Ulcer
Many people say that an ulcer is caused by stress whereas scientific journals states that it is caused by bacteria. Actually, ulcer has traditionally been thought as a condition brought by stress as well as the consumption of coffee and spicy foods. Generally, an ulcer was believed to be a by-product of lifestyle factors like diet and stress. In the past few years, it has emerged that an ulcer is caused by a bacterial infection as stated in various scientific journals on ulcers. This change can be attributed to the fact that researchers determined that stomach acids like hydrochloric acid generates the formation of an ulcer. The determination that an ulcer is largely caused by bacterial infections raises concerns on whether bacteria survive the gastric juice and cause harm to an individual's body.

Gastric juice is primarily made of hydrochloric acid and pepsin, an enzyme that breaks down protein. Given its….

Pressure Ulcers in the Elderly During Hospital Stays
Pressure ulcers are potentially fatal skin lesions that develop especially in frail, elderly patients on bony or cartilaginous areas such as the sacrum, elbows, and ankles. Within acute care in the United States, the incidence of pressure ulcers lies between 0.4% and 38%. The incidence within long-term and home care is significantly lower while intensive care units report that 8% to 40% of ICU patients develop pressure ulcers during the hospital stay (Cuddigan, Berlowitz & Ayello, 2001). An epidemiological study of pressure ulcers reports that hospital-acquired pressure ulcers cost the U.S. $2.2 to $3.6 billion per year in 1999 (Vandenkerkhof, Friedberg & Harrison, 2011). These statistics carry important implications for guidelines of identification and treatment of pressure ulcers in the United States. In the complexity of the medical system, the application of Jean Watson's Theory of Nursing Caring and the developing role of….

Pressure Ulcers/Case Study
Bedsores are also known as pressure ulcers. They are lesions that are primarily caused when soft tissues are pressed against bone for a long period of time, restricting blood flow to the area. These often occur when a patient is immobile or reclining in a recovery bed for a long period of time. They are common on the hips, elbows, knees, ankles and even the back of the head. Current research shows that they are exacerbated by other conditions like diabetes, perspiration, incontinence, infection, or medications that impair the circulatory system. Pressure ulcers are particularly serious in older patients -- particularly those in a wheel chair or in cases in which the patient does not move or exercise. Bedsores are often fatal, even when treated aggressively and are one of the leading causes of death from complications in many developed countries -- second only to adverse drug reactions….

Peptic Ulcer Disease: Pathophysiology
A peptic ulcer can be defined as "a focal mucosal defect with inflammatory cell infiltration and coagulation necrosis extending through the muscularis mucosae" (Halter, 1995, p. 2). Contrary to erosion, a peptic ulcer extends beyond the epithelial structures into that intestinal tract section that happens to be in constant contact with pepsin and acid-containing gastric juice (Halter, 1995). Peptic ulcers cause an imbalance between the gastro duodenal defense-influencing factors such as prostaglandin, bicarbonate and mucus, and those such as NSAID use, H. pylori, pepsin and gastric acid, which promote mucosal damage (Elsevier, 2012). If peptic ulcers keep recurring at the same site, the imbalance worsens, resulting in peptic ulcer disease (PUD).

Two types of peptic ulcers can be deduced from the explanation above; duodenal and gastric ulcers (Elsevier, 2012).

Gastric Ulcers: there are four major classifications of gastric ulcers: type I, type II, type III and type IV (Elsevier,….

Preventing Pressure Ulcers in Postoperative Patients
this is a nursing research evidence-based practice project paper. THIS IS A NURSING PROJECT. SINGLE SPACE. 6 PAGES FOR THE PROJECT, 2 PAGES FOR THE LISTED INFO Directions: 1. You developed EVIDENCE-BASED NURSING PRACICE PROJECT (EBP).

What are the best practices to prevent pressure ulcers in postoperative patients?

This project aims at implementing evidence-based prevention strategies for pressure ulcers in postoperative patients.

There are many risk factors associated with pressure ulcers such as lack of movement, poor nutritional intake, hypothermia, and dry skin. Postoperative patients are at increased risk of developing pressure ulcers because they often have long period of immobility and poor nutritional intake. As a result, they experience pain and discomfort and poor quality of life as a result of pressure ulcers. Pressure ulcers are preventable using strategies such as repositioning of patients to prevent accumulation of pressure, use of mattress overlays to reduce pressure on….

