Pearson Decision Making Case 4: Peptic Ulcer Disease

Pearson Decision Making Case 4: Peptic Ulcer Disease Which client requires the most urgent care? - AnswersMr. Lamont Wallace, who noticed he had dark black, tarry stools this morning Rationale: Mr. Wallace has a bleeding ulcer, which requires more immediate attention than the other clients who do not have bleeding ulcers. Due to his bleeding ulcer, Mr. Wallace is prescribed 80 mg bolus esomeprazole IV, then 8 mg/h esomeprazole IV for 72 h. What client teaching do you need to give related to the side effects of esomeprazole? - AnswersMr. Wallace should notify the nurse immediately if he experiences severe diarrhea or pain during urination. Rationale: Severe diarrhea and pain during urination are adverse effects of esomeprazole that may require discontinuation of the drug. Because Mr. Wallace is taking a high dose of esomeprazole to treat his bleeding ulcer, he should notify the nurse immediately if he experiences these adverse effects. After starting Mr. Wallace's IV, you check on Mr. Torres. He says that the physician told him he had an ulcer, and he has heard that ulcers are caused by bacteria. He insists on getting some antibiotics in addition to the ranitidine that the physician prescribed. How would you respond to Mr. Torres? - Answers"Clients who are treated with antibiotics but do not have H. pylori have a worse outcome, so we need to wait until the H. pylori test results are back before prescribing antibiotics." Rationale: This statement provides the correct rationale for why antibiotics have not yet been prescribed to Mr. Torres. If H. pylori is not present, then antibiotics are not needed, and actually would cause a worse outcome for clients with PUD.