Gastrointestinal (GI) and Hepatobiliary Disorders.
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.Gastrointestinal (GI) and Hepatobiliary Disorders.
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.
Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:
• Synthroid 100 mcg daily
• Nifedipine 30 mg daily
• Prednisone 10 mg daily
• 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.Gastrointestinal (GI) and Hepatobiliary Disorders.
• 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.
The most likely diagnosis for this patient based on the symptoms of diarrhea, nausea and vomiting that she presented with is acute gastroenteritis. It is also called infectious diarrhea and involves inflammation of the stomach, GI tract and the small intestines caused by either a parasite, virus or bacteria that is spread through contaminated food or water. As highlighted by Al Jassas et al. (2018), the actual signs and symptoms of gastroenteritis are: diarrhea, nausea and vomiting, which cause a patient to lack energy and be dehydrated, symptoms which the client presented with.Gastrointestinal (GI) and Hepatobiliary Disorders.
Drug Therapy Plan
• Start the patient on IV fluids and place the patient NPO in the initial 24 hours to promote bowel resting.
• Maintain hydratin with 0.9% NS IV fluid to replace the fluids lost through vomiting and diarrhea and prevent dehydration (Scallan et al., 2018).
• Administer Phenergan, 12.5mg-25 mg IV every 4-6 hours to provide relief from vomiting and nausea. Phenergan has weak dopamine receptor antagonist and will be used as an anti-emetic in managing this patient. The drug has anticholinergic effects since it works by blocking H1 receptors in the brain’s upper centers (Canziani, 2018).
• It will also be necessary to start the patient on Imodium 4mg after the initial loose stool administered orally then 2 mg after each loose stool. The maximum dosage per day should be 16mg. After approximately 48 hours, the patient should have some clinical improvement. Imodium is the best choice in this case since it will slow down movement of the gut and help in diarrhea management (Arcangelo et al., 2017). Therefore, apart from stool becoming less watery, the episodes of bowel movements experienced by the patient will reduce.Gastrointestinal (GI) and Hepatobiliary Disorders.
• As emphasized by Lacy (2016), the patient will be educated to maintain hand and food hygiene and ensure that water for drinking is safe and clean.Gastrointestinal (GI) and Hepatobiliary Disorders.