40mg OD
24/9/13
27/9/13
IV Maxalon 10mg TDS
24/9/13
27/9/13
Tab Sangobion 1 OD
24/9/13
27/9/13
Tab Flagyl 400mg TDS
25/9/13
27/9/13

44. OGDS
• Atropic chronic gastritis with tiny
perforation

45. Colonoscopy
• Query CA terminal ileum – small
polyp 5cm

48. NURSING DIAGNOSIS
 Potential fall related to
weakness.

54. NURSING DIAGNOSIS
 Alteration in nutritional
status less than body
requirement related to
nausea, vomiting and loss
of appetite.

57. NURSING DIAGNOSIS
 Potential infection
related to intravenous
cannulation.