You admitted a patient with hypotensive crisis with the following data and doctors patient juan dela cruz 45 years old NGT for gavage feeding every 4 hours
With indwelling foley catheter for urine output monitoring
6:30 a. m. clients vs bp =70/40 rr = 15 pr = 59 o2sat = 98%
doctor's order fluid regimen
R hand start ivf off d5lrs 1 liter to run 48 hours using macro set with slide drift of levophed to ampules + 96 cc of pnss x 15 ugtts per minute
second line le start ivf pnss 1 l x 10 gttsper minute start blood transfusion of two unit prbc once available properly type and crossmatch
you receive the patient at exactly 7:00 a. m. and started the fluid regimen
8:00 a. m. started gavage feeding of 1 glass osterized feeding with 1/2 glass of plain water to dilute the feeding
8:00 a. m. urine output
8:30 a. m. pack rbc for blood transfusion available
9:00 a. m. started blood transfusion with 250 ml of 1 unit prbc to run for 4 hours no reactions noted
12:00 noon next feeding do but the patient was restless was not available to give the full feeding remaining half glass was discarded
1:00 p. m. urine collected is 200ml
1:30 p. m. finish one prbc, hooked 2nd prbc with same rate
3:00 p. m. no urine output recorded
End of Shift
instruction complete the intake and output form every two hours
8-9:00 a. m.
9 to 10
10-11
11-12
12-1
1-2
2-3​

Harold, a fifty-eight year old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. this was happening several nights a week. he was also experiencing occasional discomfort in the middle of the afternoon. harold decided to schedule an appointment with his physician. the doctor listened as harold described his symptoms and then asked harold some questions. he noted that harold's appetite had suffered as a result of the pain he was experiencing and as a result of the fear that what he was eating may be responsible for the pain. otherwise, harold seemed fine. the doctor referred harold to a physician that specialized in internal medicine and had harold make an appointment for a procedure called an endoscopy. the endoscopy was performed at a hospital later that week. during the procedure, a long, thin tube was inserted into harold's mouth and directed into his digestive tract. the end of the tube was equipped with a light source and a small camera which allowed the doctor to observe the interior of harold's stomach. the endoscope was also equipped with a small claw-like structure that the doctor could use in order to obtain a small tissue sample from the lining of harold's stomach, if required. the endoscopy revealed that harold had a peptic ulcer. analysis of a tissue sample taken from the site showed that harold also had an infection that was caused by helicobacterpylori bacteria. the doctor who performed the endoscopy gave harold prescriptions for two different antibiotics and a medication that would decrease the secretion of stomach acid. the doctor also instructed harold to schedule an appointment for another endoscopy procedure in 6 months. 1. list the subjective findings in this case study. 2. what is an endoscopy? (2 points) what is a biopsy? 3. how was a biopsy performed on harold? 4. differentiate between gastric and duodenal ulcers by location. 5. what role does h. pylori play in the formation of peptic ulcers? 6. define occult and frank blood. (4 points) what is a guaiac test? 7. how can peptic ulcers cause bleeding? 8. why were antibiotics prescribed? 9. why would a medication that would decrease the secretion of stomach acid be beneficial?

Anurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. which of the following statements by the client indicates an understanding of the teaching? a. “i can take two aspirin to treat headaches.” b. “i should avoid dairy products when taking this medication.” c. “i can expect fine hand tremors when taking this medication.” d. “i should not take an antacid within 1 hour of taking this medication.”

Anurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. which of the following findings should the nurse include as risk factors for an adverse drug reaction? (select all that apply.) a. decreased percentage of body fat b. polypharmacy c. multiple health problems d. increased rate of absorption e. decreased renal function