Question

A patient was admitted to the hospital because of severe epigastric pain. He has noted that his stools were darker than the usual brown color. He appears pale and very anxious. The history reports that he drinks 2-3 beers per day and smokes 2 packs of cigarettes a day. Based on the assessment data, what condition might the nurse determine this patient has, and why?

a. The patient most likely has a bleeding gastric ulcer. The most distressing symptom of a gastric ulcer is gnawing epigastric pain that seems to bore through to the back. As his stools are darker than usual and he is pale and anxious, he probably has a bleeding ulcer.
b. The patient most likely has a gastric ulcer. The most distressing symptom of a gastric ulcer is gnawing epigastric pain that seems to bore through to the back.
c. The patient most likely has gallstones. The radiating pain indicates gallstones, and the darker than usual stools indicates a problem with lipid absorption.
d. The patient most probably has appendicitis. The darker than usual stools indicates that the appendix has ruptured, and the stools contain blood.
e. The patient most likely has internal bleeding, as his stools are darker than usual and he is pale and anxious.

Answer 1

The most probable diagnosis is a bleeding gastric ulcer, based on symptoms such as severe epigastric pain, dark stools, paleness, and anxiety, coupled with the patient's daily alcohol and cigarette consumption. This condition is serious and requires medical treatment to prevent complications.

Step-by-step explanation:

Based on the provided assessment data, option a. The patient most likely has a bleeding gastric ulcer is the most probable diagnosis. The told symptoms of severe epigastric pain, dark stools (which may indicate digested blood, known as melena), along with pale complexion and anxiety, suggest that the patient could have a bleeding peptic ulcer, specifically a gastric ulcer. Stomach acid and irritation from lifestyle factors such as daily consumption of 2-3 beers and smoking 2 packs of cigarettes can contribute to the development of gastric ulcers and lead to conditions where stomach wall protection is compromised, allowing for bleeding to occur. This is supported by the explanation that substances like alcohol and cigarettes can damage the protective mucus of the stomach, resulting in ulcer formation and potential bleeding.

Treatment would typically involve a combination of antibiotics, acid-neutralizing medications, and changes to lifestyle to prevent further bleeding and promote healing. Ignoring such symptoms could lead to serious complications, including perforation of the stomach lining and peritonitis.