Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
The focus of this paper is HL’s case in treating stomach and liver problems. HL, the patient, is experiencing vomiting, diarrhea, and nausea at the clinic. There’s a possibility HL has Hepatitis C because of a history of drug use. Currently, HL is taking Synthroid, Nifedipine, and Prednisone.
Table of Contents
My primary diagnosis for HL is gastroenteritis, an infection in the intestines caused by a virus, bacteria, or parasite. Norovirus, a common cause of viral gastroenteritis, may be responsible for HL’s symptoms. It spreads easily from person to person or through contaminated food or drinks, causing symptoms like vomiting, abdominal pain, and fever.
The patient’s use of prednisone is significant in this diagnosis. Prednisone is converted to prednisolone in the liver. Corticosteroids like prednisone can worsen liver function, increase hepatitis C virus levels, and exacerbate liver problems, leading to stomach issues like nausea, vomiting, and diarrhea.
To manage symptoms, the patient should sip water frequently throughout the day and gradually reintroduce easy-to-digest foods like crackers, toast, and gelatin. If nausea returns after eating, the patient should stop eating. The focus of drug therapy should be on managing symptoms and tapering off prednisone gradually. I would decrease the prednisone dosage slowly until it’s stopped. Adding ondansetron, a less sedating antiemetic, could help manage nausea. Nifedipine and Synthroid can continue as prescribed.
References
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547852
Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Gastrointestinal (GI) and hepatobiliary disorders affect the stomach, liver, and related systems. They often share similar symptoms like abdominal pain, constipation, and nausea. It’s crucial for nurses to accurately diagnose and treat these disorders based on their cause rather than just treating symptoms.
After identifying the underlying cause, nurses can recommend a suitable drug therapy plan considering the patient’s medical history and individual factors. In this assignment, a patient’s case study with symptoms suggesting a GI/hepatobiliary disorder is analyzed, and a drug therapy plan is devised accordingly.
To Prepare
Review the assigned case study and consider the patient’s symptoms, medical history, and current medications.
Propose a diagnosis for the patient, considering whether the symptoms stem from a gastrointestinal/hepatobiliary disorder or another condition.
Devise a drug therapy plan based on the diagnosis and the patient’s current medications.
By Day 7 of Week 4
Write a 1-page paper addressing:
Explanation of the diagnosis and rationale behind it.
Description of a suitable drug therapy plan considering the diagnosis and current medications.
Justification for the chosen drug therapy plan with specific examples.
Submission and Grading Information
Save your Assignment as “WK4Assgn+last name+first initial.(extension)”.
Refer to the Week 4 Assignment Rubric for grading criteria.
Submit your Assignment via the Week 4 Assignment link.
Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
The case of HL is the subject of this Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders paper. In the clinic, patient HL presents with the following symptoms: vomiting, diarrhea, and nausea. There is a possibility that the patient has Hepatitis C due to a history of drug misuse. These are the medications that HL is now taking: Synthroid, Nifedipine, and Prednisone.
Gastroenteritis would be my primary diagnosis for HL. An infection of the lining of the intestines is known as gastroenteritis, which can be caused by a virus, bacteria, or parasite. The second most prevalent ailment in the United States is viral gastroenteritis. There is a good chance that norovirus is to blame. It can be passed from person to person or by contaminated food or drink. Vomiting, chills, abdominal pain, and fever are among the patient’s symptoms. Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
The patient’s use of prednisone is the basis for this diagnosis. The liver converts prednisone to prednisolone. This patient’s liver function may have been affected by corticosteroids, which can increase hepatitis C virus (HCV) RNA levels, ultimately leading to aggravation of the underlying liver illness and causing nausea, vomiting, and diarrhea in the stomach (LiverTox, 2020).
Take tiny, frequent sips of water throughout the day. Slowly get back into the habit of eating. Foods that are easy to digest, such as soda crackers, toast, and gelatin, are a good place to start. Stop eating if your stomach starts to feel nauseous after eating. The patient’s drug therapy should focus on symptom management and tapering off prednisone. I would gradually decrease the dosage of prednisone until it was eliminated. An antiemetic like ondansetron would be a good addition. It is less sedative than promethazine; thus, I choose ondansetron instead. There is no need to stop taking nifedipine and Synthroid; thus, I would recommend doing so.
References
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547852
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 http://writingcenter.waldenu.edu/57.htm). 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. Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
- Click on the Submit button to complete your submission.
| 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. Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
|
| 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. Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders |
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 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
|
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 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
|
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
|
| Total Points: 100 |
|---|
