NURS 6531 Week 6 discussion Diagnosing Gastrointestinal Disorders

Week 6 discussion

Diagnosing Gastrointestinal Disorders

In primary care settings, patients often present with
abdominal pain. Although this is frequently a sign of a gastrointestinal (GI)
disorder, abdominal pain could also be the result of other systemic disorders,
making this type of pain difficult to assess. While abdominal pain is most
common, many other GI symptoms also overlap multiple disorders, further
increasing the difficulty in diagnosing and treating patients. This makes
provider-patient communication essential. You must be able to formulate
questions that will prompt the patient to provide the necessary information, as
this will guide your assessment and diagnosis. For this Discussion, consider
potential diagnoses for the patients in the following case studies.

Case Study 1:

A 49-year-old man presents to the office complaining of
vague abdominal discomfort over the past few days. He states he does not feel
like eating and has not moved his bowels for the last 2 days. His patient
medical history includes an appendectomy at age 22 and borderline hypertension,
which he is trying to control with diet and exercise. He takes no medications
and has no known allergies. Positive physical exam findings include a
temperature of 99.9 degrees Fahrenheit, heart rate of 98, respiratory rate of
24, and blood pressure of 150/72. The abdominal exam reveals abdominal
distention, diminished bowel sounds, and lower left quadrant tenderness without
rebound.

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Case Study 2:

A 40 year-old female presents to the office with the chief
complaint of diarrhea. She has been having recurrent episodes of abdominal
pain, diarrhea, and rectal bleeding. She has lost 9 pounds in the last month.
She takes no medications, but is allergic to penicillin. She describes her life as stressful, but
manageable. The physical exam reveals a pale middle- aged female in no acute
distress. Her weight is 140 pounds (down from 154 at her last visit over a year
ago), blood pressure of 94/60 sitting and 86/50 standing, heart rate of 96 and
regular without postural changes, respiratory rate of 18, and O2 saturation
99%. Further physical examination reveals:

Skin: w/d, no acute lesions or rashes

Eyes: sclera clear, conj pale

Ears: no acute changes

Nose: no erythema or sinus tenderness

Mouth: membranes pale, some slight painful ulcerations,
right buccal mucosa, tongue beefy red, teeth good repair

Neck: supple, no thyroid enlargement or tenderness, no
lymphadenopathy

Cardio: S1 S2 regular, no S3 S4 or murmur

Lungs: CTA w/o rales, wheezes, or rhonchi

Abdomen: scaphoid, BS hyperactive, generalized tenderness,
rectal +occult bloo

Case Study 3:

A 52-year-old male presents to the office for a routine physical.
The review of symptoms reveals anorexia, heartburn, and weight loss over the
past 6 months. The heartburn is long standing, occurring most days during the
week. He takes TUMS or Rolaids to relieve the discomfort. The patient describes
occasional use of ibuprofen for back pain, but denies other medications
including herbals. He has no known allergies. He was adopted so does not know
his family history. Social history reveals that, although he stopped smoking
ten years ago, he smoked for 20 years. He occasionally consumes alcohol on the
weekends only. The only positive physical exam finding for this patient was
slight epigastric tenderness. The remainder of his exam was negative and the
rectal exam was negative for blood.

To prepare:

Review this week’s media presentations and Part 12 of the
Buttaro et al. text in the Learning Resources.

Select one of the three case studies listed above. Reflect
on the provided patient information including history and physical exams.

Think about a differential diagnosis. Consider the role the
patient history and physical exam played in diagnosis.

Reflect on potential treatment options based on your
diagnosis.

NURS 6531 Week 6 discussion Diagnosing Gastrointestinal Disorders 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	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: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	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: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	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: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	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: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. 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. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.