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2 GI Medication Case Study 1

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Gastrointestinal Medication Case Presentation 1
“You are called in the early hours of the morning to a local residence in a lower income
area of town for a 47-year-old man who presents with severe abdominal pain that woke
him from his sleep. As you arrive on scene you notice the home is poorly maintained
with a moderate amount of “junk” around the property. You do not perceive any
immediate threats and you approach the front entrance where the door is open. You
announce yourself and your partner. The patient tells you to come in. As you enter you
find the patient, a thin, slightly emaciated man is sitting on the couch in obvious
distress. He has purposeful movements as you approach and ask his chief
complaint. In a clear voice using appropriate words he states he has intermittent
abdominal pain for a week and was awoken from his sleep about 15 minutes ago with
intense abdominal pain. You note his airway is clear, he is breathing rapidly and his
pulse is fast and easily felt. Your partner prepares the stretcher for transport while you
continue to ask history questions and assess vital signs. He describes the pain as an
intermittent “gas-like” pain in the epigastric region. He says he feels like he needs to
“burp.” He continues to describe it as a band like pattern around his upper abdomen
and lower chest. It is most intense when he lies flat but seems to have some relief
when sitting upright smoking a cigarette. He took two tablets of Naprosyn to reduce his
typical aches and pains in his knees and ankles. He reports mild nausea but has not
vomited. His last bowel movement was yesterday and described as a loose watery
stool of normal color. He denies chest pain, palpitations nor shortness of breath. He
denies chronic medical conditions and does not take any medications, OTC,

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prescription or herbal medications on a regular basis. He also denies recreational drug
use but admits from 6-8 beers daily. He denies allergies.
On physical examination, his temperature is 35.4°C (95.7°F), blood pressure 111/62
mm Hg, heart rate 97 beats per minute, and respiratory rate of 28 breaths per minute
sating 98% on room air. He is diaphoretic, skin is normal in color and warm. He is
unable to get comfortable on the gurney and is writhing in pain. Mucus membranes are
dry, eyes are non-icteric with pupils that are round, equal and react to light. His lungs
are equal, clear to auscultation with good excursion bilaterally. No rales or rhonchi are
found. The abdomen is exquisitely tender on palpation to the epigastric region and both
upper quadrants with focal rebound tenderness and guarding. No tenderness or
masses are felt in the lower quadrants”
Question no. 1 What other assessment or diagnostic information would you
gather on this patient?
For this patient, the following assessment and diagnostic information shall be sought:
1. Current and any past history of Helicobacter Pylorus infection as well as any
record of results of Helicobacter Pylorus test in the past.
2. Pattern of use of the Non-Steroidal Anti Inflammatory Drugs (NSAIDs), their side
effects observed by the patient in the past
3. Detailed smoking history of the patient.
4. Cardiac status of the patient as determined by electrocardiography or
echocardiography.

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Gastrointestinal Medication Case Presentation 1 “You are called in the early hours of the morning to a local residence in a lower income area of town for a 47-year-old man who presents with severe abdominal pain that woke him from his sleep. As you arrive on scene you notice the home is poorly maintained with a moderate amount of “junk” around the property. You do not perceive any immediate threats and you approach the front entrance where the door is open. You announce yourself and your partner. The patient tells you to come in. As you enter you find the patient, a thin, slightly emaciated man is sitting on the couch in obvious distress. He has purposeful movements as you approach and ask his chief complaint. In a clear voice using appropriate words he states he has intermittent abdominal pain for a week and was awoken from his sleep about 15 minutes ago with intense abdominal pain. You note his airway is clear, he is breathing rapidly and his pulse is fast and easily felt. Your partner prepares the stretcher for transport while you continue to ask history questions and assess vital signs. He describes the pain as an intermittent “gas-like” pain in the epigastric region. He says he feels like he needs to “burp.” He continues to describe it as a band like pattern around his upper abdomen and lower chest. It is most intense when he lies flat but seems to have some relief when sitting upright smoking a cigarette. He took two tablets of Naprosyn to reduce his ty ...
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