Question

thnd. for the n- a, a, ia ㄧ CASE STUDY B Peptic Ulcer and Peritonitis Ms. X., age 76, has been admitted throu t s department with severe generalized abdominal y ing. No significant findings were immediately evidean o cate a cause. Six hours later, Ms. X.'s blood drop, and her pulse was rapid but thready. Exploratory ahd nal surgery revealed a perforated gastric ulcer and 1. Describe the process by which an ulcer develops. 2. Suggest several possible factors contributing to ulcer omi- formation 3. Explain why peptic ulcer may not be diagnosed in an earl stage of development. 4. Describe the process of perforation of an ulcer and the development of bacterial peritonitis. 5. Explain why Ms. X. showed signs of shock. Following surgery, Ms. X. had no bowel sounds, and her abdomen was distended. 6. Describe how paralytic ileus could have developed. Ms. X. was given antibiotics, intravenous fluids, and intravenous alimentation (total parenteral nutrition). 7. Explain the reason for each of these treatments. 8. Explain why older individuals may have difficulty in compensating for fluid and electrolyte imbalances. 9. List other poten tial complications of immobility for whic Ms. X. is at risk during a prolonged recovery

Answer 1

Case study B: Peptic ulcer and Peritonitis

Case Sludly B : Replic Uley and Periotis 1. Desesibe the Process veloPs Pe ptic ulcavs are open Sons thel deve lop on the inside a{the lin Stomach and proximal uodainum. Aud o Pepsn Penethate the mucosal barrieys the tissuer get e "sed to Continues amoge becaus e Gcid walTe ulee penethati more clapl nt the muclaris and nal Pe larcl the a Sugest Several possible lactors Contributim 4 Inadspuat blood Sry eauted by- Scar tissua, anemia Protact against acid B. NSAIDs Such as Aspin Abopluy

diagnosed a ean symptomsィPeptic ul cri in anca, IcT elleve -Thisis oplen Confused wrth ん art b01n and may not occur eaiy dlelechon the diseae 4. Desenbe the Proass af Peifo ation of an ulce1 and the development af bade, ia) Peitonitis through the wall Prfovation occuYS . Thir clyme to ender the eioneal Cavi C Causes and Caur inlanahon Peritonaal memb and othet Strucues n ts abdominal Cavily. This nfluntn evetuay Cause toneal membrale Peritonitis 5. ExplhinW Ms. X Shard s

Plse Shock Cdhop in 3.P Tapd but thyead ls ypo volemia oecurs be cause elechalytes and roleinsSasted i eavilg are not aaycled int also ald to、 {lead loss G Descoibe houo Pavalytie ileus could have diveloped )stalsis meve Conduction is impaived and peyis decrases Reaclnt intestinal obstruction the . Explain the Teasons ol each trealmunts teal nfection A nti biotics T Lon inle Su mentation art lakan, So S arven

Explain wall old어 individuals nnad have ancos Olde peope lhae dae raiedl kuluy net unchon tTeaased mephnon foncton changes Tenal vessels , dacreased alomvolarfi Compensating fo Plaid and elecholga l ation nata elc. This makes cult 9、 List c they Potential Complications af 1S immobility for whuch Ms. x is at nisk Boros : Bones become s Sparer Like( g t and necros, sa( tissue. Tenure- olcevs Skin :工schaatnia Develops Pree vlevs Connactrve issves : Tendons, ligaments and undei go chaurges Muscle : Musele atroply Muscle Strergtu Cabilger u il be losl