Week 8

Support delay 1 journals no older than 5 years. Week 8 GI Case Study: H. Pylori taint Questions: As an NP student, needs to designate the medications for frequent H. Pylori taint. According to the ACC/AHA Guidelines, what medication should this unrepining be prescribed? Write her exhaustive customs using the custom answerableness format. ACC/AHA Guidelines Chief lamentation: “ I keep frequent H. Pylori taint”.  HPI: M.C. a 46-year-old hispanic feminine presents to the GI clinic for lamentation of frequent H. Pylori taint. She was bargained encircling 2 ½ months ago delay H. Pylori triple therapy and failed tenor. She has pmhx of dyspepsia, GERD.  She as-well indicates that she has noticed that her symptoms of dyspepsia are worsening for elapsed 2 months. She has associated her symptoms delay sea-sickness, subvert stomach delay all foods.  Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal abstinence, ardor, chills, abstinence or any other symptoms.  PMH:  H. Pylori taint gastritis Diabetes Mellitus, cast 2 Surgeries: None Allergies: NKDA Vaccination History: She receives an annual flu shot. Last flu shot was this year Social truth: High train graduate, married and no manifestation. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a previous smoker that bungped 3 years ago. Family truth: Both parents are warm. Father has truth of DM cast 2, Tinea Pedis.  mother warm and has truth of atopic dermatitis, tinea corporis and tinea pedis.  ROS: Constitutional: Negative for ardor. Negative for chills.  Respiratory: No Shortness of inhalation. No Orthopnea Cardiovascular: No edema. No palpitations. Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal abstinence. Skin: No lesions. No adventurous. No lustful.  Psychiatric: No diffidence. No debasement.  Physical examination: Vital Signs Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 corpulence, BP 110/70 T 98.0 po P 80 R 22, non-labored HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth privation seen. Gums no redness.  NECK: Neck adulatory, no obvious masses, no lymphadenopathy, no thyroid expansion. LUNGS: Lungs conspicuous bilaterally. Equal inhalation sounds. Symmetrical respiration. No respiratory disturb.  HEART: Ordinary S1 delay S2 during stolidity. Pulses are 2+ in preferable extremities. No edema. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Ordinary contour; No obvious masses. GENITOURINARY: No CVA clemency bilaterally. GU exam abundant.  MUSCULOSKELETAL: Slow space but equable. No Kyphosis. SKIN: Dry. Intact.   PSYCH: Ordinary seek. Cooperative.  Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine ordinary 1.0, AST/ALT ordinary. TSH 3.7 ordinary, glucose 98 ordinary A: Primary Diagnosis: Frequent H. Pylori taint gastritis Secondary Diagnoses: Dyspepsia Differential Diagnosis: Peptic Ulcer Disease Previous medication plan: two months ago and failed. Clarithromycin 500 mg po BID for 2 weeks Omeprazole 40 mg po BID for 2 weeks and then po daily. Cipro 500 mg po BID for 2 weeks Plan: Tests Pt had EGD goodsed 2 weeks ago that showed H. Pylori dogmatic gastritis in biopsy results.  Urea inhalation ordeal 8 weeks following bargain delay H. Pylori medications. Pt needs to bung PPI’s 2 weeks previous to Urea Inhalation ordeal.  Labs: No new labs are needed.   Referrals: may relate grounded on goods of medication therapy given for 2 weeks. Follow up: reappear to function in 8 weeks to reevaluate her symptoms.