Acute pain r/t irritation of gastric mucosa and increased cerebrovascular pressure

Risk Ineffective cerebral tissue perfusion r/t atrial fibrillation and hypertension

The patient verbalizes that her main complaint is pain along the epigastric area and nape pain due to her acute gastritis esophageal ulcer and hypertension. Accdg to maslows hierarchy of needs, physiologic need is the priority. It is the priority also since if the patient is in pain, all the vital signs increase which may aggravate the disease process. As seen in the ecg results, there is atrial fibrillation. Accdg to ABC, circulation is of priority since the heart is having difficulty to pump already and may lead to stroke. The pumping of the heart is not effective anymore. If the brain lacks oxygen for about 6 minutes only, it may cause irreversible brain damage. The patient has hypertension and the vasoconstriction itself may lead to decreased cardiac output. If it happens, all of the vital organs will suffer. It is a priority since there is inefficient pumping of the heart Considering the fact that the patient was diagnosed of DM, the problem is her blood glucose. It is a priority since if the patient had her blood glucose less than 80, hypoglycaemia will occur, if it is too high, hyperglycemia will occur which both problems leads to different complications like ketoacidosis Because of the ulceration of the esophagus, there is a possibility of bleeding because of the impaired integrity of the mucosa. Because of pain, the patient sometimes refuses to drink. There is a risk for deficient fluid volume because of the

Risk for decreased cardiac output related to increased afterload (vasoconstriction)

Risk for unstable blood glucose r/t the diabetic disease process

Risk for bleeding r/t ulceration of the esophageal mucosa

Risk for deficient fluid volume r/t restriction of fluid

Risk for infection r/t immunosuppression Fatigue r/t poor physical conditon Risk for activity intolerance r/t body weakness Risk for imbalanced nutrition: less than body requirements r/t decreased appetite

restriction of too much intake of fluid because it may aggravate the workload of the heart