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)

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

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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 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.

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.
Click on the Submit button to complete your submission.

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

Chapter 62, “Drugs for Peptic Ulcer Disease” (pp. 703–714)
Chapter 63, “Laxatives” (pp. 715–722)
Chapter 64, “Other Gastrointestinal Drugs” (pp. 723–735)
Chapter 78, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 867–886)
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.

Sample Free Essay Assignment Solution:

Gastrointestinal and Hepatobiliary Disorders
Vomiting, nausea, and diarrhea are symptoms that occur together pointing to a possible health problem. The patient could be experiencing the symptoms since Prednisone can trigger them. Another possible cause is drug abuse which can also cause malfunction of the body organs leading to nausea and vomiting. However, one of the conditions that can cause the three conditions is gastrointestinal disorder. The disorder causes the three symptoms due to inflammation of the intestines after the infection (Muradali & Goldberg, 2015). Therefore, the possible health condition that the patient is suffering from is gastrointestinal disorder.
The appropriate drug therapy for the patient is to continue taking Synthroid 100 mcg daily since it will help restore the thyroid hormone (Mace, Tehan & Marshall, 2015). The drug is necessary to treat the possible Hepatitis C. The patient also requires another drug which will be used to treat the gastrointestinal disorder. One of the best drugs includes promethazine 25mg daily. The dosage is necessary since it will treat the disorder while taking care of the drug abuse history of the patient (Mace, Tehan & Marshall, 2015). The drug does not produce sedating effects which are essential for a patient who has a history of abusing drugs that could have affected the liver. It is necessary for the patient to reduce taking Nifedipine 30 mg daily as well as Prednisone 10 mg daily. For instance, the reduction is necessary since Nifedipine is used to treat hypertension, yet the patient does not have hypertension (Muradali & Goldberg, 2015). For example, Prednisone is known to cause side effects including nausea, diarrhea, and vomiting. Drug therapy will involve taking the drugs for three days. The patient will return the clinic for further evaluation of the health condition to determine the effectiveness of the prescribed drugs.

References
Mace, O. J., Tehan, B., & Marshall, F. (2015). Pharmacology and physiology of gastrointestinal enteroendocrine cells. Pharmacology Research & Perspectives, 3(4), e00155.
Muradali, D., & Goldberg, D. R. (2015). The US of gastrointestinal tract disease. Radiographics, 35(1), 50-68.

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