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
Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea
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.
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.
- Please review the rubric.
Case Study Assigned
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
Reminder: The School 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.
Rubric Detail
| Excellent | Good | ||||
| 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. | |||
| 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. | |||
| 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. | |||
| 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 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. | 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. | |||
| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors | 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors | |||
| 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 (5%) Uses correct APA format with no errors | 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors | |||
| Total Points: 100 | |||||
| Fair | Poor | |
| 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 (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. | |
| 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 (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. | |
| 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 (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. | |
| 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 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. | |
| 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors | 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding | |
| 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors | 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors | |
Expert Answer and Explanation
Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Diagnosis for the Patient
This patient might have hepatitis C. Hepatitis is a viral infection that causes swelling in the liver and can sometimes damage the liver (Schillie et al., 2020). The symptoms of the disease include fatigue, poor appetite, weight loss, swelling of legs, vomiting, nausea, and diarrhea.
The risk factors of the disease include previous history of the virus, drug abuse, especially the ones taken through injection, and having HIV infection (Schillie et al., 2020). This disease has been selected as a diagnosis for the case because the patient experiences diarrhea, vomiting, and nausea. The patient also takes drugs, a behavior that might expose him/her to contaminated blood. He/she also has hepatitis C.
Appropriate Drug Therapy and Its Justification
Hepatitis C is normally treatable. The disease can be treated using antiviral medications. When preparing the treatment plan for a patient in this case, the goal should that no virus should be detected in the patient’s body within 12 weeks of treatment. The patient can be prescribed Relenza 10 mg inhaled per day for 10 days. I have selected this medication to treat the disease because it is an antivirus.
According to AASLD-IDSA HCV Guidance Panel (2018), antivirus medications can be used to treat patients with Hepatitis C. I have also selected the medication because Seo and Choi (2021) note that it can be used to treat Hepatitis C. Apart from treatment, the patient should take steps to prevent the disease. He or she should receive vaccinations against hepatitis A and B viruses. The viruses can cause hepatitis C. The patient should also avoid drug abuse. Because these medications might be harming the patient’s liver.
References
AASLD-IDSA HCV Guidance Panel (2018). Hepatitis C Guidance 2018 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society of America, 67(10), 1477–1492. https://doi.org/10.1093/cid/ciy585
Schillie, S., Wester, C., Osborne, M., Wesolowski, L., & Ryerson, A. B. (2020). CDC Recommendations for Hepatitis C Screening Among Adults – United States, 2020. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 69(2), 1–17. https://doi.org/10.15585/mmwr.rr6902a1
Seo, D. J., & Choi, C. (2021). Antiviral bioactive compounds of mushrooms and their antiviral mechanisms: a review. Viruses, 13(2), 350. https://www.mdpi.com/1008578
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FAQs
What are the 5 Common Diseases of the Digestive System?
The digestive system plays a crucial role in our body, breaking down food into smaller components that can be absorbed and utilized by the body. It consists of various organs, including the esophagus, stomach, liver, pancreas, small intestine, and large intestine. Unfortunately, this system is also susceptible to a wide range of diseases, which can cause discomfort, pain, and other health problems. In this article, we will explore the five most common diseases of the digestive system.
1. Gastroesophageal Reflux Disease (GERD)
GERD is a chronic condition in which the stomach acid and digestive enzymes flow back into the esophagus, causing heartburn and other symptoms. It is caused by a weakened lower esophageal sphincter, which is a muscle that acts as a valve between the esophagus and stomach. Symptoms of GERD include heartburn, regurgitation, difficulty swallowing, chest pain, and a sour taste in the mouth.
2. Peptic Ulcer Disease
Peptic ulcer disease is a condition in which open sores develop in the lining of the stomach or small intestine. It is caused by a bacterial infection called Helicobacter pylori or by long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Symptoms of peptic ulcer disease include abdominal pain, bloating, nausea, vomiting, and loss of appetite.
3. Inflammatory Bowel Disease (IBD)
IBD is a group of chronic conditions that cause inflammation and irritation in the lining of the digestive tract. The two most common types of IBD are Crohn’s disease and ulcerative colitis. Symptoms of IBD include abdominal pain, diarrhea, rectal bleeding, fatigue, and weight loss.
