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 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.
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.
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 (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.
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.
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.
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.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation5 (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
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
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
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
Total Points: 100
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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