NURS 6512 Week 4 Assignment: Gastrointestinal and Hepatobiliary Disorders

NURS 6512 Week 4 Assignment: Gastrointestinal and Hepatobiliary Disorders

As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.

How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.

Learning Objectives

Students will:

• Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders
• Justify drug therapy plans based on patient history and diagnosis

Learning Resources

 

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2^nd 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)

 

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Photo Credit: Getty Images/iStockphoto

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.

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 ). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
• Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

 

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment draft and review the originality report.

 

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:

Week 4 Assignment

 

What’s Coming Up in Module 4?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In the next module, you will examine types of drugs prescribed to patients with endocrine disorders, such as diabetes, and you will consider the impact of patient factors on the effects of these drugs.

Next Week

 

Name: NURS_6521_Week4_Assignment_Rubric

		Excellent	Good	Fair	Poor
Explain your diagnosis for the patient, including your rationale for the diagnosis.		Points Range: 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.	Points Range: 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.	Points Range: 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.	Points Range: 0 (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.		Points Range: 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.	Points Range: 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.	Points Range: 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.	Points Range: 0 (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.		Points Range: 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.	Points Range: 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.	Points Range: 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.	Points Range: 0 (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.		Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity.	Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.	Points Range: 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation		Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors	Points Range: 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors	Points Range: 0 (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.		Points Range: 5 (5%) – 5 (5%) Uses correct APA format with no errors	Points Range: 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors	Points Range: 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors
Total Points: 100

Name: NURS_6521_Week4_Assignment_Rubric

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

The patient in the assigned case study presents with nausea and vomiting, RUQ pain, elevated bilirubin levels, elevated aspartate levels, and elevated white blood cells, which suggests a diagnosis of acute calculous cholecystitis (Pisano et al., 2020). Inflammation of the gallbladder due to infections is the main diagnostic feature of this condition, which is confirmed by elevated white blood cells, in addition to the symptoms displayed above. Previous evidence also reports that patients with acute cholecystitis usually present with URQ pain especially after a fatty large meal, just like the patient in the provided case study (Arockia Singh & Anish Kumar, 2019). An additional test to confirm this diagnosis includes abdominal ultrasound and CT, for identification of gall bladder stones.

Since acute calculous cholecystitis is caused by bacteria, antibiotic therapy is usually recommended by most clinical guidelines as the most effective treatment option. The choice of the antibiotic however depends on the causative microorganism which needs to be identified by a microbial culture of a sample of the patient’s bile (Fu et al., 2021). The patient also report allergic reactions to amoxicillin, which is the most common antibiotic normally used for the management of this condition. In such a situation, the use of third-generation cephalosporins like ceftriaxone is normally recommended in combination with metronidazole (Pisano et al., 2020). As such the patient’s prescription will include Ceftriaxone 1g administered intravenously for 5 days, and Metronidazole 1 g administered initially with a loading dose of 500 mg after every 8 hours. In the management of the patient’s nausea and vomiting, antiemetics like ondansetron are recommended. Tylenol on the other hand is effective in managing the associated pain. In case of worsening symptoms, surgical intervention may be considered.

 

 

References

Arockia Singh, M. D. S., & Anish Kumar, M. P. (2019). Diagnosis and management of acute acalculous cholecystitis in an outpatient: a case report. International Surgery Journal, 6(5), 1777. https://doi.org/10.18203/2349-2902.isj20191906

Fu, Y., Pang, L., Dai, W., Wu, S., & Kong, J. (2021). Advances in the study of acute acalculous cholecystitis: a comprehensive review. Digestive Diseases. DOI: 10.1159/000520025

‌Pisano, M., Allievi, N., Gurusamy, K., Borzellino, G., Cimbanassi, S., Boerna, D., … & Ansaloni, L. (2020). 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World journal of emergency surgery, 15(1), 1-26. https://doi.org/10.1186/s13017-020-00336-x