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PN 200 Fundamentals of Nursing II Case Study - Peptic Ulcer - Mylanta/Zantac Jessie Holmes, a 48-year-old patient, complains of gawing, 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? 3. What nonpharmacologic measures can you suggest to alleviate symptoms related to peptic ulcer? The health care provider prescribes Mylanta 2 teaspoons to be taken 2 hours after meals, and ranitidine (Zantae) 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. 4. Mr. Holmes asks the purposes for Myianta and ranitidine. What is the nurse's best answer? 5. 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? 6. In what ways are ranitidine and cimetidine (Tagamet) the same and how do they differ? Explain your answer. 7. As part of patient teaching, the nurse discusses side effects or ranitidine. What is the most effective manner to teach this patient? Develop a patient teaching care plan for this 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. 8. What nursing interventions should be takin in regard to his alcohol intake?!

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Answer 1

1. Peptic ulcer is the chronic inflammation of the digestive tract .  Gastric and duodenal ulcers are types of peptic ulcers, which are open sores in the lining of the digestive tract. Gastric ulcers form in the lining of the stomach. Duodenal ulcers develop in the lining of the duodenum, which is the upper part of the small intestine.

2. Predisposing factors of peptic ulcer are :-

- genetic factors

- mechanical disturbance

- environmental factors

- stress

- smoked food

- use of NSAIDS

- eating spicy food

- alcohol consumers

- smoking

- H.pylori

Additional information needed from Holmes is about his diet , medication , alcohol and smoking history , origin etc

3. Non- pharmacological measures to alleviate symptoms of peptic ulcer are :-

1) avoid tobacco and alcohol

2) lose weight

3) avoid hot, spicy, and greasy foods

4) raise head of bed

5) don't eat before bed

6) wear loose fitting clothes

7) take NSAIDs (incl. aspirin) with foods or in decreased dosage

4. Purpose of Mylanta - used to treat symptoms of acid in stomach and also lowers the acid production in the stomach.

Purpose of ranitidine - it is an antiulcer , inhibits acid production . Heals and prevents ulcer ,decreases gastroesophageal reflux.