Abdominal Presentation Scenario

You start with your observations and record: 99 HR, 98% Sp02, 22 RR, 123/78 BP, 36.9 Temp, 4.7 blood sugar. 

What is this patients NEWS score? 

You complete an abdominal examination and find the patient is tender and guarding in the epigastric area. There are no other abnormalities reported on inspection or palpation. Bowel sounds are normal, and percussion has normal resonance. 

What is the difference between guarding and rigidity when referring to your abdominal assessment? 

What structures are typically present in the epigastric area of the abdomen? TICK ALL THAT APPLY

As you have completed your abdominal assessment, the patient also states that they have had intermittent black, tarry stools for the past 3-4 weeks but didn’t think much of it at the time. What is the medical term for this and what is it a sign of? 

The patient’s past medical history includes CVA (with no deficit), Atrial fibrillation, and Arthritis. He takes Apixaban, Simvastatin, and his own paracetamol and ibuprofen regularly for the arthritis. He doesn’t drink alcohol or smoke. On full assessment of the patient, you find his chest clear with no deficits, FAST negative with no other neurological deficits, and his ECG shows AF. He hasn’t been eating very well since this started as he frequently feels nauseated. What is the more likely diagnosis with this patient?

What medications listed above can be commonly linked to the development of peptic ulcers if used long term?

What other medication listed on the JRCALC that we can administer is also contraindicated in someone with suspected peptic ulcers?

If the patient has been complaining of the signs and symptoms of a potential GI bleed for up to a month, and has then gradually developed lethargy, shortness of breath and a pale complexion since, what is the likely secondary diagnosis?

You give the patient appropriate analgesia to settle the pain. What management plan would you have for this patient?

What is the pathophysiology behind peptic ulcer disease?

Over 50% of all cases of upper gastrointestinal bleeding is due to peptic ulcers? 

As well as chronic NSAID use, what is the most common cause of the development of peptic ulcers?

What complications can arise from peptic ulcers? TICK ALL THAT APPLY

Peptic ulcers include the formation of ulcers from what anatomy along the gastrointestinal tract?

Epigastric pain usually follows 15-30 minutes following a meal in patients with a gastric ulcer and 2-3 hours following a meal in patients with a duodenal ulcer?