4b case analysis group 3

7/27/2019 4b Case Analysis Group 3

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PHBS-2B LEC

4B-PH

GROUP 3

Dela Cruz, Kizer E.

Estacio, Banette Lysa

Esteban, Kimberly

Gerzon, Eliana

Guloy, Jr., Alvin Joseph A.


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CASE ANALYSIS AND CRITICAL THINKING

PHBS2B LECTURE

STUDY CASE 1 (for odd-numbered groups)

Patient KC, an unemployed 78 year old male patient was complaining of difficult defacation for

the past 2 weeks. There had been no incidence of passage of bloody stools. There was no note

of weight loss, weakness, polydipsia, polyuria, polyphagia. He does not have any concurrent

disease. Patient is not maintained on any medication. No history of allergy was noted as well.

Physical examination findings showed normal vital signs, heart and lung findings. Soft, non-

tender abdomen with no distention, mass or abnormal bowel sounds was noted on abdominal

exam. Rectal exam revealed the absence of varices/ hemorrhoids or mass. No impaction of

fecal material was noted.

a.Give a therapeutic proposal for your patient. (Identify the laxative of choice)

For a 78 year old geriatric patient, physiologically there is hypoactivity of the colon, thus

constipation is a common problem. Thus, colonic irritants can be given to increase the

peristalsis of the colon.

Give Bisacodyl (Pharex) 1 tablet at bedtime (5 mg as single dose). It is can be taken the

evening before a bowel movement is desired. Bisacodyl normally causes bowel movement

within 6 to 10 hours. It should be taken on an empty stomach. Do not take within one hour of

antacids, milk or other dairy products. Do not take bisacodyl more than once a day or for more

than 1 week without talking to your doctor.

b. If in the event that patient KC responded to your therapy but he started to

complain of diarrhea associated with weakness 2 weeks after the start of therapy,

what would be your next step?

If the patient develops diarrhea after two weeks of treatment, the action to be taken is to

stop the administration of Bisacodyl because it is the common side effect of this drug and inform


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the doctor of the condition. Oral rehydration therapy may be given to restore electrolytes lost

due to diarrhea.

But to rule out any infectious process, the doctor may request for a stool examination.

4b case analysis group 3

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