Nursing assessment of the child with peptic ulcer disease begins with a thorough history, including a family history of ulcer disease, past episodes of abdominal pain, or recent stressful events in the home, school, or community. A complete assessment of pain includes a description of the nature of the pain and its location ; its relationship to meals, defecation, or voiding; episodes of nocturnal pain; and medications used to effectively relieve the pain. The child is examined for the presence of epigastric tenderness, nausea, vomiting, abdominal distention, hematemesis, melena, or recent changes in appetite or eating habits.