Sample Answer for NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS Included After Question
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
- Ulcers
- Hepatitis markers
- After HP shots
- Gastroesophageal Reflux Disease
- Pancreatitis
- Liver failure—acute and chronic
- Gall bladder disease
- Inflammatory bowel disease
- Diverticulitis
- Jaundice
- Bilirubin
- Gastrointestinal bleed – upper and lower
- Hepatic encephalopathy
- Intra-abdominal infections (e.g., appendicitis)
- Renal blood flow
- Glomerular filtration rate
- Kidney stones
- Infections – urinary tract infections, pyelonephritis
- Acute kidney injury
- Renal failure – acute and chronic
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
BY DAY 7 OF WEEK 5
Complete the Knowledge Check By Day 7 of Week 5.
Attempt History
| Attempt | Time | Score | |
| LATEST | Attempt 1 | 3,764 minutes | 20 out of 20 |
Score for this quiz: 20 out of 20
Submitted Jul 2 at 11:22am
This attempt took 3,764 minutes.
A Sample Answer For the Assignment: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Title: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed + urease.
The healthcare provider suspects the client has peptic ulcer disease.
Questions:
1. Explain what contributed to the development from this patient’s history of PUD?
Your Answer:
- Helicobacter pylori infection: The presence of a positive urease test suggests the involvement of H. pylori, a common bacterium associated with PUD. H. pylori can disrupt the protective mucosal lining of the stomach and duodenum, leading to ulcers.
- Medication use: The patient’s frequent use of ibuprofen (NSAID) for pain relief can irritate the stomach lining and increase the risk of developing ulcers. NSAIDs, including ibuprofen, are known to inhibit the production of prostaglandins, which help protect the stomach lining.
- Lifestyle factors: The patient’s smoking habit, excessive alcohol consumption, and high coffee intake are known to increase the risk of developing peptic ulcers. Smoking and alcohol can impair the stomach’s protective mechanisms, while coffee stimulates acid production, which can contribute to ulcer formation.
- Stressful situation: The patient’s recent separation, pending divorce, and the stress associated with managing two homes can lead to increased psychological stress. Stress itself does not cause ulcers, but it can exacerbate existing ulcers by affecting the body’s ability to heal and increasing acid production.
- Other medical conditions: While not directly contributing to PUD, chronic sinusitis and osteoarthritis may have influenced the patient’s medication use and overall health, potentially affecting the susceptibility to ulcers.
A Sample Answer 2 For the Assignment: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Title: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed + urease.
The healthcare provider suspects the client has peptic ulcer disease.
Question:
1. What is the pathophysiology of PUD/ formation of peptic ulcers?
Your Answer:
Peptic ulcer disease (PUD) occurs due to an imbalance between aggressive factors (such as H. pylori infection and excessive gastric acid secretion) and protective mechanisms (such as mucosal defense mechanisms). Factors like NSAID use and certain lifestyle habits (smoking, alcohol, caffeine) can contribute to ulcer formation.
A Sample Answer 3For the Assignment: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Title: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Scenario 2: Gastroesophageal Reflux Disease (GERD)
A 44-year-old morbidly obese female comes to the clinic complaining of “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea.
PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2)
FH:non contributary
Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prn
SH: 20 PPY of smoking, ETOH rarely, denies vaping
Diagnoses: Gastroesophageal reflux disease (GERD).
Question:
1. If the client asks what causes GERD how would you explain this as a provider?
Your Answer:
GERD is caused by a weakened or relaxed lower esophageal sphincter (LES), which allows stomach acid to flow back up into the esophagus. Factors such as obesity, hiatal hernia, certain foods/drinks, smoking, medications, and other medical conditions can contribute to GERD. Treatment aims to reduce symptoms and may include lifestyle changes and medication.
A Sample Answer 4 For the Assignment: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Title: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Scenario 3: Upper GI Bleed
A 64-year-old male presents the clinic with complaints of passing dark, tarry, stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed.
Question:
1. What are the variables here that contribute to an upper GI bleed?
Your Answer:
The variables that contribute to an upper gastrointestinal (GI) bleed in this scenario include peptic ulcer disease (PUD), diet (beets and beef), and the presence of symptoms such as nausea, sweating, weakness, and passing dark, tarry stools (melena). Medications and underlying conditions are also potential factors.
A Sample Answer 5 For the Assignment: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Title: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Scenario 4: Diverticulitis
A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and going”. She says she has had a fever and abdominal cramps that have worsened this morning.
Diagnosis is lower GI bleed secondary to diverticulitis.
Question:
1. What can cause diverticulitis in the lower GI tract?
Your Answer:
Diverticulitis in the lower GI tract is caused by inflamed or infected diverticula, which are small pouches that form in the colon. Factors include the presence of diverticula, a low-fiber diet, age (typically over 50), lifestyle factors (obesity, sedentary lifestyle), and potential genetic factors. Prompt medical attention is crucial for evaluation and treatment.
A Sample Answer 6 For the Assignment: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Title: NURS 6501 MODULE 3 GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Scenario 4: Diverticulitis
A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and going”. She says she has had a fever and abdominal cramps that have worsened this morning.
Diagnosis is lower GI bleed secondary to diverticulitis.
Question:
- What can cause diverticulitis in the lower GI tract?
Your Answer:
The patient in the case study has diverticulitis. Diverticulitis develops when a part of the colon weakens leading to pouches and protrusion in the wall of the colon. Several factors can cause diverticulitis. One of them is aging. The risk of a patient developing diverticulitis increase significantly as one ages. The other cause of obesity. The risks of diverticulitis increase significantly with excessive weight gain. An imbalance between the bacterial flora in the colon has also been attributed to diverticulitis (Peery et al., 2021). For example, an imbalance between Clostridium coccoides and Escherichia have been identified to cause diverticulitis in most of the patients.
Diet also plays a role in the development of diverticulitis. Patients with a history of low fiber diet have an elevated risk of developing the disorder as compared to those who take fiber rich diet. Low fiber diet results in too much volume within the colon, hence, increasing the risk of diverticulitis. The other cause is physical inactivity. Physical inactivity affects intestinal microbiome as well as increases the risk of diverticulitis-associated risk factors such as obesity. Genetics also contributes to diverticulitis. Accordingly, people born to families with a history of diverticulitis are increasingly at a risk of developing the disorder. However, the direct link between the exposure and development of diverticulitis is inconclusive. The use of certain medications has also been shown to increase the risk of diverticulitis. For example, NSAIDs and steroids have been shown to increase the risk of diverticulitis due to their effect on gastrointestinal physiology. Lifestyles such as smoking also increases the risk(Peery et al., 2021). This can be seen from the evidence that most of the smokers have a high rate of diverticulitis as compared to non-smokers.
References
Peery, A. F., Shaukat, A., & Strate, L. L. (2021). AGA clinical practice update on medical management of colonic diverticulitis: Expert review. Gastroenterology, 160(3), 906-911.e1. https://doi.org/10.1053/j.gastro.2020.09.059