4. Gallstones
Gallstones are hardened deposits of digestive fluid that form in the gallbladder. They can be as small as a grain of sand or as large as a golf ball. Gallstones can cause pain and discomfort when they block the bile duct, which is a tube that carries bile from the liver to the small intestine. Symptoms of gallstones include abdominal pain, nausea, vomiting, and fever.
5. Irritable Bowel Syndrome (IBS)
IBS is a common condition that affects the large intestine. It is characterized by a group of symptoms that include abdominal pain, bloating, constipation, and diarrhea. The exact cause of IBS is unknown, but it is believed to be related to a combination of factors, including abnormal muscle contractions in the intestines, inflammation, and changes in the gut microbiome.
In conclusion, the digestive system is a vital part of our body that plays an essential role in breaking down and absorbing nutrients from the food we eat. Unfortunately, it is also susceptible to a range of diseases that can cause discomfort and pain. The five most common diseases of the digestive system include GERD, peptic ulcer disease, IBD, gallstones, and IBS. If you experience any of these symptoms, it is important to seek medical attention promptly to receive the appropriate treatment.
FAQs
- What are the symptoms of GERD?
- The symptoms of GERD include heartburn, regurgitation, difficulty swallowing, chest pain, and a sour taste in the mouth.
- How is peptic ulcer disease treated?
- Treatment for peptic ulcer disease includes antibiotics to kill the H. pylori bacteria, acid-suppressing medication, and in severe cases, surgery.
- Can IBD be cured?
- There is currently no cure for IBD, but treatment can help manage the symptoms and reduce inflammation.
Understanding Gastrointestinal Disease: Symptoms, Causes, and Treatment
The gastrointestinal (GI) system plays a crucial role in the human body as it is responsible for the digestion, absorption, and elimination of food. However, when there is a disruption in the functioning of the GI system, it can lead to various diseases that can affect an individual’s overall health. In this article, we will discuss gastrointestinal disease, its symptoms, causes, and treatment options.
What is Gastrointestinal Disease?
Gastrointestinal disease refers to any condition that affects the digestive system, which includes the esophagus, stomach, small intestine, large intestine, rectum, and anus. These conditions can range from mild to severe, and they can affect people of all ages.
Symptoms of Gastrointestinal Disease
The symptoms of gastrointestinal disease can vary depending on the specific condition and its severity. Some of the common symptoms include:
- Abdominal pain and cramping
- Bloating and gas
- Diarrhea or constipation
- Nausea and vomiting
- Loss of appetite
- Rectal bleeding
- Fatigue and weakness
- Weight loss
If you experience any of these symptoms, it is important to seek medical attention to determine the underlying cause.
Causes of Gastrointestinal Disease
There are various factors that can contribute to gastrointestinal disease, including:
Diet
A diet high in processed foods, sugar, and unhealthy fats can lead to gastrointestinal disease. These foods can cause inflammation in the digestive system, leading to conditions such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).
Infections
Infections caused by viruses, bacteria, or parasites can also lead to gastrointestinal disease. These infections can cause inflammation and damage to the lining of the digestive system, leading to conditions such as gastroenteritis and peptic ulcers.
Genetics
Certain genetic mutations can increase an individual’s risk of developing gastrointestinal disease. For example, mutations in the NOD2 gene are associated with an increased risk of developing Crohn’s disease.
Medications
Certain medications can also cause gastrointestinal disease. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) can cause damage to the lining of the digestive system, leading to conditions such as peptic ulcers.
Treatment Options for Gastrointestinal Disease
The treatment for gastrointestinal disease depends on the specific condition and its severity. Some common treatment options include:
Medications
Medications such as antibiotics, anti-inflammatories, and proton pump inhibitors (PPIs) can be used to treat gastrointestinal disease. These medications can help reduce inflammation, relieve pain, and prevent further damage to the digestive system.
Surgery
In some cases, surgery may be necessary to treat gastrointestinal disease. For example, surgery may be required to remove a tumor or repair damage to the digestive system caused by an injury.
Lifestyle Changes
Lifestyle changes such as following a healthy diet, getting regular exercise, and reducing stress can also help manage gastrointestinal disease. These changes can help reduce inflammation and promote healing in the digestive system.
FAQs
Q1. What is the most common gastrointestinal disease?
A1. The most common gastrointestinal disease is gastroesophageal reflux disease (GERD), which affects millions of people worldwide.
Q2. Can stress cause gastrointestinal disease?
A2. Yes, stress can contribute to gastrointestinal disease by causing inflammation and damaging the lining of the digestive system.
