NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Walden University NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS – Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Whether one passes or fails an academic assignment such as the Walden University NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
The introduction for the Walden University NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
After the introduction, move into the main part of the NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
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.
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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.
Sample Answer 2 for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
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
Sample Answer 3 for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
Gastrointestinal problems are a common occurrence in nursing and healthcare. Nurses and other healthcare providers utilize interventions such as comprehensive patient assessment to develop accurate diagnoses and care plans. The treatment of gastrointestinal disorders require the use of evidence-based interventions and guidelines to improve outcomes. Therefore, this essay examines a case study of a 46-year-old female that has presented to the clinic with complaints of right upper quadrant pain for the last 24 hours. The patient developed the problem an hour after having a large dinner with her family. She reported nausea and vomiting before the onset of pain. The essay develops the patient’s diagnosis and treatment plan that would aid recovery.
Diagnosis
The most probable diagnosis for the patient is biliary colic. Biliary colic is a pain in the abdomen that arises from stones in the bile duct or cystic duct of the biliary tree. Patients develop the pain after eating a large fatty mean. The meal causes gallbladder contraction (Hapca et al., 2021; Makutonin et al., 2023). Patients often describe the pain as constant and not colicky. Prolonged obstruction results in cholangitis or cholecystitis. The accompanying symptoms associated with the biliary colic include right upper quadrant pain, nausea, and vomiting (Sigmon et al., 2023). The patient in the case study also has risk factors that predispose her to biliary colic such as being overweight. There is also the elevation of white blood cells, which may indicate the risk of cholangitis or cholecystitis if responsive interventions are not implemented. Liver enzymes such as direct bilirubin, GGT, ALP, ALT, and AST may or may not be elevated in biliary colic (Doherty et al., 2022).
Appropriate Drug Therapy
An appropriate treatment for the patient in the case study is ursodeoxycholic acid. Ursodeoxycholic acid is the drug of choice that helps in dissolving gallstones in patients with biliary colic. The additional interventions include restricting fat intake and administration of analgesics and antiemetics for nausea and vomiting. The study by Pizza et al., (2020) found that Ursodeoxycholic acid significantly reduces incidence of cholelithiasis, cholecystitis among patients with biliary obstruction, hence prescribing the patient in the case study.
Conclusion
In summary, the most likely diagnosis for the patient is biliary colic. Biliary colic arises from the obstruction at the biliary tree. The presenting symptoms and risk factors align with those seen in patients with biliary colic. An effective treatment would be prescribing her Ursodeoxycholic acid.
References
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), Article 3. https://doi.org/10.3390/medicina58030388
Hapca, S., Ramsay, G., Murchie, P., & Ahmed, I. (2021). Biliary colic. BMJ, 374, n2085. https://doi.org/10.1136/bmj.n2085
Makutonin, M., Moghatederi, A., Newton, S., Ma, Y., & Meltzer, A. C. (2023). Biliary colic in the emergency department: A state-wide analysis of one-year costs and clinical outcomes. Surgery Open Science, 12, 9–13. https://doi.org/10.1016/j.sopen.2023.02.002
Pizza, F., D’Antonio, D., Lucido, F. S., Tolone, S., Del Genio, G., Dell’Isola, C., Docimo, L., & Gambardella, C. (2020). The Role of Ursodeoxycholic Acid (UDCA) in Cholelithiasis Management After One Anastomosis Gastric Bypass (OAGB) for Morbid Obesity: Results of a Monocentric Randomized Controlled Trial. Obesity Surgery, 30(11), 4315–4324. https://doi.org/10.1007/s11695-020-04801-z
Sigmon, D. F., Dayal, N., & Meseeha, M. (2023). Biliary Colic. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430772/
The patient most likely has acute cholecystitis, which is inflammation of the gallbladder. The pain is typically RUQ and can radiate to the back or shoulder. Cefazolin is a first-generation cephalosporin that is effective against both gram-positive and gram-negative bacteria. Acute cholecystitis is caused by gallbladder inflammation. Pain in the right upper quadrant of the abdomen is the most common sign of cholecystitis. This discomfort may spread to the back or shoulder. Vomiting and nausea are also common. Gout and the help of oral pills are both risk factors for cholecystitis.
Antibiotics and pain relief are recommended treatments for cholecystitis. Cefazolin, clindamycin, and levofloxacin are the most commonly used antibiotics for cholecystitis treatment. Cefazolin is a first-generation cephalosporin that has antibacterial activity in contrary to both gram-positive and gram-negative bacteria. It is effective against the bacteria that cause cholecystitis. Cefazolin is also reasonably priced and does not necessitate dose adjustment in patients with renal impairment. Morphine and hydromorphone are the most commonly used intravenous opioids for pain relief. When it comes to treating pain, IV opioids outperform oral opioids. They also act faster.
For the treatment of cholecystitis, the prescribed measurement of cefazolin is 1 g IV every 8 hours for 7-10 days. The outset dose of morphine for pain relief is 2 mg IV every 4 hours as needed. Morphine measurement can be modified as needed to manage pain. This drug remedy plan is suitable for this patient because it will treat the basic infection while also providing pain relief.
