Gastrointestinal Case Study
A 45-year-old male patient presents with the following complaints: frequent episodes of waking from sleep coughing and with a burning sensation he describes as heartburn for the past 8 months. The patient admits to drinking anywhere from 4 - 5 cups of coffee daily and 2 glasses of wine every evening with dinner. His favorite meals include pasta with tomato sauce and "lots of hot pepper." He enjoys watching television and snacking on chocolate candies and admits to tobacco use "to help me relax" - he usually smokes ½ - 1 pack per day. The Nurse Practitioner prescribes a regimen of omeprazole 60 mg once daily and Mylanta 30 mL at bedtime if needed until he is seen by his gastroenterologist.
Based on this information, answer the following questions:
Q1. What is the classification, action and rationale for each of the medications the patient is currently taking?
Q2. What adverse effects of the medications should the nurse be alert and assess for?
Q3. After an endoscopy, the gastroenterologist prescribes Famotidine 20 mg at bedtime and Sucralfate 1000 mg prn 1 hour before meals. What is the nursing rationale and what assessments must the nurse make with these two new medications?
Q4. In reviewing the EHR, the nurse notes the doctor has asked the patient to decrease the intake of chocolate, caffeine and spicy foods such as pepper and tomato sauce diet and has referred the patient to a smoking cessation program. What is the rationale for these instructions by the physician?
Q5. Based on the medications the patient is taking, identify two priority nursing problems.