The gastroenterologist performs the EGd and finds erosive esophagitis Los Angeles (LA) class B, a moderately sized hiatal hernia, diffuse erosive gastritis, and an ulcer in the antrum of the stomach that isoozing blood
The duodenal bulb showsa normal endoscopic appearance. during the EGd, the bleeding
is stopped with cautery. Biopsy specimens of the gastric mucosa are obtained, and the biopsies are negative for H. pylori bacteria; his bleeding ulcer is attributed to the NsAIds (i.e., ibuprofen). He is kept NPO
until the next morning to allow sufficient hemostasis of the cauterized site. Clear liquids are allowed at
breakfast. M.R. tolerates the liquid diet without any nausea and vomiting and is discharged to home the
next day with the following instructions:
• Advance diet slowly, as tolerated, to mechanical soft.
• Take pantoprazole 40 mg PO q am on an empty stomach, at least 30 minutes before eating.
• Make a follow-up appointment in 6 to 8 weeks with physician.
• Stop all aspirin (ASA) and over-the-counter (OTC) or herbal pain relief medications
(ibuprofen, naproxen, and so on).
• Stop or limit alcohol intake and smoking.
Why does the patient need to take the pantoprazole first thing in the morning?
The only action of this classification of medications is to inhibit acid secretion. Food and food odors
stimulate acid secretion in the stomach. Thus, for maximum efficacy, they are taken at least 30
minutes before eating or drinking anything.
You might also like to view...
A patient is undergoing a bone marrow transplant. Which of the following medications is most effective in stimulating the production of granulocytes and macrophages?
A) Bacillus Calmette-Guérin (BCG) B) Epoetin alfa (Epogen) C) Aldesleukin (Proleukin) D) Sargramostim (Leukine)
Mrs. Mulligan brings her 16-year-old son into the office for a sports physical examination. As the health care provider, you explain that normal hormone-related changes of adolescence include:
a. increased oil production. b. slowed hair growth. c. depleted apocrine glands. d. decreased sebaceous gland activity.
A nurse is preparing a presentation. How can the nurse explain one of the primary concerns of the proponents for a nontraditional collective bargaining unit versus the traditional, union-based nursing model?
a. "The traditional-based union model fre-quently puts nurses and employers in ad-versarial positions.". b. "The union dictates to members what they can and cannot do within the health care institution.". c. "The union-based model can initiate strikes that can be detrimental to the pro-vision of health care in an institution.". d. "The union-based model is too expensive and nurses are not fairly compensated by the organization.".
When delegating to non-nursing staff it would be inappropriate to delegate under which of the following conditions?
a. The individual is medically unstable. b. The task is considered safe for this individual. c. The task is considered routine for this individual. d. The task has a predictable outcome.