{"id":10699,"date":"2020-11-21T19:44:33","date_gmt":"2020-11-21T19:44:33","guid":{"rendered":"http:\/\/onlineclassesguru.com\/?p=10699"},"modified":"2020-11-21T19:44:33","modified_gmt":"2020-11-21T19:44:33","slug":"chief-complaint-i-have-recurrent-h-pylori-infection","status":"publish","type":"post","link":"https:\/\/onlineclassesguru.com\/index.php\/2020\/11\/21\/chief-complaint-i-have-recurrent-h-pylori-infection\/","title":{"rendered":"Chief complaint: I have recurrent H. Pylori infection."},"content":{"rendered":"<style type=\"text\/css\"><\/style><p>Gastro instestinal Case Study<br \/>\nChief complaint: I have recurrent H. Pylori infection.<br \/>\nHPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 \u00bd months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.<br \/>\nPMH:<br \/>\nH. Pylori infection gastritis<br \/>\nDiabetes Mellitus, type 2<br \/>\nSurgeries: None<br \/>\nAllergies: NKDA<br \/>\nVaccination History: Up-to-date<br \/>\nSocial history:<br \/>\nHigh school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.<br \/>\nFamily history:<br \/>\nBoth parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.<br \/>\nROS:<br \/>\nConstitutional: Negative for fever. Negative for chills.<br \/>\nRespiratory: No Shortness of breath. No Orthopnea.<br \/>\nCardiovascular: No edema. No palpitations.<br \/>\nGastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.<br \/>\nPhysical examination:<br \/>\nVital Signs<br \/>\nHeight: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110\/70 T 98.0 po P 80 R 22, non-labored<br \/>\nABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.<br \/>\nLabs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST\/ALT normal. TSH 3.7 normal, glucose 98 normal<br \/>\nAssessment:<br \/>\nPrimary Diagnosis: Recurrent H. Pylori infection gastritis<br \/>\nSecondary Diagnoses: Dyspepsia<br \/>\nDifferential Diagnosis: Peptic Ulcer Disease<br \/>\nPrevious medication plan: two months ago and failed.<\/p>\n<p>Clarithromycin 500 mg po BID for 2 weeks<br \/>\nOmeprazole 40 mg po BID for 2 weeks and then po daily.<br \/>\nCipro 500 mg po BID for 2 weeks<\/p>\n<p>Plan: Tests<br \/>\nPt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.<br \/>\nUrea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPIs 2 weeks prior to Urea Breath test.<br \/>\nLabs: No new labs are needed.<br \/>\nReferrals: may refer based on effect of medication therapy given for 2 weeks.<br \/>\nFollow up: return to office in 8 weeks to reevaluate symptoms.<br \/>\nAs a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection.<br \/>\nPlease discuss new therapy guidelines for H. Pylori treatment, and provide patient education.<br \/>\nBelow is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel free to consult other peer-reviewed articles within 5 years of publication.<\/p>\n<p>http:\/\/gi.org\/wp-content\/uploads\/2017\/02\/ACGManagementofHpyloriGuideline2017.pdf<br \/>\n0 0<\/p>\n<p><center><a href=\"http:\/\/onlineclassesguru.com\/orders\/ordernow\"><img decoding=\"async\" src=\"https:\/\/encrypted-tbn0.gstatic.com\/images?q=tbn:ANd9GcTyj99p60XCLyLk1htB7-1neRt8-2QdnenNlQ&usqp=CAU\"target=\"_http:\/\/onlineclassesguru.com\/orders\/ordernow\"\/><\/center><p>","protected":false},"excerpt":{"rendered":"<p>Gastro instestinal Case Study Chief complaint: I have recurrent H. Pylori infection. HPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 \u00bd months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-10699","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v17.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Chief complaint: I have recurrent H. Pylori infection. - onlineclassesguru<\/title>\n<meta name=\"description\" content=\"H. 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