A 54-year-old African American woman presented with a 1-month history of intermittent, burning epigastric abdominal pain that radiated toward her back. She noted nausea and vomited once. Her medical history included two clean-based antral ulcers treated 5 years prior with lansoprazole and intermittent omeprazole use. The main diagnosis is likely peptic ulcer disease given her symptoms and medical history of treated ulcers. Further workup and treatment would include tests like a stool occult blood test, labs, upper endoscopy, and medications like PPIs while avoiding NSAIDs. Nursing care would focus on pain management, nutrition, and anxiety reduction through education.

1. Take home exam ---------------------------------
A 54-year-old African American woman presented with a 1-month history of intermittent, burning
epigastric abdominal pain that was moderately severe in intensity. Her pain radiated toward her back in a
band-like fashion. She also noted nausea and vomited once, with the vomit consisting of food particles.
The patient denied having signs and symptoms of melena, hematochezia, or hematemesis.,and the patient
had had multiple endoscopies in the past 6 years. It was learned that she had 2 clean-based antral ulcers 5
years prior, and was started on lansoprazole, which she could not afford and so was switched to
omeprazole, which she used intermittently. She also admitted to past use of an over-the-counter analgesic
consisting of acetaminophen, aspirin, and caffeine
1- UPON THE AOVE CASE READ IT AND ANSWER THE FOLLOWINGQUESTIONS
A- WHAT IS THE MAIN DIAGNOSIS
B- LIST ALL INVISTIGATION TO E DONE FOR HM
C- WHAT ARE THE NURSINGDIAGNOSIS FOR ABOVE CASE
D- WHAT ARE THE NURSIN IMPLEMENTATION FOR THIS CASE
E- LIST THE MAIN DRUGS TO BE SAFE AND TO BE AVOIDED IN THE FOLLOW UP
F- LIST THE MAIN SIGNS AND SYMPTOMS FOR ABOVE CASE
A- Peptic Ulcer Disease
B- 1)Stool for fecaloccult blood
Labs: CBC.
liver function test, amylase, and lipase.
urea breath test
Upper GI Endoscopy
C)
Acute pain related to the effect of gastric acid secretion on damaged tissue
Anxiety related to an acute illness
Imbalanced nutrition: less than body requirements related to changes in diet.

2. e) RELIEVINGPAIN Pain relief can be achieved with prescribed medications. The patient should avoid
aspirin and other NSAIDS.
REDUCINGANXIETY:The nurse interacts with the patient in a relaxed manner; helps identify
stressors; and explains various
Case 1:A 59-year-old woman with a medical history of cerebralpalsy due to birth hypoxia, was brought
to the hospital by her carers,with a 3-day history of complete constipation and faeculent vomiting. She
had no other medical or surgical history of note and was not taking any regular medications. She lived at
home with her carers and required assistance with severalactivities of daily living, however, she was able
to eat on her own using her feet. On examination, her abdomen was distended and mildly tender in the
right iliac fossa, but there was no guarding or peritonism. Examination of the chest and cardiac system
revealed only sinus tachycardia. Observations revealed sinus tachycardia at a rate of 115 bpm, blood
pressure 139/102 mm/Hg, respiratory rate 18 bpm, temperature 37.1°C and saturation 98% on room air.
Read the above mentioned case and answer the following questions

3. 1- What is the main diagnosis of above case
2- List the main signs and symptoms after analysis the case
3- What is the main medical treatment of the above case
4- List mainly 5 nursing diagnosis
5- What are the nursing implementation for the above case
A 53-year-old woman with a medical history of learning disability, autism and partial sightedness,
presented to the hospital, with persistent bilious vomiting and abdominal distension. She had no other
medical or surgical history of note and was not taking any regular medications. She lived in a nursing
home with her carers,and required assistance with all activities of daily living. On examination, her
abdomen was distended and she was slightly tender on palpation of the centralabdomen. Examination of
the chest revealed bilateral coarse crepitations suggestive of possible aspiration pneumonia. She was
afebrile and haemodynamically stable
Answer all the following questions
1- According to above case what is the main diagnosis of the pt
2- List all investigations to be done for him
3- What are the medical treatment of above case
4- List main 4 nursing diagnosis for this case
5- List the main signs and symptoms of the diagnosed patient
6- What are the main nursing implementation for this case