References:
Markotic, F., Grgic, S., Poropat, G., Fox, A., Nikolova, D., Vukojevic, K., Jakobsen, J. C., & Gluud, C. (2020). Antibiotics for adults with acute cholecystitis or acute cholangitis or both. The Cochrane Database of Systematic Reviews, 2020(6), CD013646. https://doi.org/10.1002/14651858.CD01364
Yoshida, M., Takada, T., Kawarada, Y., Tanaka, A., Nimura, Y., Gomi, H., Hirota, M., Miura, F., Wada, K., Mayumi, T., Solomkin, J. S., Strasberg, S., Pitt, H. A., Belghiti, J., de Santibanes, E., Fan, S. T., Chen, M. F., Belli, G., Hilvano, S. C., Kim, S. W., … Ker, C. G. (2007). Antimicrobial therapy for acute cholecystitis: Tokyo Guidelines. Journal of hepato-biliary-pancreatic surgery, 14(1), 83–90. https://doi.org/10.1007/s00534-006-1160-y
Gomi, H., Solomkin, J. S., Takada, T., Strasberg, S. M., Pitt, H. A., Yoshida, M., Kusachi, S., Mayumi, T., Miura, F., Kiriyama, S., Yokoe, M., Kimura, Y., Higuchi, R., Windsor, J. A., Dervenis, C., Liau, K. H., Kim, M. H., & Tokyo Guideline Revision Committee (2013). TG13 antimicrobial therapy for acute cholangitis and cholecystitis. Journal of hepato-biliary-pancreatic sciences, 20(1), 60–70. https://doi.org/10.1007/s00534-012-0572-0
NURS 6521 Assignment Decision Tree for Neurological and Musculoskeletal Disorders
Alzheimer Disease
The case study is about a 76-year-old male Iranian patient suspected of having Alzheimer’s disease. The conclusion is reports based on his eldest son, and during the test, there were no organic disease processes found. The behavioral changes began two years earlier, which involved changes in personality and apathy, accompanied by memory loss, which challenges in recognizing the appropriate words. During the speech, self-reported euthymic mood and clinical interview confabulation are often noticed. The patient often has an impairment and a lack of impulse control in his insight and judgment. There is no reported ideation of suicide, and because of Alzheimer’s disease, the patient is diagnosed with neurocognitive disorder.
Donepezil 5 mg at bedtime will be used as the first approach. The donepezil use has been studied for decades by patients who have Alzheimer’s disease. The medication is an inhibitor of acetylcholinesterase, which raises the brain’s acetylcholine levels also makes up for the reduced cholinergic neurons function (Čolović, Krstić, Lazarević-Pašti, Bondžić, & Vasić, 2013). An evaluation of randomized clinical trials analyzes the effect that donepezil has on Alzheimer’s patients utilizing randomized control trials. The results revealed that there is evidence that donepezil is effective in managing this condition in three main fields, including behavior, functional capacity, and cognition (Knowles, 2006, pp. 195–219). These are the key areas in which the patient affected as well as the aim was to reduce his quality of life effect. As demonstrated in the case, he had major personality changes that had a negative impact on his involvement in activities of interest.
The effects of Donepezil vary as complications may occur along with minimal clinical benefits. The patient-reported side effects documented in patients taking this medication, like appetite, loss of weight, nausea, vomiting, and diarrhea. (Kumar & Sharma., 2019).
The second decision was cognitive behavioral therapy use, that has been shown to have a beneficial effect in early-stage patients of Alzheimer’s disease. In isolated cases, evidence suggesting psychosocial treatments for dementia patients identified (Forstmeier, Maercker, Savaskan, & Roth, 2015). There is also limited empirical information on such approaches, though. Among patients who have neuropsychiatric symptoms, certain researchers have described behavioral treatments as necessary. This may also be used by the patient to promote behavior, especially directed at reducing apathy & enhancing the patient’s self-control. Mood improvement might have a positive effect on the quality of life as well as the patient’s ability to engage in activities that increase his cognitive status.
In this case, the third decision will involve family members in the therapeutic process, which will continue to improve behaviors that help the patient. The aim is to improve the patient’s support system and also daily interactions, though it has been shown to have a significant effect on the emotional and cognitive well-being of dementia patients.
References
Čolović, M. B., Krstić, D. Z., Lazarević-Pašti, T. D., Bondžić, A. M., & Vasić, a. V. (2013). Acetylcholinesterase inhibitors: pharmacology and toxicology. Curr Neuropharmacol, 11(3), 315–335. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648782/
Forstmeier, S., Maercker, A., Savaskan, E., & Roth, a. T. (2015). Cognitive-behavioral treatment for mild Alzheimer’s patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials., 16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650298/
Knowles, J. (2006). Donepezil in Alzheimer’s disease: an evidence-based review of its impact on clinical and economic outcomes. Core Evid., 1(3), 195–219. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321665/
Kumar, A., & Sharma., S. (2019). Donepezil. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513257/