Question

PN 200 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. Differentiate between peptic ulcer, gastrie ulcer, duodenal ulcer, 1. 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 (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. 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 or ranitidine. What is the most effective manner to teach this patient? Develop a patient teaching care plan for this patient r. Holmes states he had a beer at lunch and has had two gin and tonics in the afternoon. He ates the drinks helps him to relax. S. What nursing interventions should be takin in regard to his alcohol intake?

Answer 1

1) Peptic ulcer disease characterized by sore or ulceration in the lining of the esophagus,stomach or duodenum. The common causative organism of peptic ulcer diseases is related to H pylori bacteria,excess usage of non steroidal anti inflammatory dugs, life style factors like smoking, skipping of food,constant stress.

- Gastric ulcer occurs in the lining of the stomach.Gastric ulcer pain occurs 1-2 hours after food intake. It can cause hematemesis or malena. Heart burn and chest discomfort are early signs. If left untreated results in cancer.

- Duodenal ulcer affects the lining of the duodenum. Duodenal ulcer pain 2-5 hours after eating. Pain is more during night time and chest discomfort is less severe when comparing to gastric ulcer.

2) Predisposing factors for developing peptic ulcer disease includes: smoking ( Nicotine in cigarettes interfere with gastric juices results in damage to the lining of the stomach). Excessive alcohol consumption, exposure to constant psychological stress, intake of junk and fried foods. Additional details to be collected from Mr Holmes includes nutritional history, life style,smoking and alcoholic history.

3) Non pharmacologic measures includes : Home care management of peptic ulcer includes life style modifications,cut down of smoking and alcohol consumption, proper intake of food, relaxation techniques like biofeedback,guided imagery to reduce stress.

4) The drug Mylanta consists of aluminum-magnesium hydroxide categorized under antacids. It works by reducing the acid level in the stomach. It neutralizes the acid present int eh stomach. Ranitidine is categorized under histamine 2 blockers it helps to reduce amount of acid produced by histamine receptors by blocking the histamine.

5) Ranitidine can take along with food in order to prevent indigestion. It helps to balance gastric juices necessary to neutralize the food thereby protecting gastric layers from acid erosion.