Effective Nursing Intervention for Management of Side-Effects of Medications in Peptic Ulcer Patient: A Case Study

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

1NURSING
Introduction
The following nursing paper is based on the analysis of the case study of Ms Candice
Tong. The patient was admitted to Deakin Hospital on 14th of July 2019 with complains of
pain in the upper part of the abdomen along with vomiting and nausea. The result of
endoscopy and biopsy highlighted that she is suffering from peptic ulcer caused by bacteria
Helicobacter pylori (H.pylori). On next day, post her admission, her discharge planning was
done along with proper medication management planning. The aim of this paper is to
highlight prospective side-effects of the medications that are being prescribed for Mr Candice
Tong. The paper will also illustrated the effective management of those side-effects by
nursing intervention and education of the patient in the domain of over-the-counter (OTC)
medication.
Answer 1
Ms Candice Tong medication list contains Clarithromycin orally, twice daily for a
week. It is an antibiotic that is used for control the infection of H. Pylori (Vernon, 2019).
Clarithromycin is macrolide and nevirapine in nature. It main mode of action is driven
through non-nucleoside reverse transcriptase inhibitor and subsequent killing of the bacterial
cells. However, clarithromycin is associated with side-effects like increase in the level of
stomach pain along with indigestion, diarrhoea along with stomach bloating. Under extreme
scenario, the prolong use of these antibiotic causes unbearable pain in the stomach with high
pain score long with increase in the heart rate (Lanas & Chan, 2017). Taking into the age and
the pathophysiological condition of Ms Tong, it can be said that she is already diagnosed with
bacteria mediated peptic ulcer, encountering pain in the stomach can be detrimental as it can
hamper her overall quality of life. Clarithromycin also hampers the secretion of gastric acid
in the stomach and thus leading to acid accumulation hydrochloric acid (HCL) in the

2NURSING
abdominal lumen and causing acidity. The medication chart of Ms Tong however contains
has medication of hypertension like felodipine and atorvastatin and but have no specific
medication for the management of pain and control of acidity. Thus increase in acidity in the
stomach further increases the level of pain along with the severity of developing gastric ulcer
(Vernon, 2019)
Konrad et al. (2018) are of the opinion that amoxicillin-clavulanic acid treatment
induce several side effects to the patient especially of the patient is an older adult or a
children and is on multidrug treatment. Ms. Tong is 56 years old and is on multidrug
treatment like amoxicillin, clarithromycin and esomeprazole. Thus development of adverse
symptoms is common in case of Ms Tong. The frequently encountered side-effect of Ms.
Tong will include development of stomach pain. Amoxicillin works by killing of the bacterial
(by inhibiting cell-wall biosynthesis) present in the stomach that is causing peptic ulcers.
High and regular dosage of amoxicillin (for Ms Tong it is 1 gram of amoxicillin per day for 7
days orally) can hamper the gastric acid section in the stomach leading to the increase in the
stomach pain. It also leads to the development of nausea and vomiting. Ms Tong is however,
have a medication for the management of vomiting and nausea, metoclopramide (Vernon,
2019).
Answer 2
The first risk of Mr Tong is increase in the level of stomach pain along with acidity in
the stomach. However, Thung et al. (2016) are of the opinion that with the increase in the
evolution of the multi-drug resistant Helicobacter pylori, multidrug treatment approach is
inevitable for successful eradication of the bacterial colonies within the stomach. Thus in
order to cope with the level stomach pain and acid formation in the stomach, proper nursing
intervention can be effective. First intervention includes application of music therapy for non-