Question

Caron eastlund

Caron Eastlund ge: 66 years Weight: 61.0 kg Grandma Smokey Background Patient History Past Medical History: Has a long history of rheumatoid arthritis Allergies: No known allergies Medications: Celecoxib 400 mg PO twice a day, ibuprofen 400 mg PO every 6 hours Code Status: Full code Social Family History: Retired administrative assistant for a brokerage firm. Her husband died of a heart attack six weeks ago. Her daughter is divorced with two teenage children and lives two cities away. Prior to her husband's death, the patient only drank or smoked at social outings. She now smokes two packs of cigarettes a day and drinks 5 to 6 alcoholic beverages a day. The daughter reports that the patient has not been out of the house since her husband's funeral. She presented for direct admission to the Medical-Surgical Unit with reports of coffee-ground emesis and black tarry stools at home. She has a history of rheumatoid arthritis for which she takes celecoxib twice daily and ibuprofen as needed for breakthrough arthritis pain. Initial Healthcare Provider's Orders: Admit to Medical Surgical Unit, Full code. Diagnosis: Chronic gastrointestinal bleed NPO Continuous oxygen saturation and cardiac monitoring Vital signs every 2 hours x 2. then every 4 hours, notify healthcare provider of heart rate greater than 130. blood pressure less than 80/40, respiratory rate greater than 30, temperature greater than 38.6 C. critical labs or worsening symptoms Bedrest IV normal saline at 50 mL/hr STAT labs: CBC, basic metabolic panel, PT, PTT, INR and arterial blood gases Hemoglobin and hematocrit every 6 hours Chest x-ray, posteroanterior and lateral views STAT

Answer 1

Answer: In the above mentioned case, the patient is suffering from GI bleeding. The increased alcohol consumption leads to inflammation in liver. The alcohol is one of the major risk which causes gastrointestinal bleeding. Alcohol abuse causes hepatitis and hence damage the liver. This causes duodenal ulcer and hence chronic gastrointestinal bleeding occurs. The other factor is the cigarette. This also increases risk of respiratory diseases and causes ulceration in the gastrointestinal part. The poor diet and improper lifestyle increases risk of chronic diseases.