Instruction: 

Please look at the American Academy of Gastroenterology Clinical Guidelines for the updated H.Pylori therapy. This is the website and you may copy it and paste it in the internet to get the article journal with the treatment guidelines: 

http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf

This is an example

 

GI Case Study: H. Pylori infection

Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.

According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.

ACC/AHA Guidelines

Chief complaint: “ I have recurrent H. Pylori infection”.

HPI: M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.

She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.

Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.

PMH:

H. Pylori infection gastritis

Diabetes Mellitus, type 2

Surgeries: None

Allergies: NKDA

Vaccination History:

She receives an annual flu shot. Last flu shot was this year

Social history:

High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis.

mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: No edema. No palpitations.

Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.

Skin: No lesions. No rash. No itching.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored

HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.

MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.

SKIN: Dry. Intact.  

PSYCH: Normal affect. Cooperative.

Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal

A:

Primary Diagnosis: Recurrent H. Pylori infection gastritis

Secondary Diagnoses:

Dyspepsia

Differential Diagnosis:

Peptic Ulcer Disease

Previous medication plan: two months ago and failed.

1. Clarithromycin 500 mg po BID for 2 weeks
2. Omeprazole 40 mg po BID for 2 weeks and then po daily.
3. Cipro 500 mg po BID for 2 weeks

Plan: Tests

Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.

Urea breath test 8 weeks after treat with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.

Labs: No new labs are needed.  

Referrals: may refer based on effect of medication therapy given for 2 weeks.

Follow up: return to office in 8 weeks to reevaluate her symptoms.

  

No Plegarism please, assignment will be checked with Turnitin. 

Will need minimum of 300 words, APA Style, double spaced, times new romans, font 12. 

 

 

Writing about one’s personal experience encourages self-reflection and improves self-awareness. In this activitystudents are invited to reflect, in writing, on their experiences related to managing clinical risks for patients. Students to write about an event they observed or were involved in during their nursing profession that they feel might have placed a patient at risk. Alternatively, students may want to write about an event that occurred to them as recipients of healthcare, or as an observer to their friends’ or family members’ experiences. The event may be one that they feel related to any of anticipation, recognition, or management of a patient safety risk. Safe patient care and reducing medical-legal risk requires nurse practitioners to be aware of potential risks and how to avoid them.

The narrative should include:

a description of the event

an explanation of how this event placed a patient at risk

the student’s reflections on the event including:

if and how the event was recognized

why and how the event occurred, for example, was the event due to

* action or inaction by an individual healthcare provide

*system failure(s)

*a combination of systems failure(s) and individual provider performance issue

what changes or improvements they would make, if any

how they felt at the time

how they currently feel about the even

Were you personally involved in the event? Discuss.

What, if any, workplace factors contributed to the event? (e.g., Was it during a handover? Did it involve a medication?)

How aware was the healthcare provider(s) of what was going on around them? (situational awareness)

How did the health care provider(s) recognize the safety problem, and how did they respond?

How did this event affect you?

What did you take away that you will use in the future?

I would do something differently next time because 

n a paper (750-1,000 words), summarize your analysis of this   exercise. Include the following:

1. Provide a summary of your learning style.
2. List your     preferred learning strategies.
3. Compare your preferred     learning strategies to the identified strategies for your preferred     learning style.
4. Discuss how the awareness of individual     learning styles, preferences and strategies influence teaching     (those who are in a position to teach) and learning (those who are     in a position to learn).
5. Cite a minimum of three references     in the paper.

Although the topic of this assignment refers to your individual   learning style, avoid the use of first person voice (words such as,   “I, we, our”) in your essay.

Prepare this assignment according to the guidelines found in the APA   Style Guide, located in the Student Success Center. An abstract is not required.

  

This is discussion board: No Plegarism please, assignment will be checked with Turnitin. Will need minimum of 250 words, APA Style, double spaced, times new romans, font 12, and and minimum 3 References with intext citations.

The Medical Interview:

The medical interview serves several functions. It is used to collect information to assist in diagnosis of the present illness, to understand the patient’s values, to assess and communicate prognosis, to establish a therapeutic relationship and to reach agreement with the patient about further diagnostic procedures and therapeutic options. The interview also offers an opportunity to influence patient behaviors.

Discuss the following:

Please answer the following questions and include your rationale and evidence-based research to support your written work.

· What does it means to document accurately and appropriately?

· What are the documenting guidelines? When is it appropriate to use abbreviations?

· What is the difference between subjective and objective data?

· What does it mean to demonstrate clinical reasoning skills?

· How can you use clinical reasoning to plan the organization of a comprehensive exam?

· How will you document variations of normal and abnormal assessment findings?

· What factors influence appropriate tools and tests necessary for a comprehensive assessment?

· Reflect on personal strengths, limitations, beliefs, prejudices, and values.

· How will these impact your ability to collect a comprehensive health history?

· How can you develop strong communication skills.

· What interviewing techniques will you use to interview the patient to elicit subjective health information about their health history?

· What relevant follow-up questions will you use to evaluate patient condition?

· How will you demonstrate empathy for patient perspectives, feelings, and sociocultural background?

· What opportunities will you take to educate the patient?