Problem: Mrs. Miller is a 62-year-old woman has been taking daily aspirin for the prevention of a myocardial infraction (MI) on the advice of a neighbor. She has noticed several episodes of tachycardia, feeling faint, accompanied by the vomiting of coffee-ground emesis and the passing of a tarry stool. After becoming concerned over her symptoms and the increased fatigue, she visits her primary care physician (PCP). Be detailed in your response and provide examples also.
Required:
- Was Mrs. Miller appropriate in taking the advice of her neighbor for a daily aspirin? Why or why not?
- How are the mucosal protective effects of prostaglandins altered with NSAID use? How do they contribute to the development of a peptic ulcer associated with aspirin or NSAID use?
- Why is there an apparent suddenness of the bleeding? Why did she not experience pain as a warning signal?
- What are other risk factors associated with aspirin or NSAID use?
- Research and fill in the normal values for the table. Include the table in your essay.
- Evaluate the findings and give an explanation as to why abnormal lab values are seen.
- Evaluate Mrs. Miller's CBC. What are your findings? Give an explanation for any abnormal findings.
- Among the results of her initial laboratory tests was an elevated BUN level. What is the reason for the elevated BUN?
- Based on this patient's pathology and findings, what would you expect to see for her indirect and direct bilirubin levels?