Q3. What is inflammatory bowel disease?
A3. Inflammatory bowel disease (IBD) is a group of conditions that cause inflammation in the digestive system, including Crohn
Early Signs of Gastrointestinal Disease
Gastrointestinal (GI) diseases can be challenging to diagnose and treat, as they often present with a range of symptoms that can be similar to other conditions. However, early detection is crucial for successful treatment and management of GI diseases. In this article, we will discuss some of the early signs of GI diseases that you should be aware of.
What is Gastrointestinal Disease?
The gastrointestinal system, also known as the digestive system, consists of organs such as the stomach, small intestine, large intestine, and rectum. GI diseases are conditions that affect these organs and can cause discomfort, pain, and a range of symptoms. Some of the most common GI diseases include:
- Inflammatory bowel disease (IBD)
- Irritable bowel syndrome (IBS)
- Gastroesophageal reflux disease (GERD)
- Peptic ulcer disease
- Celiac disease
- Colon cancer
Common Symptoms of GI Diseases
The symptoms of GI diseases can vary depending on the type of disease and the severity of the condition. However, some common symptoms of GI diseases include:
- Abdominal pain and discomfort
- Nausea and vomiting
- Diarrhea or constipation
- Bloating and gas
- Acid reflux or heartburn
- Loss of appetite or weight loss
- Rectal bleeding
- Fatigue
- Anemia
Early Signs of GI Diseases
Early detection of GI diseases can be challenging, as many symptoms can be subtle or easily dismissed. However, being aware of the following early signs can help with early detection and prompt treatment:
Changes in Bowel Habits
Changes in bowel habits such as diarrhea, constipation, or both can be a sign of GI diseases. These changes can be accompanied by abdominal discomfort, bloating, and gas.
Rectal Bleeding
Rectal bleeding, whether bright red or dark, can be a sign of GI diseases such as ulcerative colitis, Crohn’s disease, or colon cancer. It is essential to seek medical attention if you experience rectal bleeding.
Persistent Abdominal Pain
Abdominal pain that persists for more than a few days can be a sign of GI diseases such as IBD or peptic ulcer disease. It is essential to seek medical attention if the pain is severe, accompanied by vomiting or fever, or if you experience unexplained weight loss.
Unexplained Weight Loss
Unexplained weight loss can be a sign of several GI diseases, including colon cancer, pancreatic cancer, or celiac disease. If you experience weight loss without changes to your diet or exercise routine, it is essential to seek medical attention.
Difficulty Swallowing
Difficulty swallowing or the sensation of food getting stuck in the throat can be a sign of GERD, esophageal cancer, or other GI diseases. It is essential to seek medical attention if you experience difficulty swallowing.When to Seek Medical Attention
If you experience any of the early signs mentioned above or other symptoms that persist or worsen, it is crucial to seek medical attention promptly. Early detection and treatment of GI diseases can help prevent complications and improve outcomes.
Prevention and Management of GI Diseases
While some GI diseases cannot be prevented, there are steps you can take to reduce your risk and manage existing conditions, including:
- Maintaining a healthy diet rich in fiber and low in processed foods
- Staying hydrated
- Exercising regularly
- Managing stress levels
- Avoiding tobacco and excessive alcohol consumption
- Taking medications as prescribed by a healthcare provider
What is the drug SYNTHROID 100 mg used for?
Synthroid is not typically measured in milligrams (mg) but rather in micrograms (mcg). Synthroid is a brand name for levothyroxine sodium, a medication commonly used to treat hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormones.
The specific dosage of Synthroid (levothyroxine) prescribed to a patient depends on their individual thyroid hormone needs and is usually measured in micrograms, such as 25 mcg, 50 mcg, 75 mcg, 100 mcg, and so on.
Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4). It works by replacing or supplementing the thyroid hormone in the body, helping to restore normal thyroid hormone levels. This medication is essential for regulating various bodily functions and metabolism.
The common uses of Synthroid (levothyroxine) include:
- Hypothyroidism: It is the primary treatment for individuals with an underactive thyroid gland (hypothyroidism). Hypothyroidism can cause a range of symptoms, including fatigue, weight gain, cold intolerance, and depression. Levothyroxine helps alleviate these symptoms by restoring thyroid hormone levels to normal.
- Goiter: Levothyroxine can also be used to shrink an enlarged thyroid gland (goiter) when it is due to an underactive thyroid.
