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 which factor as the likely cause?

Question

a. Esophagitis
b. Perforated gastric ulcer
c. Gastric irritation from the Salem sump tube
d. A physiologic stress ulcer

Answer 1

D
Prolonged physiologic stress produces what is known as a physiologic stress ulcer, which is be-lieved to be the result of unrelieved stimulation of the vagus nerves 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. Perforation occurs occasionally, and pain is rare. Stress ulcers are a hazard for patients who are severely ill and in intensive care units for prolonged periods. Patients with multiple trauma, burns, or multisystem disorders are subject to physiologic stress ulcers, which may produce blood that has been in contact with gastric juices.