Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

Week 4: Gastrointestinal and Hepatobiliary Disorders

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. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

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.

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 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

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.htm). All papers submitted must use this formatting.

Submission and Grading Information Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

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Grading Criteria  Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

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Submit Your Assignment by Day 7 of Week 4

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Week 4 Assignment

Pharmacotherapy for Hepatobiliary Disorders Example Student Submission

Case Study Details:  Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

Patient History Review

The patient has presented at the clinic experiencing diarrhea, nausea, and vomiting.  A review of patient history has revealed that the patient is taking Synthroid, Nifedipine, and Prednisone.  Synthroid 100mcg daily has been prescribed for treatment of hypothyroidism, Nifedipine 30mcg for high blood pressure, and control of angina, and finally Prednisone 10mcg for inflammation, and immune suppression resulting from several chronic conditions.  The patient does state that he has a history of drug abuse and possible contraction of Hepatitis C. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

Primary Diagnosis

While a more comprehensive review of the patient’s medical conditions, and history, as well as diagnostic testing and labs is essential to confirm the diagnosis, based on the patient’s current condition and respective symptoms the patient is suffering from a primary diagnosis of acute gastroenteritis (Cleveland Clinic, 2019).  Gastroenteritis results in inflammation and irritation of both the stomach and intestinal tract (Cleveland Clinic, 2019). Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

This is typically is caused by contracted when one comes into contact with contaminated food containing bacteria, viruses, parasites, or toxins.  These then cause either a bacterial or viral irritation/inflammation of the stomach and intestinal walls.  Gastroenteritis can be spread through contact with a sick person, or through the consumption of food or beverage which has been contaminated with one of the aforementioned items.  Symptoms usually appear within days of exposure and can last typically between one to three days.  Since the patient does not present with fever, and only nausea, vomiting, and diarrhea one can assess that this is acute bacterial gastroenteritis.

Drug Therapy Plan

The treatment of acute gastroenteritis is based on the need to reduce symptoms as the body heals and to prevent further complications from the condition (Arcangelo & Petersen, 2017).  Since the patient is presenting with nausea, diarrhea, and vomiting the concern for dehydration is at the forefront of concerns.  Treatment would begin with intravenous fluid hydration of 0.9% normal saline to assist with dehydration (Cleveland Clinic, 2019).  Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

CBC with differential will be ordered to identify the bacteria present and with CMP to determine the level of electrolyte replacement is required.  If the results show low potassium levels IV fluids will be changed from 0.9% normal saline to also adding potassium.  Phenergan and Zofran can be given IVP for nausea and vomiting as needed every six hours.  Over the counter, Imodium utilized as a first-line defense against diarrhea (Cleveland Clinic, 2019).

As patients’ symptoms subside patient would be encouraged to drink clear liquids and broth to aid in the replacement of fluids and electrolytes lost.  When possible, stool sample will be collected to assess for CDIFF, or determination if gastroenteritis is bacterial or viral.  If labs confirm viral gastroenteritis IV fluids will be continued, and to encourage intestinal healing it would be recommended that patient abstain from food by mouth for next 24-48 hours (Cunha, 2016).  Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

The patient can also be started on Flagyl dependent on ion severity (Cunha, 2016).   If lab testing confirms bacterial gastroenteritis IV fluids will continue, however, the patient will start a regimen of broad-spectrum antibiotics such as Ciprofloxacin.  Besides, additional lab work including thyroid panel to review need to adjust Synthroid dosages, as well as starting a patient on treatment for Hepatitis C.  Consideration should also be made to assess patients need for Prednisone and if the dosage should be tapered down.

Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521 References
Excellent Good Fair Poor
Explain your diagnosis for the patient, including your rationale for the diagnosis.
23 (23%) – 25 (25%)
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.
20 (20%) – 22 (22%)
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. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
18 (18%) – 19 (19%)
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.
(0%) – 17 (17%)
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.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
27 (27%) – 30 (30%)
The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
24 (24%) – 26 (26%)
The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
21 (21%) – 23 (23%)
The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
(0%) – 20 (20%)
The response inaccurately and vaguely describes 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.
27 (27%) – 30 (30%)

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.

24 (24%) – 26 (26%)

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. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521

21 (21%) – 23 (23%)

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.

(0%) – 20 (20%)

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.

Written 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%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
(4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
(0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
(5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
(4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
(0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written 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%) – 5 (5%)
Uses correct APA format with no errors Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
(4%) – 4 (4%)
Contains a few (1–2) APA format errors. Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders for NURS 6521
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
(0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100