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- CASE STUDY: A 26 year old woman appeared in the outpatient clinic with the complaint of abdominal discomfort, diarrhea, and an 18lb, unintentional weight loss during the past 2-3 years. She related a similar period of 5-6 years of abdominal distress and diarrhea in childhood, but this essentially disappeared when she was about 12-13 years old. She was now having three to five bowel movements daily, which were described as bulky, malodorous, and floating. She weighed 106lb and was 67 in tall. She never had surgical procedures. Physical examination revealed poor skin turgor, general pallor, and a protuberant abdomen. Abnormal clinical laboratory values included those in Case Study table 28.5.1 Fecal examination revealed no ova or parasites, and bacteriologic culture revealed no pathogens. CASE STUDY TABLE 28.5.1 Analyte Result Hemoglobin 8.1 g/dL Hematocrit 30% RBC count 4.1 X 10^6/uL Serum sodium…Case study: Constipation and pharmacological management of peptic ulcer A 75-year-old female patient has visited the clinic with a presenting history of not having had a bowel movement for four days. She states that she is ‘always regular or every day. She lives in a residential home and suffered a sprained ankle two weeks ago, for which she has been taking co-codamol, which has been effective in managing the pain. She admits that the injury has restricted her movements, and she has been unable to ‘get about’ as she usually does. She also reveals that she has been experiencing heartburn regularly, especially after a spicy meal or after a glass of whisky, which she sometimes takes to help her to relax since the injury. She has been taking an antacid for the last few days, which initially helped, but she is still experiencing indigestion. She has a past medical history of hypertension and persistent atrial fibrillation (AF), for which she takes digoxin 125micrograms od, aspirin 75mg od,…Case study: Constipation and pharmacological management of peptic ulcer A 75-year-old female patient has visited the clinic with a presenting history of not having had a bowel movement for four days. She states that she is ‘always regular or every day. She lives in a residential home and suffered a sprained ankle two weeks ago, for which she has been taking co-codamol, which has been effective in managing the pain. She admits that the injury has restricted her movements, and she has been unable to ‘get about’ as she usually does. She also reveals that she has been experiencing heartburn regularly, especially after a spicy meal or after a glass of whisky, which she sometimes takes to help her to relax since the injury. She has been taking an antacid for the last few days, which initially helped, but she is still experiencing indigestion. She has a past medical history of hypertension and persistent atrial fibrillation (AF), for which she takes digoxin 125micrograms od, aspirin 75mg od,…
- CASE STUDY: Nelson Amoah, 54-year-old male presents to the emergency department with abdominal pain, nausea, vomiting, abdominal distension and constipation which started 3 days prior to presentation. He denied fever, chills and headache. Except for peptic ulcer disease, he is otherwise healthy with no previous surgeries. He is a smoker, smoking a little less than a pack a day for twenty-two years. On examination he was afebrile, with a heart rate of 120 beats/min, blood pressure 130/80 mmHg and respiratory rate of 22 cycles/min. Abdominal examination revealed mild distension with generalized guarding and marked rebound tenderness in the epigastrium. There were no palpable masses and bowel sounds were absent. Erect and supine abdominal and chest radiographs were normal. However, abdominal ultrasonography revealed free fluid throughout the abdomen and pelvis. a. State at least FIVE questions that you would ask in analyzing Mr. Amoah’s pain b. Identify all;…5) Female,54 years old, with a history of gallstone for 8 years. Severe upper abdominal pain for 2 days radiating to the waist, accompanied by nausea and vomiting,and the blood amylase increased twice The following most valuable check is() A Abdominal X-ray B Upper gastrointestinal barium meal C ECG D Abdominal CT E Endoscopy12. Please provide a brief explanation of subtotal gastrectomy long-term consequences.
- 41. A newborn with esophageal atresia has just returned from surgery to place agastrostomy tube. Which nursing diagnosis will the nurse use to plan the care for thisclient?A. Risk for imbalanced nutritionB. Risk for deficient fluid volumeC. Risk for impaired thermoregulationD. Risk for ineffective gas exchangeCASE: PEPTIC ULCER DISEASE Chief complain: Mr. Garcia, a 57-year-old man, was admitted yesterday after he began passing black stools. He has a two-day history of severe stomach pains and has had indigestion on and off for several months. He undergoes an endoscopy this morning and has been newly diagnosed as having a bleeding duodenal ulcer. His doctor discharge him the same day and was given with a discharge medication order. Answer the following: 4. Following a review of the discharge medication order, the following are prescribed: enalapril 5 mg twice daily,omeprazole 20 mg twice daily, and furosemide 40 mg daily. It was documented that Naproxen should bediscontinued. What is the reason for this? 5. Will you recommend Mr. Garcia the use of antacids for his ulcer? 6. Considering the medical history of Mr. Garcia, below are some options that you can recommend to the doctor as a replacement for Naproxen, for his arthritis. Discuss which of the given will be suitable.• Paracetamol +…Please give briefly description of long-term complications of subtotal gastrectomy.
- Give typed explanation the nurse is aware that prolonged complications of bowel obstraction could result in tissue necrosis Nd bowel resection?Describe the nursing considerations for a patient with a gastrointestinal bleed.1.Please provide a brief explanation of subtotal gastrectomy long-term consequences.