What does coffee ground material indicate

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Reference no: EM133634292

Assignment

Case study PUD/UGI bleed

Cedric Fillmore, age 40, came to the emergency room after reportedly vomiting a large of bright red blood. His bleeding was controlled via an endoscopic procedure and the presence of a large duodenal ulcer was noted at the time. After undergoing the endoscopic procedure, Mr. Filmore received 2 units of packed red blood cells (PRBCs).

This is Mr. Filmore's third episode of ulcer disease. He is a truck driver and has difficulty maintaining a normal eating schedule. His ulcer biopsy was positive for h. pylori and he is now admitted to the medical-surgical floor for further treatment.

Current medications are Naproxen sodium 200mg PO 3 times per day and Omeprazole 40mg PO BID

Question I: Analyzing cues: Identify 5 of the underlining/listed data you want to pay specific attention to in your physical exam and WHY?

Question II: Which of these meds could be an underlying cause of upper GI bleeding and WHY?

MR. Filmore has a nasogastric tube connected to intermitted suction and intravenous (IV) solution of D5 1/2 normal saline with potassium chloride 20m/Eq/ Liter@ 100ml/hour via infusion pump. There is an order to irrigate the NG tube with 30 ml noral saline Q4hours and prn.(The nurse notes that the NG tube is draining coffee ground material).

Question III: Why is potassium being added to his IV when his K+ is WNL?

Question IV: What does coffee ground material indicate?

Mr. Filmore tells the nurse that he normally drives his truck at least 12 hours every day and he eats after stopping for the night. He generally eats fast food and smokes 2 packs of cigarettes per day. When he was getting stomach pain during the night, he would take a "couple of aspirin." The nurse diagnosis established is: Ineffective Health maintenance related to a lack of knowledge about contributing factors manifested occurrences of peptic ulcer disease.

Question V: Based on his information, list at least 5 teaching points that you would provide for MR. Filmore prior to discharge?

Reference no: EM133634292

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