Assessment for Peptic Ulcer
Patient history acts as an important basis for diagnosis. Patients were asked to describe the pain and the methods used to eliminate them. Peptic ulcer pain is usually described as a burning or gnawing and occurs approximately occurs after 2 hours after meals. This pain often awakens the patient hours of midnight and 3 am. The patient stated that the pain is only removed by antacids, eating or vomiting.
Patients were asked when vomiting occurs. If so, how much? Is vomit bright red or coffee color. Does the patient have a bowel movement with bloody stool? During the history taking, the nurse asked the patient to write the input of food, usually a period of 72 hours and include all eating habits (eating speed, regular meals, a fondness for spicy food, use herbs, use of beverages containing caffeine).
The level of tension and nervousness of patients studied. Does the patient smoke? If yes, how much? How patients express anger, especially in the context of work and family life? Is there or is there job stress with family problems? Is there a family history of ulcer disease?
Vital signs assessed for indicators of anemia (tachycardia, hypotension), fecal occult blood checked against. Physical examination and abdominal palpation performed to localize tenderness.

4 Nursing Diagnosis and Interventions for Peptic Ulcer
1. Acute pain related to irritation of the mucosa and muscle spasms.
    Goal: Client expressed pain diminished or disappeared.
    Intervention:
    1. Give drug therapy according to the program:
    2. Instruct to avoid drugs are sold freely, especially those containing salicylates.
        R /: Medicines containing salicylates may irritate the gastric mucosa.
    3. Encourage clients to avoid foods / drinks that irritate the gastric mucosa: caffeine and alcohol.
        R /: to stimulate the secretion of hydrochloric acid.
    4. Encourage clients to use the meals and snacks at regular intervals.
       R /: Schedule regular eating helps retain food particles in the stomach that helps neutralize the acidity of gastric secretions.
    5. Instruct patient to stop smoking
        R /: Smoking can stimulate ulcer recurrence.

2. Anxiety related to the nature of the disease and long-term management.
    Goal: Decrease anxiety.
    Intervention:
    1. Encourage clients to express their problems and fears and ask questions as needed.
       R /: Open communication helps clients develop trusting relationships that help reduce anxiety and stress.
  2. Explain the reasons for the planned treatment schedule obey, such as pharmacotherapy, dietary restrictions, modification of activity levels, reduce or stop smoking.
       R /: Knowledge reduce anxiety appears to be a sense of fear due to ignorance. Knowledge can have a positive effect on behavior change.
   3. Assist clients to identify situations that cause anxiety.
         R /: stressors need to be identified before it can be overcome.
   4. Teach stress management strategies: eg drugs, distraction, and imagination.
         R /: decrease anxiety decrease the secretion of hydrochloric acid.

3. Imbalanced Nutrition, Less Than Body Requirements related to pain, which is related to food.
Goal: Getting optimal nutrition.
Intervention:
1. Encourage eating foods and drinks that do not irritate.
    R /: Food and drinks are not irritating to help reduce epigastric pain.
2. Encourage eating on a regular schedule, avoid snacks before bedtime.
    R /: Eating regularly helps neutralize gastric acid secretion; snack before bedtime increases the secretion of gastric acid.
3. Encourage eating food in a relaxed environment
    R /: less relaxed environment cause anxiety. Decreased anxiety helps reduce the secretion of hydrochloric acid.

4. Knowledge Deficit: the prevention and treatment of symptoms related to the condition of inadequate information.
Goal: Clients gain knowledge about prevention and management.
Intervention:
1. Assess the level of knowledge and readiness to learn from clients.
   R /: Desire to learn depends on the physical condition of the client, the level of anxiety and mental readiness.
2. Teach the required information: Use words that correspond with the level of knowledge of the client. Choose a time when most convenient and interested clients. Limit counseling sessions to 30 minutes or less.
    R /: Individualization counseling improve learning.
3. Assure the client that the disease can be overcome.
    R /: Gives confidence can have a positive influence on behavior change.