NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 

Sample Answer for NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders  Included After Question

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 Links to an external site.). All papers submitted must use this formatting.

A Sample Answer For the Assignment: NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 

Title: NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 

Week 4: Gastrointestinal and Hepatobiliary Disorders Assignment                                  

The case study depicts a 46-year-old female patient with a chief complaint of RUQ pain for the last 24 hours. The RUQ pain began an hour after dinner, and she had nausea and vomiting x1 before the pain started. The abdomen is non-distended but has mild tenderness. Lab results revealed a high WBC count and Direct bilirubin. The purpose of this paper is to discuss the patient’s diagnosis and treatment plan.

Diagnosis

Hepatitis A is the identified diagnosis for this case. It is caused by the hepatitis A virus (HAV) transmitted via the fecal-oral route through person-to-person contact and ingesting contaminated food or water. The classical presentation in adults includes anorexia, RUQ pain, jaundice, and hyperbilirubinemia (Abutaleb & Kottilil, 2020). Hepatitis A is the presumptive diagnosis based on pertinent positive symptoms of nausea, vomiting, RUQ pain, abdominal tenderness, and high direct bilirubin levels. Besides, an elevated WBC count indicates an underlying infection.

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Drug Therapy Plan

Treatment of Hepatitis A is usually supportive. I would recommend Acetaminophen 500 mg per oral twice daily to relieve pain. Pain relief is important to promote quality patient care in the acute phase of Hepatitis A (Ntouva et al., 2019). In addition, I would recommend Metoclopramide 10 mg PRN. Metoclopramide is an antiemetic and will be important to alleviate nausea and vomiting. In addition, inactivated Hepatitis A vaccine will be administered for active immunization against diseases associated with HAV (Ntouva et al., 2019).

NURS 6512 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 
NURS 6512 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 

Conclusion

The patient presented with symptoms consistent with Hepatitis A, such as nausea, RUQ pain, mild abdominal tenderness, hyperbilirubinemia, and an elevated WBC count. Hepatitis A could be due to transmission of HAV from contaminated food or water. The treatment plan will include supportive measures such as pain control and alleviating nausea and vomiting using an analgesic and antiemetic.

References

Abutaleb, A., & Kottilil, S. (2020). Hepatitis A: Epidemiology, Natural History, Unusual Clinical Manifestations, and Prevention. Gastroenterology clinics of North America49(2), 191–199. https://doi.org/10.1016/j.gtc.2020.01.002

Ntouva, A., Sibal, B., Balogun, K., Mandal, S., & Harding, N. (2019). Hepatitis A in primary care: working in partnership for diagnosis, management, and prevention of outbreaks. The British journal of general practice : the journal of the Royal College of General Practitioners69(687), 521–522. https://doi.org/10.3399/bjgp19X705965

A Sample Answer For the Assignment: NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 

Title: 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.

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. Hepatology71(2), 686–721. https://doi.org/10.1002/hep.31060

Jin, J. (2020). Screening for Hepatitis C Virus Infection. JAMA323(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 journal16(1), 1–10.