Question

Questions 5-8

PN 200 Fundamentals of Nursing II 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 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 ranitidin 4. Mr. Holmes asks the purposes for Mylanta 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 of 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 aftemoon. He states the drinks helps him to relax. 8. What nursing interventions should be takin in regard to his alcohol intake?

Answer 1

5. Since ranitidine reduces the acid in our stomach,it is best to have it with meals to prevent heartburn and acid indigestion. Also acidity is more during the time between meals due to acid production.

If Mylanta and ranitidine are taken together the amount of mylanta absorbed in to blood decreases and does not be effective. Since ranitidine decrease stomach acid and the other require gastric acid to be absorbed.

6. Ranitidine, is pharmacokinetically same to cimetidine.Both are H2 blockers.Ulcer healing time is Same for both.Compliance of drug is same.

Ranitidine is more potent than cimetidine. Ranitidine does not have anti androgenic side effects like that of cimetidine. Also ranitidine is more safe at high doses.

7. If patient develops difficult breathing, swelling of face ,hives,then emergency medical need is advised.Sometimes headache may occur.Other possible side effects include constipation, allergic reactions.

8. Alcohol intake for ulcer patients makes it more painful.It increases acid production and also pain from alcohol coming in contact with ulcer.It irritates stomach lining.

Nursing management include assessment for pain , assessment for pain relieving measures, administer medication prescribed, assist patient to understand his condition and factors which aggravates it, and also make him aware of why alcohol needs to be avoided.