Question

Case Study - Peptic Ulcer- Mylanta/Zantac Jessie Holmes, a 48-year-old patient, complains of gnawing, aching pain in the abdominal area that usually occurs several hours after eating. He says over-the-counter antacids help somewhat but the pain has recently intensified. Diagnostic tests indicate that the patient has a duodenal ulcer. 1. Differentiate between peptic ulcer, gastric ulcer, duodenal ulcer, 2. What are the predisposing factors related to peptic ulcers? What additional information do you need from Mr. Holmes? . What nonpharmacologic measures can you suggest to alleviate symptoms related to peptic ulcer? The health care provider presceribes Mylanta 2 teaspoons to be taken 2 hours after meals, and ranitidine (Zantac) 150 mg twice a day. The dose of magnesium hydroxide and aluminum hydroxide with simethicone (Mylanta) be taken one hour before or one hour after ranitidine. Mr. Holmes asks the purposes for Mylanta and ranitidine. What is the nurse's best 4. answer? Why does the health care provider suggest that the patient take ranitidine with meals? Why should Mylanta and ranitidine not be taken at the same time? 5. In what ways are ranitidine and cimetidine (Tagamet) the same and how do they differ? Explain your answer. 6. As part of patient teaching, the nurse discusses side effects or ranitidine. What is the mos effective manner to teach this patient? Develop a patient teaching care plan for this 7. patient. Mr. Holmes states he had a beer at lunch and has had two gin and tonics in the afternoon. He states the drinks helps him to relax. What nursing interventions should be takin in regard to his alcohol intake? 8.

Answer 1

1.

Peptic ulcer	Gastric ulcer	Duodenal ulcer
Ulceration in the lining of lower esophagus or stomach continuous till eating Pain settles after eating	ulceration inbthe stomach Continue till eating Pain settles after eating	ulceration in the duodenum Discomfort starts after 1 to 1 1/2 hours of eating Pain starts after eating

2.Some of the predisposing factors of peptic ulcer are

• Age (usually above 50 years)
• Medical conditions and medications (NSAIDS,corticosteroids, Pain killer)
• Abdominal surgery
• Helicobacter pylori infection

Some of the additional information which can be collected are

• His food habits,lifestyle
• History of alcohol,smoking, drug
• Description of the nature of pain

3.Some of the non pharmacological action which can alleviate pain are

• Changing  dietary habits ( avoid meat, high spicy foods,soft drinks)
• Avoid smoking and alcohol
• Vascular laser blood radiation reduces the production of acids is a non pharmacological intervention
• Reducing stress

4.Mylanta is an antacid which is used to treat severe symptoms like heart burn,acid indigestion.This works on the acid already present in the stomach but do not stop the production of acid.This drug works better when taken after food So this is combined with other drug which stops or controls acid production.

Ranitidine is a H2 receptor antagonist which reduces the production of acids and prevents reversing. So it is to be taken before meals.

5.Taking Mylanta after food is because the acids are produced after we eat,to neutralize or combat this it is recommended after meals.Taking Mylanta and ranitidine at the same time  is recommended because Mylanta acts faster so there are chances the acid getting dissolved easily and quickly simultaneously Ranitidine prevent production of acid which makes the stomach prone for bacterial infection without an adequate quantity of