Sample Answer for NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN Included After Question
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.
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.
A Sample Answer For the Assignment: NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN
Title: NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN
The case study concerns a 46-year-old female with reports of RUQ pain for the past 24 hours. The pain began an hour after having a large dinner. She also experienced nausea and one vomiting episode prior to the presentation. The purpose of this paper is to discuss the likely diagnosis and treatment plan.
Diagnosis
The likely diagnosis for this patient is Acute cholecystitis. This is a gallbladder inflammation that progresses over hours due to a gallstone obstructing the cystic duct. Gallaher & Charles (2022) explain that the classic presentation of Acute cholecystitis includes acute RUQ pain, fever, nausea, and vomiting associated with eating and physical exam findings of RUQ tenderness. Acute cholecystitis manifests with a high WBC count indicating inflammation (Bridges et al., 2018). In addition, serum levels of aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase may be increased, pointing to abnormalities in liver function in persons with severe biliary obstruction (Doherty et al., 2022). Direct and indirect serum bilirubin levels are also increased. Acute cholecystitis is the selected diagnosis owing to postprandial RUQ pain, nausea, vomiting, mild abdominal tenderness, high WBC, and elevated Bilirubin levels.
Drug Therapy
Drug therapy will include antibiotics with IV Ceftriaxone 2 g once daily and IV metronidazole 500 mg every 8 hours. These antibiotics have adequate coverage against the most common pathogens (Gallaher & Charles, 2022). An antiemetic like Prochlorperazine IV 2.5 mg every 4 hours will be administered to alleviate nausea and prevent fluid and electrolyte disorders caused by vomiting. Oxycodone/acetaminophen 1 tablet orally every 6 hours will be prescribed for pain control.
Conclusion
Positive findings of postprandial RUQ pain, nausea, vomiting, mild abdominal tenderness, high WBC, and elevated Bilirubin levels indicate likely Acute cholecystitis. When a gallstone impacts the cystic duct and continuously obstructs it, it results in acute inflammation causing cholecystitis. Drug therapy will include antibiotics with Ceftriaxone and Metronidazole, antiemetic with Prochlorperazine, and Oxycodone/acetaminophen for pain relief.
References
Bridges, F., Gibbs, J., Melamed, J., Cussatti, E., & White, S. (2018). Clinically diagnosed cholecystitis: a case series. Journal of surgical case reports, 2018(2), rjy031. https://doi.org/10.1093/jscr/rjy031
Doherty, G., Manktelow, M., Skelly, B., Gillespie, P., Bjourson, A. J., & Watterson, S. (2022). The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease. Medicina, 58(3), 388. https://doi.org/10.3390/medicina58030388
Gallaher, J. R., & Charles, A. (2022). Acute Cholecystitis: A Review. JAMA, 327(10), 965–975. https://doi.org/10.1001/jama.2022.2350
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Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Photo Credit: Getty Images/iStockphoto
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.
A Sample Answer 2 For the Assignment: NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN
Title: NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN
The case concerns HL, with nausea, vomiting, and diarrhea. The patient has a history of illicit drug use and a possible Hepatitis C infection. The current drug therapy includes Synthroid 100 mcg, Nifedipine 30 mg, and Prednisone 10 mg. The purpose of this paper is to discuss the diagnosis and drug therapy for this patient.
Diagnosis
The patient’s symptoms and medical history are consistent with Hepatitis C, which is caused by Hepatitis C virus (HCV). HCV is transmitted parenterally through contaminated blood from sharing and recycling syringes among drug users, unsafe sexual practices, and unsafe health practices like transfusing unscreened blood (Lazarus et al., 2020). The clinical manifestations of Hepatitis C include nausea, vomiting, anorexia, non-specific upper abdominal discomfort, jaundice, and malaise (Kouroumalis & Voumvouraki, 2022). However, some patients are asymptomatic. Hepatitis C is the presumptive diagnosis owing to the patient’s positive GI symptoms of nausea, vomiting, and diarrhea. In addition, the patient has a history of illicit drug use, which puts him at risk of contracting HCV and a history of Hepatitis C infection.
Drug Therapy Plan
Treatment guidelines for Hepatitis C recommend treatment with antiviral drugs following the initial diagnosis of the condition. Effective direct-acting antiviral drugs (DAAs) are recommended for hepatitis C to lower the chances of progressing to chronic infection. The patient’s treatment plan will include Ledipasvir/sofosbuvir (Harvoni) 1 tablet (90 mg/400 mg) orally once daily for 8 weeks (Chung et al., 2018). The oral combination of Ledipasvir and Sofosbuvir is used to treat adults with chronic hepatitis C, with or without cirrhosis.
Conclusion:
Hepatitis C is the presumptive diagnosis for this patient based on the presence of GI symptoms like nausea, vomiting, and diarrhea. The patient may have contracted HCV from sharing syringes, or it could be a chronic infection considering the history of possible Hepatitis C. Treatment will be a combination of Ledipasvir and Sofosbuvir, which is recommended for chronic Hepatitis C.
