Answered: What risk factors does Mr. B have for a…

Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)

6th Edition

ISBN:9781305964792

Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Chapter43: Specialty Laboratory Tests

Section: Chapter Questions

Problem 43.2CS

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Question

Mr. B is a 57-year-old man who was admitted yesterday after starting to pass black stools. He has a two-day history of severe stomach pains and has suffered on and off with indigestion for some months. He is a life-long smoker, with mild chronic heart failure (CHF) for which he has been taking enalapril 5 mg twice daily for 2 years. He also recently started taking naproxen 500 mg twice daily for arthritis. He works a stressful job and drinks large amounts of caffeinated coffee daily. Yesterday his hemoglobin was reported as 9.3 g/dL, hematoocrit 30%, RBC's 3.2, platelets 162, INR 1.1 with Liver Function Test normal. He was mildly tachycardic (110 bpm) and had a slightly low blood pressure of 100/77 mmHg and was given 1.5 L of saline. He has just returned from an endoscopy this morning and has been newly diagnosed as having a bleeding duodenal ulcer. They took a biopsy to determine if he is positive for H-pylori. He has been written up for his usual medication for tomorrow if he is eating and drinking again. What risk factors does Mr. B have for a bleeding peptic ulcer? Analyze lab values. Analyze vital signs. Describe the role of parietal and chief cells in PUD? Should Mr. B be given an antisecretory agent? Which one? State your reasons. If yes, what would you recommend? (Think of the 2 drug classifications that prevent the release of hydrochloric acid by the parietal cells) Has treatment been appropriate so far? What drugs should Mr. B be discharged on? What teaching would you give him about managing his condition? What follow-up should Mr. B have?

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