FIVE WEEK 5 DISCUSSION ADVANCED HEALTH AND PHYSICAL ASSESSMENT

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Colorado School of Mines *

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Nursing

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Nov 24, 2024

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1 Week #5 Discussion Student’s Name University Affiliation Course Date

2 Week #5 Discussion History Domain Under the guidance of the healthcare provider, the information provided during the background of the disease is used to determine the treatment approach to be done for the client. There is limited information regarding the individual, but what we do know is that the patient is a Latino man named Mr. Rodriguez, 39, whose primary complaint is epigastric discomfort. The fact that the patient is a farm laborer and that he came to the United States from the Dominican Republic are both relevant facts. Surprisingly, the patient abstains from all drugs except for ibuprofen, used to be a smoker but has since kicked the habit, he nevertheless drinks the equivalent of three to four bottles of wine every week (Kipritci et al., 2020). The individual information provided would be useful in constructing the disease requirements; nevertheless, I will be required to delve further into the circumstances by adding two critical questions relating to Mr. Rodriguez's background. Two significant questions I will be asking the 39-year-old client are whether or not he has been evaluated for Helicobacter pylori previously, what those results have been, and whether or not whether or not he is stressed, which might be related to his recent decision to stop smoking or his relocation from the Dominican Republic to the United States. Peptic ulcer, brought on by the infiltration of Helicobacter pylori, the ulcer- causing bacteria, and hastened by eating fatty foods and psychosocial stressors, is a leading sign of gastrointestinal symptoms that are associated with the use of non-steroidal anti-inflammatory medicines (NSAIDs) (Alterio et al., 2019). In case a client is experiencing epigastric discomfort while also having a history of social interactions and lifestyle modifications as well as Helicobacter pylori, it is important to inquire about the likelihood of stress. The response will indicate what kind of testing is necessary and offer suggestions for mitigating risk.

3 Physical Exam Domain Assessment of the organs involved in overall health as well as the major anomalies, such as epigastric discomfort, was crucial to determining the likely condition. Abdominal palpation was the gold standard for observing the gastrointestinal (GI) system, allowing doctors to pinpoint aberrant findings such as abdominal tumors, discomfort, and skin discoloration. Abdominal discomfort has been connected to the genitourinary (GU) system, which examines the urine and reproductive systems for abnormalities such as discomfort and ectopic testicles (Kamada et al., 2021). Cardiovascular (CVS) and respiratory (RES) system examinations are performed to detect and monitor anomalies that may cause cardiac and pulmonary diseases, correspondingly. Mr. Rodriguez did not report losing weight or having a high temperature, but such symptoms would be investigated by the overall health indicator. The severe stomach discomfort and nausea were the main cause of alarm. Validation of the gastrointestinal problems through an evaluation of epigastric discomfort requires a battery of diagnostic tests led by the results of the medical assessment as well as the client's history, and this, in turn, necessitates appropriate abdominal examination. Endoscopy is a diagnostic procedure where a tiny camera is inserted down a patient's throat and down the esophagus to detect irritation as well as infectious diseases in the digestive tract, and a specialized kind of x-ray is utilized to provide a visual indication of the findings. Due to the skin tone shifts, a full blood count would be necessary to determine the status of the body's blood supply (De Jonge et al., 2018). Diagnostic tests particularly blood tests for helicobacter pylori by stool or blood polymerase chain reaction (PCR) could reveal Helicobacter pylori antibodies as well as mutations if the patient reports epigastric discomfort and takes nonsteroidal anti-

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4 inflammatory medicines (NSAIDs). Signs of Helicobacter pylori infection would be utilized to categorize gastrointestinal disorders. Medical Diagnosis/ Assessment Domain Assessing and diagnosing a patient's condition relies on tying together symptoms and potential causes of sickness. Peptic ulcer illnesses would be at the top of the differential diagnoses, with the pathophysiological process involving stomach or duodenum damages from NSAID use as well as infection of Helicobacter pylori to the gastrointestinal or duodenum lining, leading to the damaged wall being exposed to food acid content. With epigastric discomfort as its primary symptom, peptic ulcer disease is exacerbated by alcoholic beverages, fatty foods, and tobacco usage. Due to its shared clinical indications and risk factors with peptic ulcer disorders, is often considered a possible cause. The client's symptoms of breathing difficulties, acid reflux, nausea, as well as upper abdomen anguish suggest esophagitis. It is a health condition that can be differentiated from peptic ulcer with gastrointestinal symptoms by the destruction of the esophagus brought on by inflammatory response due to diseases that can suppress the individual's immune system, bacteria, fungi, and viruses (Caraiani et al., 2020). Finally, the nurse practitioner would have to consider gastritis as another differential diagnosis, as it might be similar to a peptic ulcer due to the irritation of the abdominal lining brought on by a persistent infection with Helicobacter pylori.

5 References Alterio, T., Cardile, S., Trayers, C., Valenti, S., Loddo, I., Mardare, R., ... & Nobili, V. (2019). Eosinophilic esophagitis in children: current knowledge to open new horizons: Eosinophilic esophagitis in pediatrics. Scandinavian journal of gastroenterology, 54(7), 822-829. https://doi.org/10.1080/00365521.2019.1641214 Caraiani, C., Yi, D., Petresc, B., & Dietrich, C. (2020). Indications for abdominal imaging: When and what to choose? Journal of ultrasonography, 20(80), e43–e54. https://doi.org/10.15557/JoU.2020.0008 De Jonge, G., Dos Santos, T. L., Cruz, B. R., Simionatto, M., Bittencourt, J. I., Krum, E. A., ... & Borato, D. C. K. (2018). Interference of in vitro hemolysis complete blood count. Journal of clinical laboratory analysis, 32(5), e22396. https://doi.org/10.1002/jcla.22396 Kamada, T., Maruyama, Y., Monobe, Y., & Haruma, K. (2021). Endoscopic features and clinical importance of autoimmune gastritis. Digestive Endoscopy. https://doi.org/10.1111/den.14175 Kipritci, Z., Gurol, Y., & Celik, G. (2020). Antibiotic Resistance Results of Helicobacter pylori in a University Hospital: Comparison of the Hybridization Test and Real-Time Polymerase Chain Reaction. International Journal of Microbiology, 2020. https://doi.org/10.1155/2020/8853298

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