What’s Coming Up in Module 3?
In the next module, you will examine diagnoses for patients with potential GI and hepatobiliary disorders. You will also develop a drug therapy plan based on patient history and diagnosis.
Next Week
To go to the next week:
Module 3
Module 3: Gastrointestinal and Hepatobiliary Systems
Symptoms of various gastrointestinal (GI) and hepatobiliary disorders often overlap, making diagnosis and treatment challenging. For example, symptoms such as vomiting, constipation, and bloating are non-specific and could also be the result of underlying medical history or current prescription drug use. As an advanced practice nurse, you could be potentially responsible for providing care to a patient who may present with non-specific symptoms related to the gastrointestinal and hepatobiliary systems.
How would you proceed to care for this patient? What type of drug therapy might you recommend, not knowing current medical history or prescription drug use? Are there certain drugs you should avoid in ensuring a drug-drug interaction does not occur? These are the types of questions that may guide you in your role as an advanced practice nurse.
What’s Happening This Module?
Module 3: Gastrointestinal and Hepatobiliary Systems is a 1-week module, Week 4 of the course. In this module, you will examine diagnoses for patients with potential GI and hepatobiliary disorders. You also develop a drug therapy plan based on patient history and diagnosis.
| What do I have to do? | When do I have to do it? |
| Review your Learning Resources | Days 1-7, Week 4 |
| Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders | Submit your Assignment by Day 7 of Week 4. |
Week 4: Gastrointestinal and Hepatobiliary Disorders
As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.
How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?
This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.
Learning Objectives
Students will:
Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders
Justify drug therapy plans based on patient history and diagnosis
Learning Resources
Required Readings (click to expand/reduce)
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. 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.
Assignment: 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.
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.
Submit Your Assignment by Day 7 of Week 4
Sample Paper Week 4 Assignment
Walden NURS 6521 Pharmacotherapy or Gastrointestinal and Hepatobiliary Disorders
Acute Gastroenteritis
Student’s Name:
Institutional Affiliation:
Instructor:
Course:
Date:
Acute Gastroenteritis
Health providers need to ensure that they understand the HPI of a patient to make the correct diagnosis. Asking the patient questions regarding his/her condition is also important as it can help improve the patient’s health outcome. Currently, the patient is taking Synthroid, nifedipine, and prednisone. It is vital to inquire from the client the reason for taking those medications to come up with the appropriate treatment plan that will help improve the patient’s health outcome. For example, prednisone suppresses the immune system; hence it is vital to know why the client is taking that medication. In addition to that, more tests should be carried out for more information regarding the patient’s health condition.
In this case, based on the information provided, the patient is likely suffering from acute gastroenteritis. Gastroenteritis is a condition that develops due to the inflammation of the stomach and the small intestine. A bacterial or viral infection mostly causes this condition. Acute gastroenteritis occurs when water or food that is contaminated with pathogenic microorganisms or their toxins is consumed. It is also caused by contact with someone who has the virus. Symptoms of acute gastroenteritis include vomiting, diarrhea, nausea, and abdominal pain. These symptoms are evident in the case of the patient. A patient can also experience fever, dehydration, and lack of energy.
For drug therapy, I would administer patient HL with Ondansetron 8mg. This drug helps prevent vomiting and nausea. It blocks one of the natural substances in the body that causes vomiting (Parker, Van Bennekom, Anderka, & Mitchell, 2018). I would also advise the patient to take more fluids to prevent dehydration. Although prednisone normally suppresses the immune system, I would not discontinue it without tapering (Batlle, Mattie, & Irwin, 2016). It would be appropriate to follow the tapering off procedure where the prednisone dose is reduced gradually over time. Tapering off prednisone dosage too quickly can worsen inflammation (“Can tapering off prednisone cause a flare?,” n.d.). In addition to that, I would encourage the patient to exercise proper hygiene (Ibrahim, Palaian, Al-Sulaiti, & El-Shami, 2016).
References
Batlle, L., Mattie, R., & Irwin, R. (2016). A medication combination for the treatment of central poststroke pain via the adjuvant use of prednisone with gabapentin: a case report. PM&R, 8(3), 278-281.
Can tapering off prednisone cause a flare? (n.d.). WebMD. https://www.webmd.com/drug-medication/qa/can-tapering-off-prednisone-cause-a-flare
Ibrahim, M. I., Palaian, S., Al-Sulaiti, F., & El-Shami, S. (2016). Evaluating community pharmacy practice in Qatar using simulated patient method: acute gastroenteritis management. Pharmacy Practice (Granada), 14(4).
Parker, S. E., Van Bennekom, C., Anderka, M., & Mitchell, A. A. (2018). Ondansetron for treatment of nausea and vomiting of pregnancy and the risk of specific birth defects. Obstetrics & Gynecology, 132(2), 385-394.
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