The nurse is caring for a patient who is being treated for extensive burns. The nurse notes the presence of coffee-ground material in the Salem sump catheter. The nurse correctly recognizes that the probable cause is:
a. esophagitis.
b. perforated gastric ulcer.
c. gastric irritation from the Salem sump tube.
d. a physiologic stress ulcer.
D
Blood that has been in contact with gastric juices looks like coffee grounds. The physiologic stress ulcer appears in patients who are severely stressed by extensive trauma for a lengthy period of time. Prolonged physiologic stress produces what is known as a physiologic stress ulcer, which is believed to be the result of unrelieved stimulation of the vagus nerve and decreased perfusion to the stomach. A stress ulcer is pathologically and clinically different from a chronic peptic ulcer. It is more acute and more likely to produce hemorrhage.
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