Otherwise, the resources are either short or unavailable. These situations tend to make gains in pressure ulcer care quickly vanish (Cuddigan et al.).
Lastly, national records on pressure ulcer rates have remained incomplete and unreliable (Cuddigan et al. 2001). Hospital discharge records do not all reflect or include pressure ulcer cases even if the patients reach Stage III or IV. In addition, these records are unable to recognize and tally the difference between pressure ulcers at different stages and complications already present on admission. It is still a fact that pressure ulcer rates in these databases remain lower than those gathered in clinical studies, indicating the inaccuracy of the databases. Yet valid and complete information from these national databases is needed to provide accurate feedback to providers. They form the basis for sound clinical, educational and public policy decisions for the future (Cuddigan et al.).

ibliography

Allman R.M. et al. (1995). Pressure….

The use of aspirin and other NSAIDs has not been eliminated by studies as possible causes of PUD. H. pylori infection generally occurred less among patients with complicated ulcer disease than in those with uncomplicated ulcer disease. Many studies point to aspirin or NSAIDs as the other identifiable risk or cause of PUD. PPI has been shown to reduce dyspeptic symptoms, which develop from NSAID use. In the past, lansoprazole was the only FDA-approved PPI. Recently, however, professors at the University Hospital, Queen's Medical Centre of Nottingham in the United Kingdom presented their findings on a comparison among PPIs. Their study was internationally-based with more than 500 patients. It showed that esomeprazole was superior to other PPIs in managing upper gastrointestinal symptoms of arthritic patients. It also enhanced their quality of life (Howden).
PUD is not only likely to remain a persistent condition (Howden, 2003). More cases of ulcers unconnected….

ummary of Common and Conflicting Findings

Hart, Bergquist, Gajewski & Dunton (2006); Gunningberg (2005); Wipke-Tevis, Williams, Rantz, Popejoy, Madsen, Petroski & Vogelsmeier (2004); and Vanderwee, Grypdonck, DeBacquer & Defloor (2006) all indicate that pressure ulcers are unnecessarily common among patients in nursing care facilities. Pressure ulcers are generally defined as "lesions caused by unrelieved pressure, resulting in damage of underlying tissue," (Hart et al. 2006, p. 257). They occur mainly along bony protuberances such as the sacrum, hips, and ankles. Of the four studies, only Vanderwee et al. (2006) draw attention to the differences between observing pressure ulcers at different points on the body. Vanderwee et al. (2006) found that finger pressure and transparent disk methods of observation were both less sensitive at the heels and that the greatest correspondence between methods occurs at the sacrum. None of the other studies distinguished between the two main pressure ulcer observation methods: finger….

Treatment for a Patient With a Duodenal Ulcer
Until relatively recently, stress and spicy foods were deemed to be the likely causes of ulcers. That has changed, however, with the discovery of the causal link between H. pylori and duodenal ulcers. "Infection with Helicobacter pylori (commonly just called H. pylori) is the cause in about 19 in 20 cases of duodenal ulcer" (Kenny 2012). For some people who are infected, the bacteria causes no symptoms while for others it causes a disruption of the mucus barrier and an increase in the amount of digestive acid in the lining of the stomach, resulting in inflammation and discomfort, ultimately cumulating in an ulcer (Kenny 2012).

This revelation about the causation of ulcers has caused a dramatic shift in how they are treated. Instead of prescribing surgery, a 4-8-week course of acid-suppressing medication is used. The intention is to allow the ulcer to heal. A….

Marshall and arren discovered that the organism was there in almost every patient with gastric ulcer and inflammation. Based on the results of their findings, they suggested that Helicobacter pylori are involved in the aetiology of these diseases. In fact, Helicobacter pylori cause over 90% of duodenal ulcers and about 80% of gastric ulcers. After this discovery, research has been deep.
This bacterium can be diagnosed by identification of the organism in biopsies, by antibody tests or by non-invasive breath test which recognizes bacterial production of an enzyme in the stomach. The use of antibiotics to eliminate Helicobacter pylori may lead to severe problems since bacteria and chronic inflammation of the stomach remains. Marshall, arren and other researchers showed that patients could be cured from peptic ulcer by eradication of the bacteria from the stomach. Due to Marshall and arren's discovery, peptic ulcer is no longer a chronic disabling disease….

