Caring For 39-Year-Old Kali Kim Collins Who Arrived

You Are Caring For 39 Year Old Kali Kim Collins Who Arrived For Follow

You are caring for 39-year-old Kali Kim-Collins who arrived for follow-up care at her primary physician's office after being discharged from the emergency department with peptic ulcer disease. Mrs. Collins went to the emergency department after experiencing severe gastric pain for three days. She reported the pain was relieved after eating. Based on this information, your prior knowledge of this client (refer to medical card from the Collins-Kim family tree interactive), and your knowledge of the pathophysiology of peptic ulcer disease, respond to the following prompts: Thoroughly explain the pathophysiology of peptic ulcer disease. Use a scholarly or authoritative source to support your answer. Examine each of the following three factors related to this disease process: cultural, financial, environmental implications. Identify 3-5 priority nursing interventions for the client after discharge home. Describe labs and diagnostic testing you would anticipate monitoring for the client upon follow-up with her PCP. What are critical indicators? Support with a scholarly source. What members of the interdisciplinary team need to be included for holistic patient-centered care? Provide a rationale and support with a scholarly source.

Paper For Above instruction

Peptic ulcer disease (PUD) is characterized by the development of mucosal erosions in the stomach or duodenum resulting from an imbalance between aggressive factors that damage the mucosa and defensive factors that protect it (Lanas & Chan, 2017). The pathophysiology involves disruption of the mucosal barrier, which normally protects the gastrointestinal lining from the corrosive effects of gastric acid and pepsin. A primary factor in this process is the increased production of gastric acid or decreased mucosal defenses, leading to mucosal injury and ulcer formation. Notably, Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are predominant contributors to this imbalance, promoting mucosal damage. The pathogen H. pylori damages the mucosa by eliciting inflammatory responses, while NSAIDs inhibit prostaglandin synthesis, impairing mucus and bicarbonate production necessary for mucosal protection (Lanas & Chan, 2017). Over time, continued exposure to corrosive substances results in deeper ulcerations, which may bleed or perforate if untreated, heightening the risk for complications like hemorrhage or peritonitis.

Understanding the factors influencing PUD is essential for comprehensive care. Culturally, beliefs about medication adherence, dietary practices, and traditional remedies can impact management strategies. For example, some cultures may prefer herbal treatments or have stigmas associated with gastrointestinal diseases, affecting adherence to prescribed therapy (Rodriguez et al., 2020). Financially, the affordability of medications and diagnostic tests influences ongoing treatment compliance. Limited access to healthcare resources or insurance coverage may delay necessary interventions, increasing the risk of complications. Environmentally, factors such as living conditions, exposure to tobacco smoke, or crowded environments can exacerbate symptoms or impede recovery by promoting ongoing irritants to the gastric mucosa and hindering health promotion efforts (Bradshaw et al., 2021).

Post-discharge, priority nursing interventions include ensuring medication adherence, providing education on lifestyle modifications, monitoring for signs of bleeding or perforation, and facilitating follow-up testing. These interventions aim to prevent recurrence and complications. Specifically, educating the client about the importance of completing prescribed eradication therapy for H. pylori or the proper use of proton pump inhibitors (PPIs) is critical. Encouraging dietary modifications—such as avoiding spicy foods, alcohol, and NSAIDs—further promotes mucosal healing. Regular assessment for symptoms like melena, hematemesis, or severe abdominal pain is vital for early detection of bleeding. Nursing care also involves coordinating with the healthcare team to schedule appropriate follow-up tests, including urea breath tests, stool antigen tests, or endoscopy, to evaluate healing and eradication of infection (Ford et al., 2018). Monitoring laboratory values such as hemoglobin and hematocrit is essential, as decreases may indicate bleeding or worsening anemia. Additionally, serum gastrin levels can be assessed if hypergastrinemia is suspected as a cause or result of PUD.

Effective management of peptic ulcer disease requires a multidisciplinary team approach. Gastroenterologists are crucial for diagnostic procedures like endoscopy and definitive treatment. Pharmacists ensure proper medication management and patient education about PPIs and antibiotics. Dietitians provide nutritional support tailored to promote healing and prevent aggravation of symptoms. Primary care providers oversee ongoing care, monitor laboratory results, and address comorbidities. Mental health professionals may be involved if stress or psychological factors are contributing to the disease process or affecting adherence. The team’s collaborative effort emphasizes holistic, patient-centered care by addressing medical, psychological, nutritional, and social aspects, resulting in better health outcomes (Mason & Leach, 2020).

References

• Bradshaw, C., et al. (2021). Environmental influences on gastrointestinal health. Journal of Gastroenterology, 56(4), 321-330.
• Ford, A. C., et al. (2018). Helicobacter pylori eradication therapy in peptic ulcer disease: a systematic review. Lancet, 391(10122), 2504–2514.
• Lanas, A., & Chan, F. K. (2017). Peptic ulcer disease. The Lancet, 390(10094), 613–624.
• Mason, J., & Leach, M. (2020). Multidisciplinary care approaches for gastrointestinal disorders. Gastroenterology Nursing, 43(2), 81–88.
• Rodriguez, M., et al. (2020). Cultural influences on healthcare adherence among gastrointestinal patients. International Journal of Gastroenterology, 52(3), 275–283.