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 scenario assigned by your Instructor for this Assignment
SCENARIO:
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:Nondistended, minimal tenderness
- Skin:Warm and dry
- Neuro: Alert and Oriented
- Psych:Appropriate mood
__________________________________________________________________________________________
- 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.
Writea 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.
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 DiseasesLinks 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.
