Waldorf University Esophageal Varices Anatomy Case Study Paper Case Study for anatomy: Esophageal VaricesAttached is the case study and 10 questions that y

Waldorf University Esophageal Varices Anatomy Case Study Paper Case Study for anatomy: Esophageal VaricesAttached is the case study and 10 questions that you’ll have to answer in a 1500 words paper Case Study: Esophageal Varices
History of Present Illness:
A 65-year-old Caucasian man was found unconscious and face down in a pool of bright red, bloody vomitus by
his neighbor. He was resuscitated and taken to the hospital by ambulance and admitted to intensive care. He
was treated for acute gastrointestinal bleeding.
An intravenous infusion of D5W and colloid was begun through a central line. Oxygen was started. Octreotide
was administered to help stop the GI bleed.
Medical History:
The patient experienced a similar episode one month ago. At that time, an endoscopic exam revealed a bleeding
esophageal varix which was treated by band ligation therapy. He is well known to the local medical community
for chronic alcohol abuse; having tried several rehab programs with little success. Diagnosed with alcoholic
cirrhosis 5 years ago. Previous treatment for acute pancreatitis, alcohol withdrawal seizures, ascites,
coagulopathy, esophageal varices, peptic ulcer, anemia, and gastritis.
Social History:
45 year history of smoking 1 pack of cigarettes per day
He has had a “drinking problem” for most of his adult life.
Drinks 1 to 2 six packs of beer per day.
Unemployed; lost several jobs due to alcoholism
Lost driver’s license for drunk driving
Separated from his wife
Has one adult son who does not interact with him
Current Medications:
Lactulose
Spironolactone
Furosemide
Propranolol
Famotidine
Physical Examination Results and Tests
Vital Signs
BP
90/60 mmHg
Pulse 112 bpm
RR
14 breaths/min
Temp 98.0oF
Weight 190 lbs.
Height 5’11’’
Lab Results
Na
135 mEq/L
K
4.6 mEq/L
PO 4
Ca
Cl
BUN
PT*
PTT*
103 mEq/L
10 mg/dL
2.8 mg/dL
8.9 mg/dL
23 sec
54 sec
Total protein
Albumin
g/dL
Hb*
Hct*
4.9 g/dL
2.9
9.4 g/dL
28%
Cr*
1.1 mg/dL
Glu (fasting) 140 mg/dL
HCO 3
22 mEq/L
INR*
AST*
ALT*
2.3
119 IU/L
94 IU/L
NH 3
HIV
negative
59 ug/dL
Blood Gases
pH
PaCO2
PaO2
SaO2
Observations:
•
WBC
10,100/mm 3
Platelet
160,000/mm 3
Bilirubin (total) 10.4
mg/dL
Bilirubin (indirect) 9.9
mg/dL
7.38
45 mmHg
85 mmHg
95.0%
Skin
Markedly jaundiced
Spider angiomas on arms
•
Head, Eyes, Ears, Neck Throat
Icteric Sclera
Oropharynx dry
•
Cardiac
Tachycardia with normal rhythm
•
Abdomen
Soft with mild distension
Splenomegaly
•
Musculosketetal/Extremities
Warm with mild edema
•
Genital/Rectal
Stool heme (+)
•
Neuro
Alert and oriented but slow to answer questions
Questions
1. Explain the reasons for the following: spider angiomas, splenomegaly, edema, jaundice and icteric
sclera.
2. List and explain why the patient is taking each of his current medications. Specifically, what is the
benefit of prescribing spironolactone and propranolol together?
3. Why was the patient given D5W with colloid when he was brought into the hospital?
4. What is the significance of the renal lab test results?
5. What is the significance of the liver enzyme lab test results?
6. Why is a total and indirect bilirubin test done? What does this patient’s results indicate?
7. Is blood clotting a concern in this patient?
8. Why might the hemoglobin and hematocrit abnormal?
9. Does this patient have a blood gas problem? Explain.
10. Would this patient be at risk for another esophageal varix? Explain.
______________________________________________________________________________
*Abbreviations
PT (prothrombin time)
PTT (partial thromboplastin time)
Cr (creatinine)
INR (international normalized ratio)
Hb (hemoglobin)
Hct (hematocrit)
AST (aspartate aminotransferase)
ALT (alanine aminotransferase
Case study report must include the following:
Copy of case study with questions
A 4 to 8 pages typed report answering all questions
A citation list for all research used
Point Distribution:
Summary
Summary Citation/Format
25
5
Case Study Questions
Case Study Citation/Format/Grammar
Total
40
5
75
For formatting questions, use one of the following: Council of Science Editors (CSE) Citation Style. University of Wisconsin. Use
citation – sequence system. The Purdue Owl: APA Formatting and Style Guide.

Purchase answer to see full
attachment