Question

PN 200 Fundamentals of Nursing II Concept Map: Diverticulitis Tim Haute, a 57-year-old stockbroker, has come ute, a 57-year-old stockbroker, has come to the gastroenterologist for treatment of recurrent mild to severe cramping in his abdomen and blood streaked stool. 1 doing his initial assessment. is abdomen and blood streaked stool. You are the nurse ou findings include a mildly obese man (male pattern obesity) who demonstrates mild guarding of his abdomen with both direct and rebound tenderness, especially in the LLO. Vita signs are 168/98, P 110R 24 T 984 and he is slightly diaphoretic, Mr. Haute states that he has penodic constipation. He has had previous episodes of abdominal cramping, but this time the pain is getting worse. PMH: Mr. Haute has a sedentary job with many emotional moments"; he has smoked a pack of cigarettes a day for the past 30 years and has had 2-3 mixed drinks in the evening" until 2 months ago. He states, “I have not had anything to drink in 60 days." He denies regular exercise with the statement "Just no tie." His diet consists of white bread, meat, potatoes and ice cream with fruits and nuts over it. He denies a history of pulmonary or cardiac and no personal history of cancer, although his father and older brother died of colon cancer. He takes no "routine" medications and denies the use of any other drugs. The physician orders a KUB, CBC, and CMP. Based on the X-ray and lab findings, physical exam and history the physician diagnosis the patient with acute diverticulitis and discusses the outpatient treatment plan with him. The physician now orders bed rest and anticholenergies for Mr. Haute. The physician orders metronidazole for this patient. 1. Prepare a list of questions you would ask this patient prior to administering metronidazole and state your rationale. 2. Explain what a disulfiram reaction is. You continue to teach the patient about both disulfiram and metronidazole reactions and interactions. You decide that there are some other instructions you need to give to the patient regarding his metronidazole prescription. The physician has now ordered Ampicillin for the patient. 3. State additional information you would need to know before starting the patient on Ampicillin Revised 1/20

Answer 1

1. list of questions to ask the patient before prescribing Metronidazole:

- Do you drink after taking medicine

- Do you take other medicines like blood thinners, lithium etc

- Any history of liver disease.

- Any blood disorder

- regular taking of medicine

Because Metronidazole will worsen the symptoms if taken with alcohol.

2. Disulfiram reaction:

When metronidazole taken along with alcohol, adverse effect start such as nausea, vomitting.

other advice include to report if rash diarhoea starts

to reduce weight. to stop smoking, to take more fiber food to reduce constipation, drink plenty of fluids , to reduce meat intake

3. question to ask the patient before prescribing ampicillin includes any history of allergy to penicillin etc