Which assessment data would indicate to the nurse that pharmacologic treatment with antibiotics and antacids has been effective for the patient diagnosed with peptic ulcer disease (PUD) secondary to H. pylori?
Absence of burning epigastric pain after eating.
Two episodes of coffee-ground emesis.
A decrease in the patient’s alcohol intake.
Normalization of the patient’s hemoglobin levels.
The Correct Answer is A
Choice A rationale
The absence of burning epigastric pain after eating indicates that the treatment for peptic ulcer disease (PUD) secondary to H. pylori has been effective. This suggests that the ulcer has healed and the inflammation has subsided.
Choice B rationale
Coffee-ground emesis indicates the presence of blood in the vomit, which suggests ongoing bleeding and is not a sign of effective treatment for PUD.
Choice C rationale
A decrease in alcohol intake is beneficial for overall health but does not directly indicate the effectiveness of treatment for PUD secondary to H. pylori.
Choice D rationale
Normalization of hemoglobin levels is important but does not specifically indicate the effectiveness of treatment for PUD secondary to H. pylori. The primary indicator would be the resolution of symptoms such as burning epigastric pain.
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View Related questions
Correct Answer is A
Explanation
Choice A rationale
Enlarged liver (hepatomegaly) and peripheral edema are common clinical manifestations of right heart failure (RHF). RHF leads to congestion of systemic circulation, causing fluid accumulation in the liver and peripheral tissues.
Choice B rationale
Crackles in the lungs are more commonly associated with left-sided heart failure, where fluid backs up into the pulmonary circulation, leading to pulmonary edema.
Choice C rationale
A dry hacking cough is not a typical symptom of right heart failure. It is more commonly associated with respiratory conditions such as asthma or bronchitis.
Choice D rationale
Altered mentation with pinpoint pupils is not a characteristic of right heart failure. These symptoms are more indicative of neurological conditions or opioid overdose.
Correct Answer is A
Explanation
Choice A rationale
Elevated blood ammonia levels are a common consequence of liver dysfunction, particularly in conditions like cirrhosis and alcoholic liver disease. The liver is responsible for converting ammonia, a byproduct of protein metabolism, into urea, which is then excreted by the kidneys. When the liver is damaged, it cannot effectively perform this function, leading to elevated blood ammonia levels. High ammonia levels can cross the blood-brain barrier and cause hepatic encephalopathy, which manifests as confusion, memory loss, and asterixis (a flapping tremor of the hands). These neurological symptoms are consistent with the patient’s presentation.
Choice B rationale
An increased white blood cell count typically indicates an infection or inflammation. While infections can occur in patients with liver disease due to a compromised immune system, the symptoms described (increased blood glucose, blurred vision, memory loss, and asterixis) are more indicative of hepatic encephalopathy rather than an infection.
Choice C rationale
Elevated blood urea nitrogen (BUN) levels can occur in liver disease, but they are more commonly associated with kidney dysfunction. BUN is a measure of the amount of nitrogen in the blood that comes from the waste product urea. While liver dysfunction can affect BUN levels, the symptoms described are more specifically related to elevated ammonia levels and hepatic encephalopathy.
Choice D rationale
A decreased platelet count, or thrombocytopenia, is a common finding in liver disease due to splenic sequestration and decreased production of thrombopoietin. However, thrombocytopenia does not directly cause the neurological symptoms described in the patient. The symptoms of increased blood glucose, blurred vision, memory loss, and asterixis are more specifically related to elevated ammonia levels and hepatic encephalopathy.