Prevention / Intervention

Screening tools can be a cost effective means of identifying patients who are at risk for developing pressure ulcers. These tools identify specific areas that need to be addressed and watched closely. After areas of risk are identified, targeted interventions can be put into place that can further reduce the risk of pressure ulcer development.

Knowledge of pressure ulcer prevention strategies is vital. Implementation of targeted prevention strategies may be dependent on the areas that have been acknowledged to be at risk. Education is the essential piece of pressure ulcer prevention. This includes education for staff at all levels, as well as patients and caregivers. Staff education should include information on the facilities specific policies and pressure ulcer prevention program. Staff should be educated on the risk assessment tool used, excellent skin assessment skills, how to consult the wound care specialist if need be and the importance of consultation….

Role of Staff Education in Pressure Ulcer Incidence in Long-Term Care Residents
Pressure ulcers (PUs), also known as bed sores, decubitus ulcers, or pressure sores, are formed where skin and tissue are squeezed between bone and an outside surface for long periods of time, often due to immobility ("Pressure Ulcer," 2002). The development of PUs is a common problem in long-term care of the elderly. A recent report by a national pressure ulcer organization estimates the prevalence of PUs in acute care at about 15%, with about a 7% incidence after admission (National Pressure Ulcer Advisory Panel, 2001).

Because PUs are so common, cause distress to the patient and their family, and can form the basis for litigation, it is important for the long-term medical care community to find ways to reduce their prevalence and incidence. Two commonly suggested solutions to the PU problem include identifying patients at risk using risk assessment….

Evidence-based studies that delineate how to manage and treat pressure ulcers have determined that the most effective approaches include keeping the wound moist, appropriate repositioning, using support surfaces, and proper nutrition. Non-traditional approaches, including electrical stimulation, hyperbaric oxygen, growth factors and skin equivalents, and negative pressure wound therapy, are also showing promising results (esources for Managing Hospital-Acquired Conditions, 2008).

Organizational level activities for dealing with hospital-acquired pressure ulcers include:

developing and adhering to a written plan and procedure for preventing and treating pressure ulcers educating and training staff in the care processes associated with skin assessment, staging of pressure ulcers, prevention strategies, and treatment modalities carefully selecting and provisioning the necessary equipment and supplies to prevent and treat pressure ulcers the measuring and monitoring of pressure ulcer rates that depend on honest, transparent reporting of all pressure ulcers (esources for Managing Hospital-Acquired Conditions, 2008).

The significance of this study in regards to nursing….

Peptic ulcer, often known as a peptic ulcer disease, is a painful condition of the abdomen resulting in mucosal erosion of the gastrointestinal tract usually by excessive acid (consult, 2007) these erosions can only be categorized as peptic ulcers if they are larger than 0.5cm in diameter. Peptic ulcers can be classified according to the location where they appear hence the ulcers occurring in the duodenum are known as duodenal ulcers, those occurring in the stomach are known as gastric ulcers and those in esophagus are known as esophageal ulcers. The causes of peptic ulcers majorly include special spiral bacteria known as Helicobacter pylori which produces excessive acid in the gastrointestinal tract and makes its mucosa eroded. Helicobacter pylori are responsible for at least 70-90% of peptic ulcers although only 40% of these cases are reported to the doctors. Another well-known cause of peptic ulcers is the excessive usage of….

Planning and Implementing Change
Pressure ulcers are one of the most serious concerns facing hospitals and nursing homes today. This is particularly the case with older people and those with serious disabilities that keep them bed-bound for an extended period of time. emaining in one position for too long can cause painful and severe pressure ulcers, which often require hospitalization and invasive intervention. Indeed, according to Perry et al. (2012), nearly 60,000 hospital patients in the United States die as a result of complications resulting from pressure ulcers they acquire in hospitals.

In addition to mortality, the financial costs can also be severe, with a single full thickness pressure ulcer requiring as much as $70,000 to manage. Indeed, the total cost of treatment for pressure ulcers in the country is estimated at $11 billion per year.

Obviously, the effects of these costs are severe, including many stakeholders, including those suffering from pressure ulcers,….