NURS 6521 Week 4: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
In this paper, we discuss the case of a patient, HL, who is dealing with stomach and liver issues. HL is currently experiencing symptoms like throwing up, diarrhea, and feeling nauseous. Given their history of drug misuse, there’s a possibility that HL might have Hepatitis C. The medications they are taking include Synthroid, Nifedipine, and Prednisone.
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My main diagnosis for HL would be gastroenteritis. Gastroenteritis is an infection that affects the intestines and can be caused by viruses, bacteria, or parasites. In the United States, viral gastroenteritis is the second most common illness. Norovirus is a likely culprit in this case, and it can be transmitted from person to person or through contaminated food and drinks. The patient is experiencing symptoms like vomiting, chills, abdominal pain, and fever.
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The use of prednisone by the patient is a crucial factor in this diagnosis. Prednisone is converted to prednisolone in the liver, and corticosteroids like prednisone can impact liver function. This can increase the levels of the Hepatitis C virus (HCV) RNA, making the underlying liver condition worse and leading to symptoms like nausea, vomiting, and diarrhea (LiverTox, 2020).
To manage these symptoms, the patient should take small sips of water throughout the day and slowly reintroduce easy-to-digest foods like soda crackers, toast, and gelatin. If eating makes the patient feel nauseous, they should stop. The treatment plan should focus on managing symptoms and gradually reducing the use of prednisone. The prednisone dosage should be reduced slowly until it’s no longer needed. Additionally, an antiemetic like ondansetron could be added to the treatment plan because it’s less sedating than promethazine. There’s no need to discontinue Nifedipine and Synthroid, so they can continue taking those medications as prescribed.
References
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547852
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
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