NURS 6521 Week 4 Assignment Pharmacotherapy for Gastrointestinal And Hepatobiliary Disorders Essay

NURS 6521 Week 4 Assignment Pharmacotherapy for Gastrointestinal And Hepatobiliary Disorders Essay

Pharmacotherapy for Gastrointestinal And Hepatobiliary Disorders

The patient is a forty-six-year-old female who indicates a twenty-four-hour history of abdominal pain in the RUQ, which commenced about an hour after having a large meal with her family. She is also positive for nausea and vomiting. From the exams, the patient’s vitals are within the expected ranges. Non-distended abdomen with mild tenderness was noted. In addition, direct bilirubin and white blood cells are both above the acceptable range. The possible diagnosis for this patient is Hepatitis A. This is a condition usually characterized by substantial inflammation of the liver cells due to the Hepatitis A virus, which is mainly spread through the fecal-oral route (Almeida et al.,2021). The major symptoms of the condition include the onset of jaundice, irritability, fatigue, muscle or joint pain, decreased appetite, RUQ pain, vomiting, nausea, and malaise (Hofmeister et al.,2021). As such, the likely diagnosis is Hepatitis A, and the rationale for this diagnosis is that the patient had various symptoms, such as raised levels of WBC and direct bilirubin, RUQ tenderness, pain, vomiting, and nausea.

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The drug therapy for a patient with Hepatitis A usually depends on the symptoms shown by the patient. As such, the recommended medication is 5m of Metoclopramide which will help the patient to stop vomiting and alleviate nausea. The patient also needs pain relief for her RUQ pain but since bilirubin is already raised, a medication metabolized by other organs rather than liver should be used. As such, an appropriate medication, in this case, would be ibuprofen (500 mg PO q6h) (Rosenthal & Burchum, 2021). These medications have been recommended on the basis that the patient has presented with various symptoms which negatively impact his life; as such, the symptoms should be treated since the approach for this case is usually conservative. It will be key to inform the patient to adhere to the medication regimen so that the condition can disappear.

References

Almeida, P. H., Matielo, C. E., Curvelo, L. A., Rocco, R. A., Felga, G., Della Guardia, B., & Boteon, Y. L. (2021). Update on the management and treatment of viral hepatitis. World Journal of Gastroenterology, 27(23), 3249. https://doi.org/10.3748%2Fwjg.v27.i23.3249

Hofmeister, M. G., Xing, J., Foster, M. A., Augustine, R. J., Burkholder, C., Collins, J., … & Spradling, P. R. (2021). Hepatitis A person-to-person outbreaks: epidemiology, morbidity burden, and factors associated with hospitalization—multiple states, 2016–2019. The Journal of Infectious Diseases, 223(3), 426–434. https://doi.org/10.1093/infdis/jiaa636

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

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DC is a 46-year-old female who presents with a 24-hour history of RUQ pain.  She states the pain started about 1 hour after a large dinner she had with her family.  She has had nausea and on instance of vomiting before presentation.

PMH:	Vitals:
HTN	Temp:  98.8oF
Type II DM	Wt:       202 lbs
Gout	Ht:        5’8”
DVT – Caused by oral BCPs	BP:       136/82
	HR:       82 bpm

Current Medications:	Notable Labs:
Lisinopril 10 mg daily	WBC:                13,000/mm3
HCTZ 25 mg daily	Total bilirubin:    0.8 mg/dL
Allopurinol 100 mg daily	Direct bilirubin:  0.6 mg/dL
Multivitamin daily	Alk Phos:           100 U/L
	AST:                   45 U/L
	ALT:                   30 U/L

Allergies:

• Latex
• Codeine
• Amoxicillin

PE:

• Eyes: EOMI
• HENT: Normal
• GI:Nondistended, minimal tenderness
• Skin:Warm and dry
• Neuro: Alert and Oriented
• Psych:Appropriate mood
• Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.

  Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

  RESOURCES

   

  Be sure to review the Learning Resources before completing this activity.
  Click the weekly resources link to access the resources.

  WEEKLY RESOURCES

  To Prepare:

• Review the case study assigned by your Instructor for this Assignment
• Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
• Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
• Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

• BY DAY 7 OF WEEK 4

  Write a 1-page paper that addresses the following:

• Explain your diagnosis for the patient, including your rationale for the diagnosis.
• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.
• Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htmLinks to an external site.). All papers submitted must use this formatting.
  

  SUBMISSION INFORMATION

  Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

• To submit your completed assignment, save your Assignment as WK4Assgn_LastName_Firstinitial
  

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  NURS_6521_Week4_Assignment_Rubric

  NURS_6521_Week4_Assignment_Rubric

  Criteria	Ratings	Pts
  This criterion is linked to a Learning OutcomeExplain your diagnosis for the patient, including your rationale for the diagnosis.	25 to >22.25 ptsExcellent The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment. 22.25 to >19.75 ptsGood The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment. 19.75 to >17.25 ptsFair The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment. 17.25 to >0 ptsPoor The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing.	25 pts
  This criterion is linked to a Learning OutcomeDescribe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.	30 to >26.7 ptsExcellent The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 26.7 to >23.7 ptsGood The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 23.7 to >20.7 ptsFair The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 20.7 to >0 ptsPoor The response inaccurately and vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.	30 pts
  This criterion is linked to a Learning OutcomeJustify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.	30 to >26.7 ptsExcellent The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. … The response includes specific, accurate, and detailed examples that fully support the justification provided. 26.7 to >23.7 ptsGood The response provides a basic justification for the recommended drug therapy plan for this patient. … The response includes only 1-2 examples that fully support the justification provided. 23.7 to >20.7 ptsFair The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. … The response may include examples, which may inaccurately or vaguely support the justification provided. 20.7 to >0 ptsPoor The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. … The response does not include examples that support the justification provided, or is missing.	30 pts
  This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.	5 to >4.45 ptsExcellent Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4.45 to >3.95 ptsGood Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.95 to >3.45 ptsFair Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 3.45 to >0 ptsPoor Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.	5 pts
  This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	5 to >4.45 ptsExcellent Uses correct grammar, spelling, and punctuation with no errors 4.45 to >3.95 ptsGood Contains a few (1–2) grammar, spelling, and punctuation errors 3.95 to >3.45 ptsFair Contains several (3–4) grammar, spelling, and punctuation errors 3.45 to >0 ptsPoor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding	5 pts
  This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.	5 to >4.45 ptsExcellent Uses correct APA format with no errors 4.45 to >3.95 ptsGood Contains a few (1–2) APA format errors 3.95 to >3.45 ptsFair Contains several (3–4) APA format errors 3.45 to >0 ptsPoor Contains many (≥ 5) APA format errors	5 pts
  Total Points: 100 LEARNING RESOURCES Required Readings   Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597) Chapter 65, “Laxatives” (pp. 598–604) Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616) Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743) Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver DiseasesLinks to an external site.. Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367 This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder.