VD-BSN 3F-2B

GEN WARD
Nov. 16-18, 2020-2021

1. Below is a case scenario of Mr. Gatan Torogi.

a. Formulate an FDAR. (Gatan Torogi’s case)

b. Write a drug study with his medicines taken. Ex. magaldrate (Riopan) and ranitidine
(Tagamet). Include 1 Proton Pump Inhibitor (PPI). There will be 3 drugs all in all.
c. Make 1 actual and 1 potential NCP out of his situation. This will be discussed on the 2nd
day of our Virtual Duty.
d. Do your journal reading related to his case, (peptic ulcer) or journal about meds on peptic
rd
ulcer. 3 day.
e. Include your 13 areas of assessment as perceived with the case of a person with PUD.

2. All requirements are to be handwritten or encoded. Make use of this canvas for submission of
requirements and use the GC for academic communication or queries.

3. Follow formats provided by the CON. For your drug study, follow the format below in tabular form.
Index card or bond paper.

University of the Cordilleras

Format of Drug Study

I. Generic Name
Brand Name
General Classification
Route of drug administration
Dosage
II.Mechanism of Action
III.Indication/Contraindication
IV. Side effects/Adverse Effects
V.Nursing Considerations/Responsibilities

A.Before Giving the Drug

1. Diagnostic
2. Therapeutic
3. Educative

B. During the Giving of the Drug

1. Diagnostic
2. Therapeutic
3. Educative

C. After Giving the Drug

1. Diagnostic
2. Therapeutic
3. Educative
Instructions:
1. Use ½ index card or bond paper.
1. Use blue or black ink ball pen.
3. You can highlight important words. (For you to remember when you will have drug recitation in your
face to face hospital duty)

CASE SCENARIO
SITUATION
Gatan Torogi, a 48-year-old traveling salesman, had experienced increasing epigastric discomfort
during a 7-month period. When he finally sought medical care, the diagnosis was a peptic ulcer. He
began taking magaldrate (Riopan) for relief of his immediate discomfort, as well as ranitidine
(Tagamet), 150 mg b.i.d. Mr. Torogi was referred to the nurse for patient teaching and given an
appointment for a follow up visit in 3 weeks. In 3 weeks’ time, he was admitted in the Medical ward
with the same diagnosis. The nurse took his vital signs as recorded: T=37.9 degrees centigrade,
PR=98 bpm, RR= 12cpm, BP= 130/90.

Critical Thinking
1. Think about the physiology of duodenal ulcers and the various factors that can contribute to
aggravating the problem.
2. What patient teaching points should be covered with this patient regarding diet, stress factors, and use
of alcohol and tobacco?
3. What adverse effects of the drugs should this patient be aware of?
4. What lifestyle changes may be necessary to ensure ulcer healing, and how can Gatan Torogi be assisted
in making these changes fit into the demands of his job?

Discussion
Further examination indicated that Gatan Torogi is a healthy man except for the ulcer. He admits to
smoking cigarettes, drinking alcohol regularly at business lunches and dinners, and eating a great deal of
fast food and drinking a lot of coffee when he is on the road. He states that his job has become
increasingly stressful as the economy has worsened. Because he is basically healthy and does not seek
medical care unless very uncomfortable (7 months of pain), he may find it difficult to comply with his
drug therapy and any suggested lifestyle changes.

Gatan Torogi needs patient education, which for purposes of building trust should preferably be with the
same nurse. The instruction should include information on duodenal ulcer disease, ways to decrease acid
production (such as avoiding cigarettes, acid-stimulating foods, alcohol, and caffeine), and ways to
improve the protective mucous layer of the stomach by decreasing stress and anxiety causing situations.

In addition, spacing of the ranitidine and antacid doses should be stressed. Ranitidine should be taken 1
hour before or 2 hours after any antacids because they can interfere with the absorption of ranitidine and
the patient may not receive a therapeutic dose.

Gatan Torogi should be encouraged to avoid over-the-counter (OTC) medications and self-medication
because several of these products contain ingredients that could aggravate his ulcer or interfere with the
effectiveness of the drugs that have been prescribed.
Gatan Torogi should be encouraged to return for regular medical evaluation of his drug therapy and his
underlying condition. Finally, he should feel that he has some control over his situation. Because he does
not routinely seek medical care, he may be more comfortable with a medical regimen that he has
participated in planning. Allow him to suggest ways to decrease stress, ways to cut down on smoking or
the use of alcohol without interfering with the demands of his job, and the best times to take the drugs in
his schedule. He will learn in time which foods and situations irritate his condition.

However, research has not shown that bland or restrictive diets are particularly effective in decreasing
ulcer pain or spread, and they may actually increase patient anxiety. Gatan Torogi should be encouraged
to jot down the situations or times of day that seem to cause him the most problems. This information can
help to provide a guide for adjusting lifestyle and/or dietary patterns to aid ulcer healing and prevent
further development of ulcers.

“Your labor is not in vain” Do your part as a student. God bless.

Retchel Dulaycan Dapli-an

Clinical Instructor