week 8

 Support behind a while 1 journals no older than 5 years.   H. Pylori contagion      Questions: As an NP learner, needs to detail the medications for frequent H. Pylori contagion.  According to the ACC/AHA Guidelines, what medication should this unrepining be prescribed? Write her entire recipes using the recipe writing format.     ACC/AHA Guidelines  Chief grievance: “ I possess frequent H. Pylori contagion”.   HPI: M.C. a 46-year-old hispanic womanly presents to the GI clinic for grievance of frequent H. Pylori contagion. She was handleed about 2 ½ months ago behind a while H. Pylori triple therapy and failed matter. She has pmhx of dyspepsia, GERD.   She so indicates that she has noticed that her symptoms of dyspepsia are worsening for late 2 months. She has associated her symptoms behind a while disgust, overthrow stomach behind a while all foods.   Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal affliction, ferment, chills, affliction or any other symptoms.   PMH:   H. Pylori contagion gastritis  Diabetes Mellitus, image 2  Surgeries: None  Allergies: NKDA  Vaccination History:  She receives an annual flu shot. Last flu shot was this year        Social fact:  High ground furrow, married and no manifestation. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a earlier smoker that sealped 3 years ago.  Family fact:  Both parents are vivacious. Father has fact of DM image 2, Tinea Pedis.   mother vivacious and has fact of atopic dermatitis, tinea corporis and tinea pedis.   ROS:  Constitutional: Negative for ferment. Negative for chills.   Respiratory: No Shortness of life. No Orthopnea  Cardiovascular: No edema. No palpitations.  Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal affliction.  Skin: No lesions. No unwary. No hankering.   Psychiatric: No solicitude. No degradation.   Physical examination:  Vital Signs  Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 embonpoint, BP 110/70 T 98.0 po P 80 R 22, non-labored  HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth forfeiture seen. Gums no redness.   NECK: Neck sycophantic, no material masses, no lymphadenopathy, no thyroid extension.  LUNGS: Lungs lucid bilaterally. Equal life sounds. Symmetrical respiration. No respiratory pain.   HEART: Usual S1 behind a while S2 during inertness. Pulses are 2+ in conspicuous extremities. No edema.  ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Usual contour; No material masses.  GENITOURINARY: No CVA sensibility bilaterally. GU exam plentiful.   MUSCULOSKELETAL: Slow pace but constant. No Kyphosis.  SKIN: Dry. Intact.    PSYCH: Usual move. Cooperative.   Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine usual 1.0, AST/ALT usual. TSH 3.7 usual, glucose 98 usual  A:  Primary Diagnosis: Frequent H. Pylori contagion gastritis  Secondary Diagnoses:  Dyspepsia  Differential Diagnosis:  Peptic Ulcer Disease  Previous medication plan: two months ago and failed. 1.Clarithromycin 500 mg po BID for 2 weeks 2.Omeprazole 40 mg po BID for 2 weeks and then po daily. 3.Cipro 500 mg po BID for 2 weeks  Plan: Tests  Pt had EGD consequenceed 2 weeks ago that showed H. Pylori definitive gastritis in biopsy results.   Urea life ordeal 8 weeks behind handle behind a while H. Pylori medications. Pt needs to seal PPI’s 2 weeks former to Urea Life ordeal.   Labs: No new labs are needed.    Referrals: may allude grounded on consequence of medication therapy abandoned for 2 weeks.  Follow up: repay to business-post in 8 weeks to reevaluate her symptoms.