Sample Answer for NURS 6501 Week 5:Discuss 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.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 5
Complete the Knowledge Check By Day 7 of Week 5.
A Sample Answer For the Assignment:NURS 6501 Week 5:Discuss Gastrointestinal and Hepatobiliary Disorders
Title: NURS 6501 Week 5:Discuss Gastrointestinal and Hepatobiliary Disorders
The scenario depicts patient HL presenting with nausea, vomiting, and diarrhea. HL has a history of drug abuse and possible Hepatitis C. The patient is currently on Synthroid 100 mcg, Nifedipine 30 mg, and Prednisone 10 mg. Therefore, this paper seeks to discuss the diagnosis and drug therapy for this patient.
Diagnosis
Hepatitis C Virus (HCV) infection is a likely diagnosis for this patient. Clinical manifestations include fatigue, fever, night sweats, chills, joint pain, muscle pain, pruritus, lymphadenopathy, and spider nevi (Moosavy et al., 2017). GI symptoms include appetite changes, nausea, abdominal pain, diarrhea, jaundice, and indigestion (Moosavy et al., 2017). Pertinent positive findings consistent with HCV infection include nausea, vomiting, and diarrhea. HCV infection can be attributed to the patient’s history of drug abuse and Hepatitis C (Hojati et al., 2018). However, the symptoms can be associated with the side effects of the medications. Nausea is a side effect of Nifedipine and Prednisone, while diarrhea is a side effect of Synthroid.
Drug Therapy
Drug therapy should eradicate HCV and prevent the progress of HCV infection to cirrhosis, hepatocellular carcinoma, or liver failure (Nardelli et al., 2017). The drug therapy for the HCV infection diagnosis is Sofosbuvir/Peginterferon/Ribavirin combination for 12 weeks (Chung et al., 2018). The combination has a high treatment response and is recommended for drug abusers because it decreases the risk of self-injection (Hojati et al., 2018). I would recommend the therapy since it has few side effects, which will promote compliance. In addition, I would reduce the dose of current medications, Nifedipine to 10 mg and Prednisone to 5 mg, to minimize the side effects.
Conclusion
The patient has a likely diagnosis of HCV infection based on symptoms of nausea, vomiting, and diarrhea and a history of drug abuse and Hepatitis C. Sofosbuvir/Peginterferon/Ribavirin combination for 12 weeks would be appropriate since it has a high response for drug abusers and has few side effects.
References
Chung, R. T., Ghany, M. G., Kim, A. Y., Marks, K. M., Naggie, S., Vargas, H. E., Aronsohn, A.I., Bhattacharya, D., Broder, T., Falade-Nwulia, O.O.,& Fontana, R. J. (2018). Hepatitis C guidance 2018 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection. Clinical Infectious Diseases.
Hojati, S. A., Maserat, E., Ghorbani, M., Safarpour, A., & Fattehi, M. R. (2018). Hepatitis C Treatment in Patients with Drug Addiction Is Effective or Not Effective? Medical archives (Sarajevo, Bosnia and Herzegovina), 72(5), 325–329. doi:10.5455/medarh.2018.72.325-329
Moosavy, S. H., Davoodian, P., Nazarnezhad, M. A., Nejatizaheh, A., Eftekhar, E., & Mahboobi, H. (2017). Epidemiology, transmission, diagnosis, and outcome of Hepatitis C virus infection. Electronic physician, 9(10), 5646–5656. https://doi.org/10.19082/5646
Nardelli, S., Riggio, O., Rosati, D., Gioia, S., Farcomeni, A., &Ridola, L. (2019). Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms. World Journal of Gastroenterology, 25(48), 6928.
Patients of gastrointestinal and hepatobiliary disorders often face life-altering changes, including changes to diet, new treatment regimens, and more. For some disorders, treatments can include surgery.
Gastrointestinal conditions, such as ulcers, diverticulitis, and pancreatitis, often cause varying levels of pain and discomfort. Hepatobiliary conditions can also bring significant changes to patient routines and well-being.
This week, you examine fundamental concepts of gastrointestinal and hepatobiliary disorders. You explore common disorders in these categories, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives
Students will:
- Analyze concepts and principles of pathophysiology across the life span
Learning Resources
Required Readings (click to expand/reduce)
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
- Chapter 38: Structure and Function of the Renal and Urological Systems including Summary Review
- Chapter 39: Alteration of Renal and Urinary Function (stop at Fluids and electrolytes); Summary Review
- Chapter 41: Structure and Function of the Digestive System (stop at Tests of digestive function); Summary Review
- Chapter 42: Alterations of Digestive Function (stop at Cancer of the digestive track); Summary Review
Document: NURS 6501 Midterm Exam Review (PDF document)
Note: Use this document to help you as you review for your Midterm Exam in Week 6.
Required Media (click to expand/reduce)
Module 3 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 3 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check. (2m)
Liver Function Tests
Note: The approximate length of the media program is 11 minutes.
Liver Diseases
Note: The approximate length of the media program is 13 minutes.
Liver Pathophysiology
Note: The approximate length of the media program is 14 minutes.
Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 41 and 42 that relate to the hepatobiliary system. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/
A Sample Answer 2 For the Assignment:NURS 6501 Week 5:Discuss Gastrointestinal and Hepatobiliary Disorders
Title: NURS 6501 Week 5:Discuss 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:
- Explain what contributed to the development from this patient’s history of PUD?
Your Answer:
The contributing factors to the patient’s development of PUD comprise smoking, excessive alcohol consumption, stress and the persistent use of NSAIDS medications. The disease develops due to chronic wounds around and beyond the stomach’s muscular mucosa lining. Underlying factors triggering such occurrences constitute alcohol and smoking, producing acids that erode the lining. The two have the greatest possibility of increasing the production of hydrochloric acid, destroying the mucosa lining and creating wounds around the duodenum and the stomach walls. Different medications alongside chronic stress also heighten the risk of PUD for the patient. The factors explain the underlying reasons for the health outcome.
A Sample Answer For the Assignment:NURS 6501 Week 5:Discuss Gastrointestinal and Hepatobiliary Disorders
Title: NURS 6501 Week 5:Discuss 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:
- What is the pathophysiology of PUD/ formation of peptic ulcers?
Your Answer:
PUD formation into a peptic ulcer results from an imbalance between the destructive and the mucosal protective aspects of the gastric lining in the stomach. Most of the time, PUD is characterized by the development of mucosal wounds due to a high difference in the aggressive and mucosal aspects. H-pylori infections enhance the problem by creating an imbalance that perforates the ulcers in the peritoneal activity. The outcome interferes with gastric activity, causing severe discomfort and pain. Such elements illustrate the pathophysiology of PUD formation with a peptic ulcer.
A Sample Answer 4 For the Assignment:NURS 6501 Week 5:Discuss Gastrointestinal and Hepatobiliary Disorders
Title: NURS 6501 Week 5:Discuss 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:
- If the client asks what causes GERD how would you explain this as a provider?
Your Answer:
The client needs to understand that GERD is caused by the continuous regurgitation of contents in the gastric area into the esophagus. Most of the time, the condition develops due to delayed emptying of the gastric contents, impairments on the lower levels of the esophageal sphincter (LES) and reduced acid clearance from the esophagus.The three factors, together with unhealthy eating habits accompanying sleep time, influence the development of GERD. The development of GERD is directly influenced by other factors that constitute morbid obesity, causing an excessive body mass index. The foul taste in the mouth is also a common symptom, signaling problems in acid control in the patient’s gastric region. The insights guide the patient’s understanding of the causative factors of GERD.
Grading Rubric Guidelines
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
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| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
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| Performance Category | 5 | 4 | 3 | 2 | 0 |
| Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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| Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point | |
| Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
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| 0 points lost | -5 points lost | ||||
| Total Participation Requirements
per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
| Early Participation Requirement
per discussion thread |
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |