Case Study
Ms. Winnie
April 23, 2017
1. The nurse asks Ms. Winnie if she takes any medications at home. Ms. Winnie states, “I take
Ortho Tri-Cyclen once a day and I was taking Advil three to four times a day for the
...
Case Study
Ms. Winnie
April 23, 2017
1. The nurse asks Ms. Winnie if she takes any medications at home. Ms. Winnie states, “I take
Ortho Tri-Cyclen once a day and I was taking Advil three to four times a day for the aches and
pains of being sick.” Should the nurse suggest to the health care provider that these two
medications be included in Ms. Winne’s admission orders?
Ortho Tri-Cyclen may be continued but the Advil should be discontinued because it is a
contributor to Ms. Winnie’s GI problem.
2. Identify four nursing diagnoses that are appropriate for Ms. Winnie upon admission.
1. Imbalanced Nutrition: Less than body requirements
2. Acute pain
3. Ineffective Therapeutic Regimen Management
4. Deficient Fluid Volume
3. Which lab results are abnormal and what is the significance of the abnormal results in Ms.
Winnie’s case?
1. Temp 100.5
2. WBC 11,800 cell/mm3 – (4.5 – 11.0) Infection
3. Hgb 11 - (13.5 – 17.5)Low could be sign of bleeding
4. Hct 34% - (39% -49%) Low could be sign of bleeding
5. RBC’s 3.31 (4.3 – 5.7)
These lab values indicate possible bleeding and infection.
4. Distinguish between the characteristics of upper and lower GU bleeding.
Upper GI bleed. Symptoms include hematemesis or melena. Hematemesis – blood in
vomitus or gastric aspirate – may be bright red (indicating fresh bleeding) or the color of
coffee grounds (indicating older blood decomposed by gastric hydrochloric acid).
Hematemesis almost always reflects upper GI bleeding.
Lower GI bleed. Symptoms include hematochezia or maroon or black stools.
Hematochezia – bright red blood passed rectally – usually indicates lower GI (primarily
colonic) bleeding. Maroon stools, formed from gross blood combined with melena,
usually indicate bleeding distal to the duodenum
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