Question

On Wednesday, a 19 year old went to party where alcohol was served. After the party she bought cigarettes and was texting while driving and she drove off the road. In the car crash, she broke L tibia and fibula. She is on oral hormone contraceptives. She us now scheduled for surgery on Friday in the a.m.

Her orders are:

-Morphine 3mg IV every 4 hour PRN for pain

-Ibuprofen 800mg po 4x times a day

-Zofran 4mg IV every 4 hours PRN nausea/vomiting

Answer the following questions based on this patient.

1. what assessment data is relevant for the nurse when she is concerned about peptic ulcer development?

2. what interventions will you take as the nurse to help to keep this patient from getting an ulcer and why?

3. how will you know if this patient is developing an ulcer?

4. are the medications ordered for this patient appropriate? Explain.

5. are there other medications you think would benefit this patient, if so, what medications are they? and why?

6. You have decided to contact the physician regarding additional and alternate medications.

7. Write an SBAR to the admitting patient for this (these):

- Situation

-Background

-Assessment

-Recommendation

Answer 1

a 19-year-old came with broke L tibia and fibula.

Her orders are:

-Morphine 3mg IV every 4 hour PRN for pain

-Ibuprofen 800mg po 4x times a day

-Zofran 4mg IV every 4 hours PRN nausea/vomiting

1. While the examination nurse should concern that she is drinks alcohol and smokes cigarettes which are the risk factors for the peptic ulcers but now Ibuprofen is an NSAID (Non-sterodal anti-inflammatory drugs), which is the greatest risk factor for developing peptic ulcers.

2.

Peptic ulcer occurs due to acid imbalance in the stomach, that means excess acid in stomach damage the inner lining of the stomach and causes an ulcer.

The nurse can replace NSAIDs with other pain killers.

The nurse should encourage the client to drinks plenty of water.

Nurse encourages the client to avoid smoking

Avoid foods that irritate the stomach

3.

Signs and symptoms of peptic ulcer include

- Pain in stomach

- Nausea and vomiting

- loss of appetite

- heartburn and acid reflux

- burning sensation in the stomach

4.

PPI (Proton pump inhibitors) like pantoprazole and esomeprazole can inhibit the acid secretion of the stomach and reduces the chances of peptic ulcer.