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Bed 6 Dx : Duoenal Ulcer with acute hemorrhage with H. Pylori with severe…

- - - - Patients should be under regular visual observation and, for every unit transfused, minimum monitoring should include:
      - Pre-transfusion pulse (P), blood pressure (BP), temperature (T) and respiratory rate (RR).
      - P, BP and T 15 minutes after start of transfusion – if significant change, check RR as well.
      - If there are any symptoms or signs of a possible reaction – monitor and record P, BP, T and RR and take appropriate action.
      - Post-transfusion P, BP and T – not more than 60 minutes after transfusion completed.
      - Inpatients observed over next 24 hours and outpatients advised to report late symptoms (24-hour access to clinical advice).
      - Observe signs including itching, rashes, palpitation, fever, chest pain.
    - - The patient has no signs and symptoms of UGIB including tarry-colored stool, Hematemesis, or vomiting of blood, Fainting, Lightheadedness, Fatigue, Abdominal pain.
        
        The patient doesn’t has side effects of Contoloc.
        
        The patient doesn’t has signs and symptoms allergies of LPRC.
        
        Laboratory results are stable on baseline of the patient including Hb 6.2 g/dL, Hct 23%
- - - - Assess the patient in history of medication use by asking the patient how to use the medicine. What’s medicine use for treat himself.
      - Allow the patient to open up about previous experience and health teaching. Older patients often share life experiences to each learning session. They learn best when teaching builds on previous knowledge and experience.
        
        Acknowledge racial/ethnic differences at the onset of care. Acknowledgement of racial/ethnicity issues will enhance communication, establish rapport, and promote treatment outcomes.
        
        Consider the patient’s learning style, especially if the patient has learned and retained new information in the past.
        
        Educate the patient about over-the-counter drugs and avoid products that contain aspirin or NSAIDs such as ibuprofen and naproxen. These drugs not only decrease normal platelet aggregation but also decrease the integrity of gastric mucosa through inhibition of cyclooxygenase (COX)-1 inhibitor and therefore increase the risk for gastrointestinal bleeding.
        
        Educate the patient and family members about limiting the use of herbal remedies that are linked with an increased risk for bleeding like dongquai, feverfew, ginger, ginkgo biloba, and chamomile. Most herbal preparations interfere with platelet aggregation through inhibition of serotonin release from the platelet. Other herbs increase the effect of antiplatelet and anticoagulant medications, thus increasing the risk for bleeding.
        
        Assess the patient by the patient can answer questions about OTC NSAID use for prevention UGIB 4 out of 5 questions.
      - Evaluation
        
        The patient has more understands in NSAID use.
        
        The patient can answer questions about OTC NSAID use for prevention UGIB 5 questions correctly.
- - - - Signs and symptoms of GI bleeding can be either obvious (overt) or hidden (occult). Signs and symptoms depend on the location of the bleed, which can be anywhere on the GI tract, from where it starts the mouth to where it ends the anus and the rate of bleeding.
        
        Overt bleeding might show up as : Vomiting blood, which might be red or might be dark brown and resemble coffee grounds in texture, Black or tarry stool, Rectal bleeding, usually in or with stool
        
        With occult bleeding, you might have : Lightheadedness, Difficulty breathing, Fainting, Chest pain, Abdominal pain
        
        Symptoms of shock If your bleeding starts abruptly and progresses rapidly, you could go into shock. Signs and symptoms of shock include : Drop in blood pressure, Not urinating or urinating infrequently, in small amounts, Rapid pulse, Unconsciousness
    - - MIRACID used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).
      - Amoxicillin is used to treat a wide variety of bacterial infections. This medication is a penicillin-type antibiotic. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
      - Metronidazole is an antibiotic that is used to treat a wide variety of infections. It works by stopping the growth of certain bacteria and parasites.This antibiotic treats only certain bacterial and parasitic infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.Metronidazole may also be used with other medications to treat certain stomach/intestinal ulcers caused by a bacteria (H. pylori).
      - Klacid is used to treat certain bacterial infections, such as respiratory tract infections, skin infections, peptic ulcer.
      - FBC This medication is an iron supplement used to treat or prevent low blood levels of iron (such as those caused by anemia)
      - Sucralfate, sold under various brand names, is a medication used to treat stomach ulcers, gastroesophageal reflux disease, radiation proctitis, and stomach inflammation and to prevent stress ulcers. Its usefulness in people infected by H. pylori is limited. It is used by mouth and rectally.