increase the gastritis symptoms. Lastly, most of these items would not contain the adequate fiber GG needs to have a healthy digestive system – such as fruits or vegetables. “Chocolate bars during the day” –It is recommended for clients to avoid simple sugars and simple carbohydrates as well as sweetened food items. Chocolate bars contain a significant amount of sugar, simple carbohydrates in addition to caffeine. Consuming caffeine is also encouraged for patients to avoid because may cause an inability to sleep well. Lastly, caffeine may cause an increased amount of stomach acid product and thus damaging the stomach lining overtime and increasing her stomach pain symptoms. “Milk” – products should be limited and taken one hour after a meal. Excess dairy, or any “nutrient-rich drink” cause trigger symptoms because of the rich emulsions present. Therefore, it is usually encouraged for clients to consume lactose-free products. Drinks: “Strong, black coffee throughout the day and into the night” – Decaffeinated beverages are encouraged because they can cause or irritate symptoms of the condition. It may cause increased amount of stomach acid product and thus damaging the stomach lining overtime and increasing her stomach pain symptoms. In addition, drinking liquids throughout the day isn’t encouraged. Ratini suggests to not eat solids and liquids at the same time; do not drink during the sixty minutes around a meal – thirty minutes before until thirty minutes afterwards. Lastly, caffeine intake later in the day and at nighttime can have a great affect on her inability to sleep well. “Rum and coke at bedtime” – Large amounts of alcohol often irritates the gastritis symptoms. Not only will the caffeine, from the coke, have a great affect on her inability to
from a decrease in calcium from the AlternaGel medication. Secondly, her bilirubin total was also elevated at 0.6 mg/dl. An increased TBIL may also indicate liver damage – if too much bilirubin is produced or the liver is unable to remove bilirubin properly, blockage in the bile ducts and liver disease may develop; ultimately causing stomach pain. Lastly, her elevated Amylase level – of 350U/L – may indicate recent intake of alcohol, stomach ulcer, pancreatitis, blockage to intestines, gallstones, or kidney failure – all of which may induce LUQ pain. (Dugdale, Medline Plus, WebMD) In the second set of lab values, glu, BUN, Cr, ser alb, Na, K, Cl, hgb, and hct all dropped. This probably means that GG was: c. Dehydrated when the first labs were drawn. I believe “C” is the correct answer because GG returned to her “old ways” of caffeine and alcohol prior to returning to the hospital. Therefore, she would induce dehydration in her system prior to the ER visit. In the second set of lab values, serum amylase, AST, and ALT all dropped. This probably means that: a. enzymes were elevated due to alcohol. I believe “A” is the correct answer because her history indicated “another binge and drank too much” the evening before the ER visit. If she has an increased alcohol intake prior to blood testing, her lab values would be altered and elevated. Refer to the two lab tables again, and not that two days after admission, GG’s Alk Phos and CPK remained essentially unchanged. Why? a. These enzymes are not affected by alcohol or hydration. Although it is not recommended to consume food or beverages 10 hours prior to blood testing for Alk Phos, GG had passed the 10 hours mark when she went to the ER the next morning. Special pre-testing procedures are not required for CPK blood testing.