NURS 6521 Week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
NURS 6521 Week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Gastrointestinal problems are a common occurrence in nursing and healthcare. Nurses and other healthcare providers utilize interventions such as comprehensive patient assessment to develop accurate diagnoses and care plans. The treatment of gastrointestinal disorders require the use of evidence-based interventions and guidelines to improve outcomes. Therefore, this essay examines a case study of a 46-year-old female that has presented to the clinic with complaints of right upper quadrant pain for the last 24 hours. The patient developed the problem an hour after having a large dinner with her family. She reported nausea and vomiting before the onset of pain. The essay develops the patient’s diagnosis and treatment plan that would aid recovery.
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Diagnosis
The most probable diagnosis for the patient is biliary colic. Biliary colic is a pain in the abdomen that arises from stones in the bile duct or cystic duct of the biliary tree. Patients develop the pain after eating a large fatty mean. The meal causes gallbladder contraction (Hapca et al., 2021; Makutonin et al., 2023). Patients often describe the pain as constant and not colicky. Prolonged obstruction results in cholangitis or cholecystitis. The accompanying symptoms associated with the biliary colic include right upper quadrant pain, nausea, and vomiting (Sigmon et al., 2023). The patient in the case study also has risk factors that predispose her to biliary colic such as being overweight. There is also the elevation of white blood cells, which may indicate the risk of cholangitis or cholecystitis if responsive interventions are not implemented. Liver enzymes such as direct bilirubin, GGT, ALP, ALT, and AST may or may not be elevated in biliary colic (Doherty et al., 2022).
Appropriate Drug Therapy
An appropriate treatment for the patient in the case study is ursodeoxycholic acid. Ursodeoxycholic acid is the drug of choice that helps in dissolving gallstones in patients with biliary colic. The additional interventions include restricting fat intake and administration of analgesics and antiemetics for nausea and vomiting. The study by Pizza et al., (2020) found that Ursodeoxycholic acid significantly reduces incidence of cholelithiasis, cholecystitis among patients with biliary obstruction, hence prescribing the patient in the case study.
Conclusion
In summary, the most likely diagnosis for the patient is biliary colic. Biliary colic arises from the obstruction at the biliary tree. The presenting symptoms and risk factors align with those seen in patients with biliary colic. An effective treatment would be prescribing her Ursodeoxycholic acid.
References
Doherty, G., Manktelow, M., Skelly, B., Gillespie, P., Bjourson, A. J., & Watterson, S. (2022). The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease. Medicina, 58(3), Article 3. https://doi.org/10.3390/medicina58030388
Hapca, S., Ramsay, G., Murchie, P., & Ahmed, I. (2021). Biliary colic. BMJ, 374, n2085. https://doi.org/10.1136/bmj.n2085
Makutonin, M., Moghatederi, A., Newton, S., Ma, Y., & Meltzer, A. C. (2023). Biliary colic in the emergency department: A state-wide analysis of one-year costs and clinical outcomes. Surgery Open Science, 12, 9–13. https://doi.org/10.1016/j.sopen.2023.02.002
Pizza, F., D’Antonio, D., Lucido, F. S., Tolone, S., Del Genio, G., Dell’Isola, C., Docimo, L., & Gambardella, C. (2020). The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial. Obesity Surgery, 30(11), 4315–4324. https://doi.org/10.1007/s11695-020-04801-z
Sigmon, D. F., Dayal, N., & Meseeha, M. (2023). Biliary Colic. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430772/
Margo Sacoyah White
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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:bNondistended, minimal tenderness
- Skin: Warm and dry
- Neuro: Alert and Oriented
- Psych: Appropriate mood
Pharmacotherapy for 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.
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
Learning Resources
- 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 Diseases
Links 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.
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.htm
Links 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
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6521_Week4_Assignment_Rubric
NURS_6521_Week4_Assignment_Rubric
| Criteria |
Ratings |
Pts |
| This criterion is linked to a Learning Outcome Explain 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 Outcome Describe 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 Outcome Justify 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 Outcome 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 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 Outcome Written 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 Outcome 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 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 |
