2)case scenario


The patientwas admitted on January30, 2021at7:00am with achief complaint of abdominalpain 8/10 with hematemesisandmelena,was admittedto malemedical wardofEastAvenue MedicalCenter, hookedto D5NR 1L X 12hours at DF of 15. Admitto:

Diet:NPO, thenregular diet no coffee ortea

Vital signs:Every 4 hours, posturalBP

IVF tofollow: D5NR 1L X 12hours, D5NM 1L X12hours,(thenalternately)

Diagnostics:Bariumswallow, FecalOccult Blood, CBC, Urinalysis, Na, K, Amylase, Ca, ECG, Wholeabdomen Ultz, UpperGI endoscopy

Monitor:Pain,Bleeding

Therapeutics:Medical Management

1.Medications:Sucralfate(Iselpin) 1gram in 20 ml water QID 1 hour before meals and at bedtime,Omeprazole40 mgTIV every 12hours,Metronidazole500mg/100ml 1bottle TIV every 8 hours, Clarithromycin500 mgpowdered diluted to distilled water TIV every 12 hours,Tramadol(Tramal)50mg/ml TIV PRN for pain, Plasil5mg/mlPRN.
2.NursingManagement

Bed sidecare

Assess GIstatus to monitor signs of bleeding

Monitor andrecords, V/S, I and O, and lab studies

Relieve ofpain by adherence to medication and avoid foods that cause mucosalirritation

DAT to meetthe metabolic demands and promote wound healing

NGT insertionfor saline lavageuntil returnis clear if bleeding is present

Maintainposition and patency of low suction of NGT

Bloodtransfusion of PRBC 4 units of blood after properly checked andcross matched

3.Watch out forcomplication

QUESTION

1)MAKE 2 NCPFOR THIS CASE

2) makeDiagnostics test result for the following :Bariumswallow,Fecal Occult Blood, CBC, Urinalysis, Na, K, Amylase, Ca, ECG, Wholeabdomen Ultz,Upper GI endoscopy

1 NCP for peptic ulcer disease
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