Peptic Ulcer Disease — NCLEX Cheat Sheet
H. pylori + NSAIDs = ulcerAlso known as: stomach ulcer · duodenal ulcer · gastric ulcer · PUD · ulcer
Use this quick-reference guide to spot, treat, and prevent Peptic Ulcer Disease on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
⚠️ Causes
- H. pylori, NSAIDs, ↑ stomach acid
- smoking, ETOH, stress, steroids
🩺 Signs
- gastric: pain WITH food
- duodenal: pain 2-3h AFTER, relief w/ food
- epigastric burning, dyspepsia
🚩 Report
- coffee-ground emesis, melena → bleed
- rigid board-like abd → perforation
- sudden severe pain, ↓BP, ↑HR
🧪 Meds
- triple Tx: PPI + 2 antibiotics
- PPIs (-prazole), H2 (-tidine)
- sucralfate on empty stomach
📌 Avoid
- NSAIDs, aspirin, caffeine, ETOH
- no smoking → delays healing
📚 Peptic Ulcer Disease — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Gastric ulcer pain increases with food intake; duodenal ulcer pain is relieved by food and recurs 2-3 hours after meals.
- Helicobacter pylori infection and NSAID/aspirin use are the leading causes.
- Burning or gnawing epigastric pain is the classic symptom.
- Bleeding ulcers cause hematemesis (coffee-ground or bright red) and melena.
- Perforation causes sudden, severe, board-like rigid abdomen with rebound tenderness.
- Duodenal ulcers are more associated with nighttime pain and weight stability; gastric ulcers with weight loss.
Nursing priorities
What to do, in order- Administer proton pump inhibitors or H2 blockers to reduce acid and promote healing.
- Give antibiotic combination therapy for H. pylori eradication as prescribed.
- Monitor stools and emesis for occult or frank blood and watch for signs of bleeding.
- Teach avoidance of NSAIDs, aspirin, alcohol, caffeine, and smoking.
- Assess pain pattern in relation to meals to distinguish gastric from duodenal ulcers.
Red flags — report now
Escalate immediately- Sudden severe abdominal pain with a rigid board-like abdomen indicates perforation, a surgical emergency.
- Hematemesis or melena with vital sign changes signals active GI hemorrhage.
- Signs of shock (tachycardia, hypotension, cool clammy skin) require immediate intervention.
Labs & values
Numbers to know- Hemoglobin: 12-18 g/dL (decreased with bleeding)
- Hematocrit: 37-52% (decreased with bleeding)
- H. pylori test (urea breath/stool antigen) positive
Patient teaching
What patients must know- Avoid NSAIDs, aspirin, alcohol, caffeine, and smoking, which damage the mucosa.
- Complete the entire H. pylori antibiotic regimen even if symptoms improve.
- Report black tarry stools, vomiting blood, or sudden severe abdominal pain immediately.
❓ Peptic Ulcer Disease: NCLEX FAQs
What are the priority nursing interventions for Peptic Ulcer Disease?
Administer proton pump inhibitors or H2 blockers to reduce acid and promote healing. Give antibiotic combination therapy for H. pylori eradication as prescribed. Monitor stools and emesis for occult or frank blood and watch for signs of bleeding. Teach avoidance of NSAIDs, aspirin, alcohol, caffeine, and smoking.
What are the warning signs of Peptic Ulcer Disease a nurse must report?
Sudden severe abdominal pain with a rigid board-like abdomen indicates perforation, a surgical emergency. Hematemesis or melena with vital sign changes signals active GI hemorrhage. Signs of shock (tachycardia, hypotension, cool clammy skin) require immediate intervention.
What do I need to know about Peptic Ulcer Disease for the NCLEX?
Gastric ulcer pain increases with food intake; duodenal ulcer pain is relieved by food and recurs 2-3 hours after meals. Helicobacter pylori infection and NSAID/aspirin use are the leading causes. Burning or gnawing epigastric pain is the classic symptom. Bleeding ulcers cause hematemesis (coffee-ground or bright red) and melena.
What patient teaching is important for Peptic Ulcer Disease?
Avoid NSAIDs, aspirin, alcohol, caffeine, and smoking, which damage the mucosa. Complete the entire H. pylori antibiotic regimen even if symptoms improve. Report black tarry stools, vomiting blood, or sudden severe abdominal pain immediately.
Quick Tip
Gastric ulcer pain increases with food intake; duodenal ulcer pain is relieved by food and recurs 2-3 hours after meals.
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