- Thyroid Cancer: In some cases, levothyroxine may be used as part of the treatment for thyroid cancer, particularly after thyroid surgery to suppress thyroid-stimulating hormone (TSH) and prevent the growth of any remaining cancer cells.
It’s important to note that the dosage and use of Synthroid (levothyroxine) should be determined by a healthcare professional based on individual patient needs, and regular monitoring of thyroid hormone levels is typically required to ensure that the medication is effectively managing the condition. Additionally, the dosage may need to be adjusted over time to maintain proper thyroid hormone levels.
What are the side effects of SYNTHROID 100 mg?
Synthroid (levothyroxine) is typically not prescribed in milligrams (mg) but rather in micrograms (mcg), and it’s important to note that side effects can vary from person to person. However, I can provide information on potential side effects associated with levothyroxine at various dosages, including 100 mcg. Keep in mind that not everyone will experience these side effects, and some individuals may experience none at all. It’s crucial to take this medication as prescribed by a healthcare professional and to report any unusual or severe side effects to your healthcare provider. Common side effects of Synthroid (levothyroxine) can include:
- Overstimulation: Some individuals may experience symptoms of overstimulation, which can include nervousness, restlessness, anxiety, or irritability.
- Insomnia: Difficulty sleeping or insomnia can occur in some people taking levothyroxine, especially if the dosage is too high for their needs.
- Tachycardia (Rapid Heartbeat): An increased heart rate or palpitations may occur, particularly if the medication dosage is too high.
- Sweating: Excessive sweating can be a side effect in some individuals.
- Heat Intolerance: An increased sensitivity to heat, along with excessive sweating, may occur.
- Weight Loss: In some cases, individuals may experience unintended weight loss while taking levothyroxine, especially if the dosage is too high.
- Digestive Issues: Gastrointestinal symptoms such as diarrhea, nausea, or abdominal cramps can occur, although they are less common.
- Muscle Weakness or Tremors: Some people may experience muscle weakness or tremors, particularly if the medication dosage is not properly adjusted.
- Hair Loss: Hair loss or changes in hair texture can be a side effect, but it is usually temporary and resolves with continued use of the medication.
- Skin Rash: In rare cases, individuals may develop a skin rash or hives as a reaction to levothyroxine.
What is considered a high dose of synthroid?
A high dose of Synthroid (levothyroxine) can vary depending on individual factors such as a person’s age, weight, the severity of their thyroid condition, and their response to the medication. Generally, a high dose of Synthroid is one that exceeds the typical dosage range used to treat hypothyroidism and other thyroid disorders.
Typical doses of levothyroxine for adults with hypothyroidism often range from 25 micrograms (mcg) to 200 mcg per day. However, in some cases, individuals with severe hypothyroidism or certain medical conditions may require doses higher than 200 mcg per day to effectively manage their thyroid hormone levels. Doses exceeding 200 mcg per day are usually considered high.
It’s crucial to emphasize that determining the appropriate dosage of Synthroid is a complex process that requires careful monitoring by a healthcare provider. The goal of treatment is to restore and maintain thyroid hormone levels within the normal range for the individual patient while minimizing the risk of side effects or complications.
High doses of levothyroxine can increase the risk of side effects associated with excessive thyroid hormone levels, such as:
- Cardiac Issues: Tachycardia (rapid heart rate), palpitations, and arrhythmias (irregular heart rhythms) can occur with high doses.
- Nervousness and Anxiety: Excessive doses can lead to symptoms of overstimulation, including nervousness, restlessness, and anxiety.
- Insomnia: High doses may cause difficulty sleeping or insomnia.
- Heat Intolerance: An increased sensitivity to heat and excessive sweating can result from high doses.
- Weight Loss: Some individuals may experience unintended weight loss with high doses.
- Muscle Weakness: Muscle weakness or tremors can occur with excessive dosages.
- Digestive Issues: Gastrointestinal symptoms like diarrhea and abdominal cramps are possible but less common.
To avoid these complications, healthcare providers carefully adjust the dosage of levothyroxine based on the patient’s thyroid function tests and their clinical response to treatment. Regular monitoring of thyroid hormone levels is essential to ensure that the dosage remains appropriate.
It’s crucial never to adjust your Synthroid dosage on your own without consulting your healthcare provider. If you have concerns about your dosage or are experiencing side effects, contact your healthcare provider for guidance and possible adjustments to your medication regimen. Adjusting the dosage without medical supervision can lead to health risks and complications.