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. DOI: 10.1093/cid/ciy585
Kouroumalis, E., & Voumvouraki, A. (2022). Hepatitis C virus: A critical approach to who really needs treatment. World journal of hepatology, 14(1), 1–44. https://doi.org/10.4254/wjh.v14.i1.1
Lazarus, J. V., Roel, E., & Elsharkawy, A. M. (2020). Hepatitis C Virus Epidemiology and the Impact of Interferon-Free Hepatitis C Virus Therapy. Cold Spring Harbor perspectives in medicine, 10(3), a036913. https://doi.org/10.1101/cshperspect.a036913
A Sample Answer 3 For the Assignment: NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN
Title: NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN
The patient in the case study presents with nausea, vomiting, and diarrhea. He has a drug abuse history and likely Hepatitis C. The current drug therapy includes Synthroid, Nifedipine, and Prednisone. The purpose of this assignment is to discuss the diagnosis and appropriate pharmacotherapy for the patient.
Diagnosis
Hepatitis C infection is the presumptive diagnosis. This is a liver inflammation caused by Hepatitis C virus (HCV). It is spread through sexual intercourse with infected persons, sharing personal items, and sharing drug-injection equipment (Ghany et al., 2020). Most infected persons are asymptomatic. Symptomatic cases present symptoms like fatigue, fever, reduced appetite, nausea, vomiting, abdominal discomfort, pale feces, dark urine, myalgia, and jaundice (Jin, 2020). Therefore, Hepatitis C is the primary diagnosis because of the positive symptoms of nausea, vomiting, and diarrhea and the client’s history of drug abuse and Hepatitis C infection.
Appropriate Drug Therapy
The recommended drug therapy will include a combination of Ombitasvir/paritaprevir/ritonavir (Technivie) for 12 weeks to treat Hepatitis C infection. Technivie is indicated for HCV infection in patients without cirrhosis. Ombitasvir inhibits HCV NS5A, which is needed for Hepatitis C viral replication. Paritaprevir inhibits NS3/4A serine protease required for proteolytic cleavage of the HCV-encoded polyprotein into mature forms (Wu et al., 2019). Ritonavir is a protease inhibitor that elevates paritaprevir serum levels. Nifedipine would be reduced to 10 mg and Prednisone to 5 mg since they are associated with GI side effects.
Conclusion
The patient’s nausea, vomiting, and diarrhea symptoms are consistent with Hepatitis C infection. Besides, the history of Hepatitis C and drug abuse make HCV infection the likely diagnosis. A combination of Ombitasvir/paritaprevir/ritonavir will be recommended to treat the HCV infection,
References
Ghany, M. G., Morgan, T. R., & AASLD‐IDSA hepatitis C guidance panel. (2020). Hepatitis C guidance 2019 update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology, 71(2), 686–721. https://doi.org/10.1002/hep.31060
Jin, J. (2020). Screening for Hepatitis C Virus Infection. JAMA, 323(10), 1008-1008. doi:10.1001/jama.2020.1761
Wu, J., Huang, P., Fan, H., Tian, T., Xia, X., Fu, Z., … & Zhang, Y. (2019). Effectiveness of ombitasvir/paritaprevir/ritonavir, dasabuvir for HCV in HIV/HCV coinfected subjects: a comprehensive analysis. Virology journal, 16(1), 1–10.
Grid View
| Excellent | Good | Fair | Poor | ||
| Explain your diagnosis for the patient, including your rationale for the diagnosis. | Points Range: 23 (23%) – 25 (25%)
The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment. |
Points Range: 20 (20%) – 22 (22%)
The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment. |
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment. |
Points Range: 0 (0%) – 17 (17%)
The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing. |
|
| Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. | Points Range: 27 (27%) – 30 (30%)
The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. |
Points Range: 24 (24%) – 26 (26%)
The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. |
Points Range: 21 (21%) – 23 (23%)
The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. |
Points Range: 0 (0%) – 20 (20%)
The response inaccurately and vaguely describes 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. | Points Range: 27 (27%) – 30 (30%)
The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. The response includes specific, accurate, and detailed examples that fully support the justification provided. |
Points Range: 24 (24%) – 26 (26%)
The response provides a basic justification for the recommended drug therapy plan for this patient. The response includes only 1-2 examples that fully support the justification provided. |
Points Range: 21 (21%) – 23 (23%)
The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. The response may include examples, which may inaccurately or vaguely support the justification provided. |
Points Range: 0 (0%) – 20 (20%)
The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. The response does not include examples that support the justification provided, or is missing. |
|
| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. |
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. |
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. |
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. |
|
| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
|
| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. | Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors |
|
| Total Points: 100 | |||||
Name: NURS_6521_Week4_Assignment_Rubric
NURS 6521 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders IN Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
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Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |