NURS 6501 Week 5:Discuss Gastrointestinal and Hepatobiliary Disorders

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

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Learning Resources

NURS 6501 Week 5 Discuss Gastrointestinal and Hepatobiliary Disorders
NURS 6501 Week 5 Discuss Gastrointestinal and Hepatobiliary Disorders

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

Osna, N. A., Donohue, T. M., Jr., & Kharbanda, K. K. (2017). Alcoholic liver disease: Pathogenesis and current management. Alcohol Research: Current Reviews, 38(2), 7–21

 

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

MedCram. (2013, April 14). Liver function tests LFTs explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=bFdTgty0T0I

Note: The approximate length of the media program is 11 minutes.

 

Liver Diseases

MedCram. (2019, May 15). Diagnosis of key liver diseases: Hepatitis A, B C vs. alcoholic vs. ischemic (AST vs ALT labs) [Video file]. Retrieved from https://www.youtube.com/watch?v=ZZRHA2JvCGA 

Note: The approximate length of the media program is 13 minutes.

 

Liver Pathophysiology

MedCram. (2013, April 9). Liver explained clearly: Pathophysiology, LFTs, hepatic diseases  [Video file]. Retrieved from https://www.youtube.com/watch?v=BTGkB8nOu7g

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:

  1. 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:

  1. 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:

  1. 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.

  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
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

  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
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)

  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • 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
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.

  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  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

  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
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.