Question

Tolimentin 400mgm po tid (non-steroid NSAID) Doing a quick assessment, you find a pale man who is sleepy but arousable and oriented. He is still dizzy, hypertensive and tachycardia. You hear S 3 and S 4 heart sounds. Peripheral pulses are present and trace pedal edema is present. Lung sounds are clear. Bowel sounds are present, gastric tenderness is noted and the liver margin is 4cm below the costal margin. A Swanz-Ganz catheter and an arterial line are inserted. 1. State the home medication(s) that probably precipitated Mr. West's GI bleeding. 2. Explain the most serious potential complication of Mr. West's bleeding and the rationale for your selection. 3. Demonstrate documentation of the patient's admission assessment in the nurse's notes 4. Prepare a list of signs and symptoms (both direct and indirect) of GI bleeding and loss of fluid volume from the history the patient and wife gave you and from your assessment. 5. Prepare a list of additional complications that you would anticipate as a result of the patient's hypovolemia as well as the rational for your selections Mr. West receives a total of 4 units of PRBC's, 5 units of FFP (fresh frozen plasma) and many units of crystalloid solution to keep his systolic B/P above 90mmHg.

Answer 1

1- nsaid group of drug percipitat Gi bleeding

2- hypovolemic shock and encephalopathy are most potential serious complications

4 - sign and symptoms of gi bleeding

Hemoptysis- blood in vomiting, upper GI bleeding,most common cause gastric ulcer

Hematochezia - blooding per rectum ,lower gi bleeding

Patient are lethargic, abdominal pain, tachycardia, tachypnea