An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis
She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient's problem is:
A. Mallory-Weiss tear
B. Esophageal varices
C. Gastric ulcer
D. Colon cancer
ANS: C
Bleeding occurs after an area of gastric mucosal injury has ulcerated. Explore symptoms of epigastric and/or periumbilical discomfort. Identify potential causes of gastric mucosal injury—the most common being NSAID use and stress. Many elderly individuals self-medicate with over-the-counter aspirin preparations and various NSAIDs. Commonly, they use too many medications that have side effects of gastric irritation.
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Which of the following should the nurse include in the examination of the patient's cranial nerves and extraocular eye muscles?
a. red reflex c. disc characteristics b. macular characteristics d. six cardinal fields of gaze
A patient has been prescribed a beta agonist for acute asthma attacks. Which beta agonist should not be used for acute exacerbations of asthma?
a. Salmeterol b. Albuterol c. Metaproterenol d. Pirbuterol
The nurse takes a blood pressure with the 65-year-old patient lying down and then again with the patient standing, with the resultant readings of 152/92 and 130/62. The nurse should record:
1. normal blood pressure for age. 2. orthostatic hypotension. 3. age-related hypertension. 4. exertional hypertension.