A Brief Note On Onset Of Black Tarry Stools And Development Of Diarrhea

You are the nurse working in an anticoagulation clinic. K.N. is a patient who has a longstanding irregularly irregular heartbeat (atrial fi brillation, or A-fi b) for which he takes the oral anticoagulant warfarin (Coumadin). Recently, K.N. had his mitral heart valve replaced with a mechanical valve. You know that there are different PT/INR (prothrombin time/International Normalized Ratio) goal recommendations based on the indication for anticoagulation. (NOTE: PT has now been replaced by or is reported, in most cases, with INR [International Normalized Ratio], an international value that allows for laboratory standardization. PTT is more properly written

Mindy Perkins is 48 year old woman who presents to the ED with 10- 15 loose, liquid stools daily for the past 2 days. She completed a course of oral Amoxicillin seven days ago for a dental infection. In addition to loose stools, she complains of lower abdominal pain that began 2 days ago as well. She has not noted any blood in the stool. She denies vomiting, fever, or chills. She is on Prednisone for Crohn’s disease as well as Pantoprazole (Protonix) for severe GERD.

B.S. is an 81 year old Caucasian female presenting with abdominal pain, diarrhea, nausea and vomiting in the emergency room on February 3, 2013. B.S. has a history of glaucoma, hypothyroidism, degenerative arthritis and diverticulosis. She has allergies to iodine and vicodin. B.S. is admitted for diverticulitis with possible partial bowel obstruction and hydronephrosis. B.S. was admitted on February 3, 2013 here at Verdugo Hills Hospital.

The current state of his intestinal milleu is probably in a pretty acute state of dysbiosis considering pathogenic growth is fostered by unarrested growth, and added substrate allowing gut permeability to occur due to the following factors:

A thorough history is essential when a pediatric patients presents with bloody diarrhea, and knowing what disease processes commonly affect certain age ranges will also help lead the provider to the proper diagnosis. Questions should be directed according to the patient's age. Some essential questions to ask the parents will entail questions about the amount of blood, the exact color (bright red, dark, tarry, maroon, etc.), how many episodes, how many days, pain, emesis involved, history of straining with bowel movements, abdominal pain, trauma, travel, ill contacts, food consumed, current medications, and any other associated symptoms. Knowing whether the blood is mixed in the stool or dark red blood may suggest a proximal source with some

A review of her medical records indicates that she has a positive occult stool. Her HGB is 7.9 where as her previous HGB was 8.2. She is schedule to follow up with a GI specialist. She suffers from poorly controlled hypertension, poorly controlled bilateral leg edema- she refused to elevate her legs. She also suffers from type 2 DM which is controlled with medication.

Diagnostic studies such as, endoscopy, CT scan, abdominal ultrasound, lack intolerance, celiac disease and blood test to rule other symptom cause. Patient can be test for food allergy, bacteria and parasite. Surgery for obstruction and video assist endoscopy. Treatment is individualizes, fibers, antidiarrheal, antispasmodic (reduce muscle) anti-constipation (regulate bowel) sedative and antidepressant (relief anxiety and mood swing) can be used for both IBS and IBD. Similar treatment used in UC can be used in CD to make a differential diagnosis. Stool culture check for infection. Mesalamine products (5-aminosalicylic acid) is treatment of choice. Corticosteroids and immunosuppression to reduce inflammatory process. Severe disorder requires resting and placing the patient on TPN (malnutrition). Surgery if necessary in severe cases of total proctocolectomy, with end ileostomy, ileorectal anastomosis or ileal pouch anal anastomosis for obstruction, hemorrhage and perforation.

As an advanced practice nurse (APN), it is common to see people with gastrointestinal (GI) disorders. For the purpose of this discussion, I will evaluate the case study #2 and give a differential diagnosis with an explanation. I will discuss how the physical examination and patient history plays a role in the diagnosis and provide examples of treatments based on the diagnosis.

A malrotation of the gut occurs when something goes wrong during development the small intestine (gut or small bowel). When this occurs, the small intestine is not fixed in the abdomen (belly). The intestines are held by just their blood supply. When the intestines become twisted, because they are not fastened down, it cuts off their blood supply. It is much like a hose getting kinked. This loss of blood supply leads to damage to the gut. This condition is also called volvulus.

- Presents as pain in the back followed by weakness or numbness, change in the normal bowel or bladder habits 3

This is a 60 year-old male with a past medical history of hypertension who presented with several week history of recurrent fever accompanied by poorly localized abdominal pain. His physical examination revealed an acutely ill-appearing man with tender hepatosplenomegaly.Routine laboratory workup revealed pancytopenia, transaminitis as well as elevated alkaline phosphatase and

Added to that, poor bowel habits, the irritable bowel syndrome, hemmoroids, pregnancy, medications, and laxative abuse. A person can initiate a cycle of constipation by disregard the urge to have a bowel elimination . Some people do this to avoid using public toilets, others because they are too busy or did not have enough time. After A period of time, a person may stop feeling the urge. So, the people should prevent the causes of altered intestinal elimination to avoid the constipation and its

A UC can be easily induced in animals by administering either the chemicals or bacterial infection. [46]. An ideal experimental model should mimic human UC quite closely, simple to induce, cheap and highly reproducible. Unfortunately, human UC is so complex that there is no single model that fully imitates it [46] but every model of colitis contributes valuable observations into one or another major aspect of the disease, and together they have provoked the formation of now a generally accepted set of the principle of human UC pathogenesis [59]. Amongst that different causes of induced or genetically based inflammation give rise to a limited number of common pathways of immunopathogenesis; normal resident gut microbiota can lead to an intestinal inflammation; loss of oral tolerance and alteration of the epithelial barrier contribute to the development of intestinal inflammation; and polarized T helper cell responses, as well as defects in innate immunity, mediate disease [12].

Diarrhea or otherwise, even experienced constipation (difficult bowel movements). In case of constipation, bias assisted by enema or kolonhidroterapi (intestinal washing) muscle or joint pain

Hemorrhoids are a very common gastrointestinal disease that seen in obesity, elderly, and pregnancy. Hemorrhoids results are from an increased blood pressure of the veins in the rectum. From having this pressure by (“Zelman, M. Ph.D., Tompary, E., Raymond, J. Ph. D., Holdaway, P. MA, & Mulvihill, M.L. Ph.D”, 2010) “straining or even high blood pressure”, causes the veins to swell in that area making it painful for sitting. Hemorrhoids are a treatable gastrointestinal disease; a physician can prescribe a hemorrhoid cream, which found over the counter in every pharmacy. Stool softeners can also be used to prevent the hemorrhoids from pushing outwards; surgery is another preventable option to help with this gastrointestinal disease. Changing the