Gastrointestinal And Hepatobiliary Disorders Essay Example

Gastrointestinal And Hepatobiliary Disorders Essay Example

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 And Hepatobiliary Disorders Essay Example

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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. Gastrointestinal And Hepatobiliary Disorders Essay Example

DC is a 46-year-old female who presents with a 24-hour history of RUQ pain. She states the pain started about 1 hour after a large dinner she had with her family. She has had nausea and on instance of vomiting before presentation.

PMH: Vitals:

HTN Temp: 98.8oF

Type II DM Wt: 202 lbs

Gout Ht: 5’8”

DVT – Caused by oral BCPs BP: 136/82

HR: 82 bpm

Current Medications: Notable Labs:

Lisinopril 10 mg daily WBC: 13,000/mm3

HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL

Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL

Multivitamin daily Alk Phos: 100 U/L

AST: 45 U/L

ALT: 30 U/L

Allergies:

Latex
Codeine
Amoxicillin
PE: Gastrointestinal And Hepatobiliary Disorders Essay Example

Eyes: EOMI
HENT: Normal
GI:non distended, minimal tenderness
Skin:warm and dry
Neuro: Alert and Oriented
Psych: appropriate mood

Write a 1-page paper that addresses the following: (Anything longer than 1 page will be penalized)

-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

Case Study: Pancreatitis

The most appropriate primary diagnosis for this patient is pancreatitis. Pancreatitis, the inflammation of the pancreas, is a condition caused by the presence of gallstones that pass through and get stuck in the bile or pancreatic duct (Li et al., 2019). The condition is characterized by right upper quadrant pain, bloating, nausea, or vomiting (Li et al., 2019). The symptoms of pancreatitis may commence suddenly and last for days or may occur over many years for chronic cases. The patient presented similar symptoms thus the diagnosis. Further, the development of acute pancreatitis caused by gallstones has been linked to eating a large meal (Leppäniemi et al., 2019). The patient developed the symptoms after having a large dinner with the family. Acute pancreatitis is associated with almost normal blood pressure, temperature, and heart rate (Mederos et al., 2021)Gastrointestinal And Hepatobiliary Disorders Essay Example. However, the disease is also associated with elevated AST as suggested by the laboratory results.

An appropriate drug therapy plan for the patient is ciprofloxacin 500 mg PO q12hr for 7-14 days (Leppäniemi et al., 2019). Ciprofloxacin, a drug belonging to the quinolone group exhibits good tissue penetration into the pancreas and has high anaerobic coverage as an added advantage (Pagliari et al., 2019). The minimal inhibitory concentration (MIC) of the bacteria that are frequently present in secondary pancreatic infections is sufficiently covered by quinolone tissue penetration into the pancreas (Leppäniemi et al., 2019)Gastrointestinal And Hepatobiliary Disorders Essay Example. Although quinolones exhibit a high rate of resistance worldwide and their use discouraged, their use in the treatment of acute pancreatitis is recommended only in patients with allergies to beta-lactam agents. The patient in this case study is allergic to Amoxicillin, a beta-lactam antibiotic. Further, no harmful effects due to drug interactions have been shown with ciprofloxacin and the currently prescribed drugs used by the patient.

References

Leppäniemi, A., Tolonen, M., Tarasconi, A., Segovia-Lohse, H., Gamberini, E., Kirkpatrick, A. W., Ball, C. G., Parry, N., Sartelli, M., Wolbrink, D., Van Goor, H., Baiocchi, G., Ansaloni, L., Biffl, W., Coccolini, F., Di Saverio, S., Kluger, Y., Moore, E., & Catena, F. (2019). 2019 WSES guidelines for the management of severe acute pancreatitis. World Journal of Emergency Surgery, 14(1). https://doi.org/10.1186/s13017-019-0247-0 Gastrointestinal And Hepatobiliary Disorders Essay Example

Li, J., Chen, J., & Tang, W. (2019). The consensus of integrative diagnosis and treatment of acute pancreatitis-2017. Journal of Evidence-Based Medicine, 12(1), 76-88. https://doi.org/10.1111/jebm.12342

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Mederos, M. A., Reber, H. A., & Girgis, M. D. (2021). Acute pancreatitis: Review. JAMA, 321(4), 382-390. https://doi.org/10.1001/jama.2020.20317

Pagliari, D., Brizi, M. G., Saviano, A., Mancarella, F. A., Lago, A. A., Serricchio, M. L., Newton, E. E., Attili, F., Manfredi, R., & Gasbarrini, A. (2019). Clinical assessment and management of severe acute pancreatitis: a multi-disciplinary approach in the XXI century. European Review for Medical and Pharmacological Sciences, 23, 771-787. https://doi.org/10.26355/eurrev_201901_16892 Gastrointestinal And Hepatobiliary Disorders Essay Example