The client, a 56-year-old Hispanic male, presents with complaints…

Question Answered step-by-step The client, a 56-year-old Hispanic male, presents with complaints… The client, a 56-year-old Hispanic male, presents with complaints of a four-week history of gradually increasing upper abdominal pain. He describes the pain as “burning” in nature, localized to the epigastrium, and that previously it had been relieved by drinking milk or Mylanta. The pain is much worse now and milk or antacids do not provide any relief. He scores the pain as a “7” on a scale of 1-10. The patient does not feel the pain radiating into his back and has not noticed any blood in his stools. He denies any nausea, vomiting, weight loss, shortness of breath, neurologic symptoms, or chest pain with exercise. He maintains that his appetite is excellent. He has been taking 400 mg ibuprofen almost daily for knee pain for the last 18 months. He injured his right knee in a car accident 15 years ago. He also takes daily doses of 81 mg aspirin “for his heart,” although this has not been prescribed. He does not take any other prescribed or OTC medications. The patient smokes 11 ?2 packs of cigarettes every day and has done so for 5 years since his wife passed away. He does not drink alcohol or use illegal drugs. The patient is allergic to meperidine and develops a skin rash when he is treated with it. He admits to feeling “stressed out” as he recently lost his job of 20 years as an insurance salesman and has had difficulty finding another. Furthermore, his unemployment compensation recently lapsed. M.S. has been feeling a bit tired lately. He was diagnosed with HTN (stage 1) three years ago and has been managing his elevated BP with diet and regular workouts at the gym. His younger brother also has HTN and both his parents suffered AMIs at a young age.  M.S. has a history of gallstones and laparoscopic removal of his gallbladder six years ago. He also has a history of migraine headaches.No abdominal bruits, masses, or organomegaly • Positive bowel sounds present throughout with no distension • Epigastric tenderness w/palpation but w/o rebound or guarding Alert and oriented to time, place, and person, appropriately anxiousAll blood chemistries including Na, K, Ca, BUN, and Cr normal • WBC 7500/mm3 w/NL WBC Diff • Hct 37% • ALT, AST, total bilirubin normal • Amylase  90 IU/L • ECG normal sinus rhythm w/o evidence of ischemic changes • Stool heme-positive; Endoscopy Results • Normal appearing esophagus • 1-cm gastric ulcer w/evidence of recent bleeding but no signs of acute hemorrhage in the ulcer crater • T 98.8ºF, P 90 and regular, RR 18 and unlabored, BP 156/98 left arm sitting. Discussion QuestionsWhat are the abnormal and their clinical significance? 2Prioritize the top 3 abnormal. 3List the 5 most important interventions for the top priority (from question #2) and provide the rationale for each intervention. 4Identify three factors that may have contributed to a peptic ulcer in this patient.  5Why might the healthcare provider have inquired about possible shortness of breath or chest pain with exercise? 6Why might the PCP order an ECG for this patient?  7(Opinion Question) What type of management would be appropriate for this patient?  Health Science Science Nursing NURS MISC Share QuestionEmailCopy link Comments (0)